Universal healthcare is supported by something like 60 or 70% of Americans. Don’t be fooled by those trying to make it into a party issue.
Agreed, it’s crazy. Making healthcare contingent on employment is barbaric but aligned with other practices (like W2 tax withholding) where the government effectively deputizes your employer to enforce the civic contract.
"Medicare for all willing to pay 10% of taxable income" seems like a way to sneak universal healthcare through the political backdoor. It will initially have a funding shortfall due to adverse selection (it will attract primarily people with low incomes, high risks or both) but you would gradually move all public subsidies towards that program and remove all incentives, tax credits and rate protections from those who choose the free market option, and when just a minority still hangs on to the private providers, you make the 10% health tax mandatory to all.
The way I see it, you will never wrestle away the trillion dollar bone from the mouth of the US healthcare industry, but you can make it wither away indirectly by creating a better universal system and dismantling the status quo. It's not like Europeans are forbidden the option of private insurance, it's just that it can't take hold and grow to control a significant part of the spending because everyone can see it's not the solution that will save you when you will get really really sick.
Let's look at another country that has "great universal health care". Let's look to Europe, that's always "up there", right?
For statutory or public health insurance, you pay for your insurance through social contributions, the rate of which is 14.6% of the income as determined by the Federal Ministry of Health for 2024.
I would support universal healthcare if I think the government is actually capable of reigning in the avg healthcare costs of an American.
I’d bet the $800/mo eyedrops this poor lady is relying on don’t cost that much in any other country (and I don’t mean poor countries - I mean in other rich countries like Japan, Singapore or Australia). So when she switches to Medicare as soon as she turns 65, how much are the US taxpayers paying for these eyedrops? It’s just wealth transfer from US taxpayers to the US medical industry complex.
So I fear “Medicare for All” would simply mean we pay even more taxes than we already do now and the US government will keep spending insane amounts of money on healthcare as compared to every other developed nation in the world with no better outcomes.
I think there is credible research that US drug costs are primarily the result of a fragmented market and lack of collective bargaining. So a single buyer regime will by itself lower the prices since manufacturers will be forced to compete among themselves based on price and an objective metric of the therapeutic benefit - as opposed to marketing and the best sales network and "conference" benefits the prescribing physicians.
For example, if the generic option reduces the burden of disease by 10 DALYs and costs essentially ~0$ it will be fully covered, any other patented option with a 15 DALY average benefit will be covered up to a financial ceiling given by the total funding available and the extra 5DALY benefit it brings. A patented option that does not fit that ceiling will require patients to pay from their pocket, therefore cratering sales, therefore strongly incentivizing the pharmaceutical company to lower the price to fit the ceiling.
This is how other advanced countries lower spending on drugs without infringing on intellectual property - by forcing all manufacturers of all drugs for all diseases to compete on price, or risk selling basically nothing in that country until their patents expire. Since the marginal production cost of drugs is close to zero, it' always better to have some sales at some lower prices instead of no sales at a very profitable price.
Between medicare, medicaid, Tricare, chips, etc around half the people in the United States are already on some sort of government supplied medical insurance.
Getting to 60% for for such a deal shouldn't be too hard!
I certainly don't want it and nobody I know that actually understands the real cost does either. Every single nation that provides socialized healthcare is hopelessly strained by its cost, and the service has suffered as a result. The system relies on eithe dramatic reductions in the cost of healthcare or a positive birthrate to sustain it.
Nobody I know in socialized healthcare systems has good things to say about it when they actually need it.
The US has the most expensive healthcare costs per capita in the OECD, and the poorest health outcomes on average.
You might think that this is merely because so many people in the US are not covered at all. But even when you account for people who are covered, the results are mixed at best. With the US performing slightly better in some areas, but much worse across the board.
I also know a few people who have moved back from the US, even though they had health insurance, just to receive better socialised medical care in their own countries. I also know of a who went to the US to get cancer treatment. None of that means anything really. The number of people you know and their uninformed attitudes are statistically insignificant.
What is special about healthcare in this regard and where should be draw the line? This argument could be used to justify socializing all kinds of costs, almost anything up to UBI.
> Maybe there are millions in America that only keep their jobs for the health benefits rather than starting a 1-2 person business.
I'm not 100% sure about upcoming changes, seems similar from what I can see, but ACA gives an option for this. No job = very low income = you'll qualify for hugely reduced premiums
It's silly that believing more government intervention will solve the problem, given that a big reason healthcare became tied to employment in the first place was wage freezes by the government, from which employer sponsored health insurance was exempt.
We're not going to solve it by constraining the supply of healthcare by regulating every aspect of it, and then subsidizing the demand.
I made this argument in a paper I wrote for a college economics class. I had first hand experience with it because I had recently done the math and figured that I would have to stop my flexible contracting job and seek more traditional employment as I was going to lose my parents insurance and the 'open market' option was unaffordable. Ended up being the reason that I dropped out of college.
If people need a job to have healthcare, it gives employers a lot of power. and because superpacs have allowed people with the most money the most say in american elections, the capitalists can just keep wringing people out.
Our GDP would take a really bad hit if we stopped wasting 10+% of it overpaying for healthcare (a white-collar make-work jobs program—like, god, couldn't we just start up the CCC again? At least they built nice stuff that we're still enjoying... imagine what they could do with 10% or more of GDP!)
I suspect this, plus other ways the US reports sheer waste as GDP to a much higher degree than most peer states, is the main reason folks report the US feeling a lot poorer than second-tier EU countries that on-paper have far lower GDP/capita, even with PPP adjustments. But the fake-healthcare-GDP is probably the single biggest culprit, being absolutely enormous.
The powers that be don't care at all about thousands of insurance adjusters losing their jobs. But they care very deeply about vaporizing hundreds of billions in shareholder equity.
I own an Agency and write a ton of individual ACA along with Group and Medicare.
Final pricing hasn't even been released yet. I'll betcha that her premium won't be anywhere near 2800, theres no information about how shes quoted what she did such as age, zip code, carrier and income. This article is rage bait.
Here's a better source of information regarding how and why premiums are going up.
I am trying to do the before/after for a single Adult earning $25,000 per year. It looks to be a 4% difference. I am not sure how you go from ~$500 to $2800 using this calculator. Short of starting to cover more people like children, etc.
Universal healthcare doesn't change the overall cost. To a large degree, the ACA/Obamacare was a good stab at getting universal healthcare! The change in this article is about undoing universality, by changing the subsidies for those with lower income.
To structurally reduce the fraction of GDP devoted to healthcare, we need to make far bigger changes. A lot of the setup right now is to subsidize those on Medicare by those on private insurance programs. The cross-subsidization goes very deep, and anything that might reduce costs also has the risk of undoing cross-subsidization. With half the country refusing to reform health care for the past 30 years, and the other half having their hands tied behind their back on trying to improve health care, we have built a gigantic overly complex system that's very hard to unwind.
Surely the complete removal of insurance and advertising from the US healthcare system would have an impact on the overall cost. Not to mention the amount of early preventative care that could be carried out instead of people waiting until it was really serious due to fear of medical bills.
We are about twice as expensive as healthcare system from other similar countries. Eliminating all administrative fees from insurance, all advertising, does not close that gap. There's a lot more going on!
Yes, the problem is insurance, not who pays for healthcare. There's not universal government funded car maintenance and it works just fine for the most part. Insuring predictable, recurring costs is a scam.
There's room, either private or public, to backstop catastrophes, but not the rest.
> Universal healthcare doesn't change the overall cost.
Something like 15% of US healthcare spending goes towards administrative fees just around insurance. That's order of $800 billion annually, roughly $1,500 per American, that does not contribute in any way to improving health. This is roughly the size of the US defense budget that we spend on gating healthcare.
There are knock-on effects of our system that increase some costs, such as people skipping preventative care or medications due to high costs or lack of insurance and then ending up in higher-cost emergency care. Or see the recent trend of physicians documenting how much of their time spent arguing with insurance companies on behalf of patients, time not spent providing medical care (and thereby increasing costs).
Whatever the problem with health care in America is, the solution is not more money. We already spend double what all other countries spend as a percent of GDP and we have worse outcomes.
There are a lot of similar mysteries in America. For example, why does it cost a billion dollars a mile to do subways which is 20x almost everywhere else.
> Universal healthcare doesn't change the overall cost.
It can, at least to some degree. Every doctor's office has people who run through the insurance maze, trying to get services paid for. And every insurance company has people on the other side, trying to find ways to not pay for stuff. Having only one organization to deal with would simplify that; having one organization with clear, transparent rules would simplify it more.
> Universal healthcare doesn't change the overall cost
I get the sense I'm probably preaching to the choir here. But, the U.S. spends almost 2x what comparable countries (with universal healthcare) spend on healthcare. And we get worse than average results on virtually every measure.
This, of course, makes sense. When you're running healthcare as a for-profit business, part of our expenses are... profit to pay out shareholders. And advertisement budgets. And middlemen (insurance). And employees to do things like decline coverage. Medical employees to deal with insurance companies declining coverage. Etc. etc. There's a whole industry that only exists to support our private healthcare system that would cease to exist in a universal healthcare system.
Maybe you didn't have good health insurance? If you have children or anything big happen, you want to be in major metro area of the US with broad network, expensive insurance. It's the best in the world, by miles.
What would a public insurance option involve? Do you mean insurance that's provided at-cost without a company profiting?
Insurance companies are already required to spend at least 80% (or 85%) of the premiums they collect on paying out claims. If they spend less, they are required to give rebates / premium refunds to policy holders.
It wouldn't be crazy to increase that percentage even more, since it's effectively a cap on the profit margin insurers are allowed to earn on premiums.
My Canadian father-in-law had to wait over a year before being able to see a neurologist about his suspected Parkinsons symptoms. Fortunately, he's well off enough that he was able to afford medical treatment in another country, but many people trapped in such systems are not.
Just to share a perspective from someone who used to live in New York… I had what I suspected was a mild concussion with some annoying symptoms at the time. I could see a neurologist within 3 days IF my schedule was flexible (it was not). I ended up getting seen 10 days later.
Half of my work colleagues received health care abroad. Wait times in Quebec are insane. Yes, constant joint pain may be not 'life threatening' yet degrades quality of life significantly. Basically if you are not actively dying you can't get access to healthcare in Quebec.
"Backlog" - there is never a moment that this isn't just wrong.
I'm from Australia. If I want to "skip the line" I can just pay to do so. Private practice exists. People don't, because it's expensive and they can't afford it.
This is exactly like the US, except in the US you just don't get healthcare at all and die instead.
The "backlog" in any public healthcare system is a triage line. If you actually need care, you get it immediately. If you can live with it but keep it monitored, you might not for longer then is optimally comfortable if you can't afford private consults.
Unless you have good insurance, and then you get everything, the best, the quickest. Australia is a joke compared to healthcare in the US with good insurance.
Now, the US sucks really bad if you don't have good insurance / any insurance....
Such as? Have you ever had a major medical event using your health insurance in America?
"We have the best!". But like, so do dictators of 3rd world countries. Do you actually have access to the best care? Are you sure? Because about 1 in 10 Americans are uninsured[1] and a substantially larger percentage are underinsured[2].
Meanwhile Australian life expectancy is higher then America[3] (I mean let's be fair: most of the western world's life expectancy is higher then America...I wonder what common trait most of those places have...)
I don’t disagree about the overall healthcare system being broken in the US, but I find it pretty funny that you replied to that person with more arguments about how healthcare sucks for the average person… When they were discussing healthcare being excellent for folks with great insurance.
you two are talking past each other, and talking about two different cohorts of people.
The person talking about "good insurance" provided no examples of even what that statement is meant to mean, or what they actually expected to get from it.
Just "the best care ever", no qualifiers, examples and no indication of costs.
Just what does "good healthcare" in America get you, that you imagine people in other countries do not get?
"good" is a relative term. In health care insurance world, it's the expensive plans, with broad coverage, and the best facilities in network (who participate in research and are at the forefront of treatment - MD Anderson, Mayo, Cleveland, Sloan Kettering etc). You get fast access to the best facilities with the best doctors and best treatments.
Maybe look at the rankings of best treatment facilities globally. Here is the list for oncology. Choose any dropdown you like. You are going to see a lot of "US" at the top.
Good question. I actually think the US should have a healthcare system more like other countries, don’t get me wrong. But I can directly answer your question, as someone who lives in the U.S. and is very happy with the care i receive.
In the U.S. i’d consider good health insurance to be:
- low monthly premiums (majority of cost is covered by a generous employer). Say $30-50 per paycheck for a single adult.
- A PPO plan, not an HMO (HMO limits your options when picking doctors).
- A plan that does NOT require pre-authorizations for most procedures and tests. They are a pain in the butt. And many crappy insurance companies like United Healthcare tend to auto-deny many things as “not medically necessary”.
- A medical plan that covers almost every non-experimental drug prescription, at low cost ($30 or less). Including antibiotics, EpiPen, GLP-1 (Ozempic), inhalers, etc.
- A reasonably low annual out-of-pocket max, say $2,500 or less? ALL costs after that max are fully covered by insurance. So you have peace of mind if something really bad happens.
- $0 or very low deductible for seeing your doctor. Also a very low coinsurance rate, say 20% or less. Coinsurance is the % of the bill you pay before your insurance covers the remainder.
All the above basically means, “low stress” when you get sick or into an accident, or get pregnant.
What does good “care” look like? I think we all know. In the U.S. this is _very_ region dependent. Most people don’t consider this when buying a home for some reason lol.
There are many cities with excellent hospitals and medical centers and also some top notch hospitals GLOBALLY. And then there are many “medical deserts”, typically cheaper areas to live, where care is harder to come by.
Examples of good care:
- QUICK access to your primary doctor/PCP (within 1-2 weeks)
- ability to get care urgently, within a days notice, from another doctor. urgent care, etc.
- ability to see a specialist within 3 months, ideally less than 1 month. Yes this is possible in some parts of the U.S. believe it or not.
- Living near (45 min or less) a major, well-rated hospital, in case you have a heart attack, get into a nasty car accident, etc.
The unfortunate truth is a LOT of americans are in a “healthcare desert”, or they are poor and can’t afford care, or their employers are not generous and offer them crappy plans. For example where the out of pocket max is $15k lol. Or where monthly premiums for a single person are $400.
The US is not a fun place to live if you’re lower class or lower-middle class. And our healthcare system is a confusing mess. :)
This magical "good insurance" doesn't exist, because it's not up to the insurance company.
Scheduling is controlled by the hospital. Right now american hospitals are insanely booked out, and have been for many years. There's no magical insurance that bumps someone else out of the line.
If you aren't experiencing 3 month delays for non-emergency medicine, it's not that you have "good insurance", it's that you live in a place where the local medical infrastructure is seriously underutilized. This might mean you just live in a rich enough place where more hospitals than needed were built, or it could mean that a lot of your neighbors just aren't getting the healthcare the local hospitals were expecting to serve.
Or maybe what you are hinting at is that in your state, the affordable health insurance for most people doesn't actually get them any real treatment options, so only very wealthy people can afford to actually get treated, so hospitals around you don't do much healing.
And that's fucking ghastly and should be seen as the abhorrent thing it is. You have hospitals around you that are not treating people even though there are plenty of people needing healthcare. A lot of resources were already spent building that hospital and training doctors and we are not utilizing those resources because of some abhorrent "but then I might have to wait a month for a completely non-threatening medical concern" ideology. Yes, that's called efficient use of resources. Triage is a core part of healthcare. Sometimes that means someone else gets treated before you, and that's because they need it more than you do.
US healthcare is such a pain -- very high premiums, high deductibles, tons of paperwork, no price transparency.
My wife is from mexico, so while her visiting familly there I've had some opportunity to interact with and observe their system.
It seems better!
There are public hospitals which are open to all. The quality and wait times are reasonble, not fantastic. There is very little paperwork. (You don't have to jump through hoops like signing up for Medicaid or something.)
Alongside that, you can buy private insurance and go to private hospitals, which, in my (admittedly limited) experience, are very good -- efficient and reasonably priced. I would _guess_ because of less regulation and because they have to provide value above and beyond the free healthcare that's available?
In the US we seem to have created sort of the opposite incentive structure -- public healthcare is only available to a limited set of people, and everyone else is more or less forced into the private healthcare system (or "private", since it seems heavily intertwined w/ govt -- e.g., standard govt websites to pick a povider, tax penalty (tho since lifted) if you aren't signed up).
Somehow there's always a mountain of paperwork and bills that dribble in over months, and you never know how much the final cost is going to be.
Another seemingly-insane feature of the US system is if I pay for a service w/o insurance, I'll be billed some crazy rate. With insurance, I'll copay some reasonable-ish rate, and the insurance company will also pay some reasonable rate, often at like a 90% discount to the "quoted" rate. It feels like I'm coerced into insurance because I can't out-of-pocket pay the actual real reasonable rates.
Another annoyance is it also doesn't seem possible to buy insurance that just covers accidents, which I would personally do if I could...
> In the US we seem to have created sort of the opposite incentive structure -- public healthcare is only available to a limited set of people, and everyone else is more or less forced into the private healthcare system (or "private", since it seems heavily intertwined w/ govt -- e.g., standard govt websites to pick a povider, tax penalty (tho since lifted) if you aren't signed up).
There is no “we”. The rich and influential people that run the US _designed_ the system this way on purpose. To extract as much money from citizens. We didn’t reach this point by accident. Is there a presidential party or candidate that’s running on “tear the whole stupid system down and rebuild it to be simple and affordable”? Little baby steps like obama care don’t count in my opinion. No reasonable person would design a healthcare system where a hospital charges $500 for dispensing ibuprofen for example. Or a system where it’s impossible to predict how much you’ll pay as a patient. And they call it a “marketplace” lol. That’s lunacy.
If you know someone running on that as their campaign, please let me know. I’d be happy to vote for them. I’ll even donate to their campaign!
> Another annoyance is it also doesn't seem possible to buy insurance that just covers accidents, which I would personally do if I could...
That sounds like an interesting concept. Travel insurance is sort of like that, but not the same thing obviously.
meh it doesnt matter. Biden tries "government that delivers", it didnt' work. instead his VP lost to one that promised cruelty. I used to be a what's good for type person. Now im just slowly giving up, and adopting a "eff you, I got mine" attitude.
The winds may change. The media was campaigning super hard for Trump, and still refuses to cover him fairly and hold him to task for the things he does, but the results are already so awful that people see through the fawning media coverage of Trump.
Don't give up hope, don't give up caring for your fellow person. A lot of fools made really bad choices, but it doesn't take many people to smarten up to drastically improve the system. You wouldn't see the Texas redistricting that's going on right now if Trump didn't know that he's completely screwed in next year's election. It's a desperate attempt to hold onto power, even if they media won't say that outright, or even dare to criticize Trump.
I try to read a balanced set of news sources, but to me you seem to view things from a much different perspective. I guess it depends on what you consider ‘the media’, for one.
Take for example two basic proposals: Harris's housing proposals, which were widely misreported inserting right-wing misinformation and assumptions about them to denigrate the proposals.
Compare that to Trump's tariff proposals, which most media just assumed he'd not be so stupid as to actually implement, and never reported on critique of them. I've talked to so many center-right people that thought "oh I didn't know this would happen. Oh well I guess it's going to be ok because it's Republicans in charge."
The media covers for Trump's weakness and Trump gives them so many things to critique that never even get discussed. Very serious things. Meanwhile the media has to make up things about Democrats in order to criticize them. It's all hugely biased.
I wonder what would happen if every last social program were repealed. People would be screwed and angry. Would they push for real change then? Are all these programs keeping America just below boiling point?
It took 1 out of every 5 americans being unemployed and starving and dying for like a decade to elect FDR and a cadre of Democrat congresspeople who promised to build a mild welfare state.
We aren't even close to that, so uh, don't expect progress anytime soon. It will take basically an entire generation growing up with a clear (clear as in impossible to disagree with and still be considered mentally sound) failure of Republican policy. It took decades of suffering and failure and maybe even world war and that was before the moronic "But Stalin did horrible things so providing for your neighbor must be a terrible thing because stalin promised that" trading cards were printed.
So yeah, strap in. We aren't all going to make it to the other side.
FWIW this is about a pandemic era subsidy expiring. It sucks that a seemingly “temporary” subsidy was holding things together for folks
> The credit was a pandemic-era relief measure that has contributed to record enrollment in the insurance sold through the Affordable Care Act marketplaces.
Is there any republican justification for this, other than, by the time people notice it will be too late / we will try to blame it on the other party? Are they expecting the states to step up and pay instead?
They're setting the ACA up to "naturally" fail anyway, so this doesn't matter to them, or is even a step in the right direction.
They kicked out one of its three "legs" (the "individual mandate") so this right-wing heritage foundation promoted healthcare scheme is now guaranteed to face a price death-spiral anyway, unless that changes.
They gave up on repealing it, because it was so popular, and have settled for breaking it in ways that most folks will have trouble figuring out they should blame Republicans for (those chickens won't come home to roost for years, and I guarantee it's only a tiny minority of voters who understood the necessity of the mandate for the whole thing to work, anyway), so eventually it'll be popular to get rid of it.
> by the time people notice it will be too late / we will try to blame it on the other party?
This is it.
A lot of the things that the Republicans are doing that will completely fuck the lower/middle class don't actually take effect until after the mid-terms. This is an insurance policy so that if they get absolutely wrecked in the mid-terms, they can point to Democrats having the majority push blame onto them. On the flip side, if Republicans maintain control after mid-terms, by the time the next election takes place, people will have forgotten who it was that screwed them over.
Alternatively, they can just keep saying it's all Obama/Biden's fault. That still works.
They're misinformed voters that will be told that their food is more expensive because of Bidenflation, not because ICE arrested and deported the farm workers. As health care gets more expensive, they just get told it's because of ObamaCare.
When in doubt, just cry "WOKE!" and "DEI!" and they'll bend over for Trump and any Republican that claims to be friends with him.
I have an ACA plan and am going to take a giant hit when the tax subsidies end.
At the same time, I wonder if it might be not such a bad thing.
Yes, I and millions will suffer higher premium costs.
Yes, many people will drop insurance or take bad plans.
Yes many more people will die because of this.
But ultimately, prices for health care must come down. If we continue to route infinite tax dollars towards the price setters (hospitals and doctors) then why would they change?
The only way they would reduce prices is if less people will pay. The only way that happens is if there is some pain, somewhere.
I don’t want people to suffer, but we have been headed in the wrong direction for so long… something needs to shake things up.
And ultimately, if this means some MAGA voters question their vote because they cannot get health care due to this change, then extra good.
But then again, it’ll still be Obama’s fault somehow.
There used to be a popular meme claiming that anything private tends to get cheaper over time, while anything regulated or run by the government keeps getting more expensive. But is that really true for all goods? If it is, then why do so many countries choose to adopt universal healthcare systems with tightly regulated insurance?
Maybe the more relevant question is: why is healthcare so expensive in the United States? It can’t just be because the U.S. is more advanced or developed. After all, one of the hallmarks of an advanced country should be making essential services affordable, if not cheaper.
The article is surprisingly unclear about this, but the enhanced subsidies that are expiring apply to households making over 4x the Federal poverty level ($62,600 for a single person or $128,600 for a family of 4). Subsidies for those making less remain intact.
paying $400 for health care out of pocket was already a lot. Paying 2800/month for healthcare is absurd. You may as well just foot the entire hospital bill yourself.
and I thought this would be in a high CoL area. But the woman quoted lives in West Virginia. How is she paying 2-3x her rent for healthcare? For eyedrops of all things too.
Honestly the story gets sadder the farther I read:
>Like an asthma medication [that] can run $700 a month. There's an eye drop medication that can be $800 a month... "Luckily I can do that, but that's money I won't be able to save for investing in my 401(k) for retirement,"
They are going to kill ACA, all of it is timed to kick in after the elections next year. They cannot really kill it because its a law, so they make it unaffordable and essentially be useless and unused
All the people saying "Government is inefficient". Come on, do you think the CEOs who only work for quarterly returns are going to provide great healthcare? No, they are going to use every opportunity and propaganda to keep ripping you off.
We need to stop paying doctors millions of dollars. That’s the only way it’s going to come down. Half a million, whatever they get paid is making it so people have to do without decent insurance. That’s the biggest variable I see in the US vs other countries (not to mention bogus drug pricing, but there are controls hopefully being implemented for that.
s/doctors/private equity. The CEOS who keep acquiring hospitals and running them to the ground are the real ones at fault. We can definitely pay doctors a good salary after 10+ years of post-secondary schooling.
>not to mention bogus drug pricing, but there are controls hopefully being implemented for that
not really much "hope" for this administration. Especially when it comes to doing things that benefit the working class.
What it amounts to is a Covid era subsidy expiring. The article title makes it seem like ACA health insurance is going up 5x but in reality the expectation is 75%, this particular case must be an outlier. The person in the article even laughs it off since she turns 65 soon and will then switch to Medicare.
I still feel that something like Medicare for All should just be an issue for those that are all about free markets and entrepreneurship.
Maybe there are millions in America that only keep their jobs for the health benefits rather than starting a 1-2 person business.
It just seems so silly.
Universal healthcare is supported by something like 60 or 70% of Americans. Don’t be fooled by those trying to make it into a party issue.
Agreed, it’s crazy. Making healthcare contingent on employment is barbaric but aligned with other practices (like W2 tax withholding) where the government effectively deputizes your employer to enforce the civic contract.
"Medicare for all willing to pay 10% of taxable income" seems like a way to sneak universal healthcare through the political backdoor. It will initially have a funding shortfall due to adverse selection (it will attract primarily people with low incomes, high risks or both) but you would gradually move all public subsidies towards that program and remove all incentives, tax credits and rate protections from those who choose the free market option, and when just a minority still hangs on to the private providers, you make the 10% health tax mandatory to all.
The way I see it, you will never wrestle away the trillion dollar bone from the mouth of the US healthcare industry, but you can make it wither away indirectly by creating a better universal system and dismantling the status quo. It's not like Europeans are forbidden the option of private insurance, it's just that it can't take hold and grow to control a significant part of the spending because everyone can see it's not the solution that will save you when you will get really really sick.
Australia has a medicare levy of 2% taxable income - and last time I did the math I'd pay an equal amount in tax there as I do in the US
Seems ridiculous the US doesn't have it
Does it?
Let's look at another country that has "great universal health care". Let's look to Europe, that's always "up there", right?
https://www.germany-visa.org/insurances-germany/health-insur...Pretty sure that's up but let's assume 15% of income.
A huge number of Australians (over half of the population) also pay for private insurance.
https://www.commonwealthfund.org/international-health-policy...
I would support universal healthcare if I think the government is actually capable of reigning in the avg healthcare costs of an American.
I’d bet the $800/mo eyedrops this poor lady is relying on don’t cost that much in any other country (and I don’t mean poor countries - I mean in other rich countries like Japan, Singapore or Australia). So when she switches to Medicare as soon as she turns 65, how much are the US taxpayers paying for these eyedrops? It’s just wealth transfer from US taxpayers to the US medical industry complex.
So I fear “Medicare for All” would simply mean we pay even more taxes than we already do now and the US government will keep spending insane amounts of money on healthcare as compared to every other developed nation in the world with no better outcomes.
I think there is credible research that US drug costs are primarily the result of a fragmented market and lack of collective bargaining. So a single buyer regime will by itself lower the prices since manufacturers will be forced to compete among themselves based on price and an objective metric of the therapeutic benefit - as opposed to marketing and the best sales network and "conference" benefits the prescribing physicians.
For example, if the generic option reduces the burden of disease by 10 DALYs and costs essentially ~0$ it will be fully covered, any other patented option with a 15 DALY average benefit will be covered up to a financial ceiling given by the total funding available and the extra 5DALY benefit it brings. A patented option that does not fit that ceiling will require patients to pay from their pocket, therefore cratering sales, therefore strongly incentivizing the pharmaceutical company to lower the price to fit the ceiling.
This is how other advanced countries lower spending on drugs without infringing on intellectual property - by forcing all manufacturers of all drugs for all diseases to compete on price, or risk selling basically nothing in that country until their patents expire. Since the marginal production cost of drugs is close to zero, it' always better to have some sales at some lower prices instead of no sales at a very profitable price.
Between medicare, medicaid, Tricare, chips, etc around half the people in the United States are already on some sort of government supplied medical insurance.
Getting to 60% for for such a deal shouldn't be too hard!
>60 or 70% of Americans polled*
I certainly don't want it and nobody I know that actually understands the real cost does either. Every single nation that provides socialized healthcare is hopelessly strained by its cost, and the service has suffered as a result. The system relies on eithe dramatic reductions in the cost of healthcare or a positive birthrate to sustain it.
Nobody I know in socialized healthcare systems has good things to say about it when they actually need it.
The US has the most expensive healthcare costs per capita in the OECD, and the poorest health outcomes on average.
You might think that this is merely because so many people in the US are not covered at all. But even when you account for people who are covered, the results are mixed at best. With the US performing slightly better in some areas, but much worse across the board.
I also know a few people who have moved back from the US, even though they had health insurance, just to receive better socialised medical care in their own countries. I also know of a who went to the US to get cancer treatment. None of that means anything really. The number of people you know and their uninformed attitudes are statistically insignificant.
Could say the same thing about interstate highways or the military though
It's also an equality issue. People stay in abusive relationships because of healthcare.
Related: "My gift to USA" by Harald Eia (Norwegian comedian) https://www.youtube.com/watch?v=PguJ-lm4uLg
Takeaway of that video: "Can you really be free if you have to depend on somebody else?"
What is special about healthcare in this regard and where should be draw the line? This argument could be used to justify socializing all kinds of costs, almost anything up to UBI.
> Maybe there are millions in America that only keep their jobs for the health benefits rather than starting a 1-2 person business.
I'm not 100% sure about upcoming changes, seems similar from what I can see, but ACA gives an option for this. No job = very low income = you'll qualify for hugely reduced premiums
It's silly that believing more government intervention will solve the problem, given that a big reason healthcare became tied to employment in the first place was wage freezes by the government, from which employer sponsored health insurance was exempt.
We're not going to solve it by constraining the supply of healthcare by regulating every aspect of it, and then subsidizing the demand.
I made this argument in a paper I wrote for a college economics class. I had first hand experience with it because I had recently done the math and figured that I would have to stop my flexible contracting job and seek more traditional employment as I was going to lose my parents insurance and the 'open market' option was unaffordable. Ended up being the reason that I dropped out of college.
If people need a job to have healthcare, it gives employers a lot of power. and because superpacs have allowed people with the most money the most say in american elections, the capitalists can just keep wringing people out.
"something like Medicare for All"
If that's the case, then you've never looked into the complexity of Medicare.
Medicaid for all, and concierge services for those who want to pay exalted prices for exalted services -- that may make sense.
Well, there's two forces at work:
1. Capitalism never sleeps.
2. Current healthcare employs thousands of people who would be out of work in a medicare for all system.
While #1 is a horrid excuse, #2 is what controls the real world.
Our GDP would take a really bad hit if we stopped wasting 10+% of it overpaying for healthcare (a white-collar make-work jobs program—like, god, couldn't we just start up the CCC again? At least they built nice stuff that we're still enjoying... imagine what they could do with 10% or more of GDP!)
I suspect this, plus other ways the US reports sheer waste as GDP to a much higher degree than most peer states, is the main reason folks report the US feeling a lot poorer than second-tier EU countries that on-paper have far lower GDP/capita, even with PPP adjustments. But the fake-healthcare-GDP is probably the single biggest culprit, being absolutely enormous.
The powers that be don't care at all about thousands of insurance adjusters losing their jobs. But they care very deeply about vaporizing hundreds of billions in shareholder equity.
they’ll adjust
I own an Agency and write a ton of individual ACA along with Group and Medicare.
Final pricing hasn't even been released yet. I'll betcha that her premium won't be anywhere near 2800, theres no information about how shes quoted what she did such as age, zip code, carrier and income. This article is rage bait.
Here's a better source of information regarding how and why premiums are going up.
https://acasignups.net/
True, its safe to say health insurance didn't get scammier.
I am hopeful, of course, that the lady doesn't suffer, and that you're correct about "rage bait."
Thanks for sharing the linky link.
There is a calculator mentioned in the article: https://www.kff.org/interactive/how-much-more-would-people-p...
I am trying to do the before/after for a single Adult earning $25,000 per year. It looks to be a 4% difference. I am not sure how you go from ~$500 to $2800 using this calculator. Short of starting to cover more people like children, etc.
I put 75k income and it says:
Your cost for a silver plan would increase by $1,577 per month ($18,924 per year) without enhanced subsidies
That's for a 63 year old in a random zip code in WV.
We wouldn't have this problem if we have universal healthcare in America, no?
The US system is so dumb not to mention inefficient.
Universal healthcare doesn't change the overall cost. To a large degree, the ACA/Obamacare was a good stab at getting universal healthcare! The change in this article is about undoing universality, by changing the subsidies for those with lower income.
To structurally reduce the fraction of GDP devoted to healthcare, we need to make far bigger changes. A lot of the setup right now is to subsidize those on Medicare by those on private insurance programs. The cross-subsidization goes very deep, and anything that might reduce costs also has the risk of undoing cross-subsidization. With half the country refusing to reform health care for the past 30 years, and the other half having their hands tied behind their back on trying to improve health care, we have built a gigantic overly complex system that's very hard to unwind.
Surely the complete removal of insurance and advertising from the US healthcare system would have an impact on the overall cost. Not to mention the amount of early preventative care that could be carried out instead of people waiting until it was really serious due to fear of medical bills.
We are about twice as expensive as healthcare system from other similar countries. Eliminating all administrative fees from insurance, all advertising, does not close that gap. There's a lot more going on!
Yes, the problem is insurance, not who pays for healthcare. There's not universal government funded car maintenance and it works just fine for the most part. Insuring predictable, recurring costs is a scam.
There's room, either private or public, to backstop catastrophes, but not the rest.
> Universal healthcare doesn't change the overall cost.
Something like 15% of US healthcare spending goes towards administrative fees just around insurance. That's order of $800 billion annually, roughly $1,500 per American, that does not contribute in any way to improving health. This is roughly the size of the US defense budget that we spend on gating healthcare.
There are knock-on effects of our system that increase some costs, such as people skipping preventative care or medications due to high costs or lack of insurance and then ending up in higher-cost emergency care. Or see the recent trend of physicians documenting how much of their time spent arguing with insurance companies on behalf of patients, time not spent providing medical care (and thereby increasing costs).
> Something like 15% of US healthcare spending goes towards administrative fees just around insurance.
True parasites.
Whatever the problem with health care in America is, the solution is not more money. We already spend double what all other countries spend as a percent of GDP and we have worse outcomes.
There are a lot of similar mysteries in America. For example, why does it cost a billion dollars a mile to do subways which is 20x almost everywhere else.
> Universal healthcare doesn't change the overall cost.
It can, at least to some degree. Every doctor's office has people who run through the insurance maze, trying to get services paid for. And every insurance company has people on the other side, trying to find ways to not pay for stuff. Having only one organization to deal with would simplify that; having one organization with clear, transparent rules would simplify it more.
> Universal healthcare doesn't change the overall cost
I get the sense I'm probably preaching to the choir here. But, the U.S. spends almost 2x what comparable countries (with universal healthcare) spend on healthcare. And we get worse than average results on virtually every measure.
This, of course, makes sense. When you're running healthcare as a for-profit business, part of our expenses are... profit to pay out shareholders. And advertisement budgets. And middlemen (insurance). And employees to do things like decline coverage. Medical employees to deal with insurance companies declining coverage. Etc. etc. There's a whole industry that only exists to support our private healthcare system that would cease to exist in a universal healthcare system.
Yup. Eventually it’ll likely be burned to the ground (uh, I mean ‘reformed’) but folks are trying to squeeze what they can out now.
Try living in a few different countries. The US healthcare system is amazing if you have good insurance - really freaking amazing.
I live in the US and have good insurance. Our healthcare system is garbage.
I've lived in over 7 countries and the US healthcare system is by far the worst one I've personally experienced.
Maybe you didn't have good health insurance? If you have children or anything big happen, you want to be in major metro area of the US with broad network, expensive insurance. It's the best in the world, by miles.
I like the idea of a public insurance option. Would bolt right onto our current system and help bring costs down.
What would a public insurance option involve? Do you mean insurance that's provided at-cost without a company profiting?
Insurance companies are already required to spend at least 80% (or 85%) of the premiums they collect on paying out claims. If they spend less, they are required to give rebates / premium refunds to policy holders.
It wouldn't be crazy to increase that percentage even more, since it's effectively a cap on the profit margin insurers are allowed to earn on premiums.
If a company's profits are capped at x% of the money they spend, aren't they incentivized to support higher medical costs?
It depends on what problem you’re referring too. Many socialized healthcare systems have huge backlogs right now.
Ration on price. Or availability. Or quality.
Eventually, every system ends up with one of the three. Sometimes 2.
Somehow, America is doing all 3 at once, without ever truly offering universal healthcare to begin with.
My Canadian father-in-law had to wait over a year before being able to see a neurologist about his suspected Parkinsons symptoms. Fortunately, he's well off enough that he was able to afford medical treatment in another country, but many people trapped in such systems are not.
Just to share a perspective from someone who used to live in New York… I had what I suspected was a mild concussion with some annoying symptoms at the time. I could see a neurologist within 3 days IF my schedule was flexible (it was not). I ended up getting seen 10 days later.
a year is just crazy.
Half of my work colleagues received health care abroad. Wait times in Quebec are insane. Yes, constant joint pain may be not 'life threatening' yet degrades quality of life significantly. Basically if you are not actively dying you can't get access to healthcare in Quebec.
So exactly like the US except it doesn't cost a fortune.
"Backlog" - there is never a moment that this isn't just wrong.
I'm from Australia. If I want to "skip the line" I can just pay to do so. Private practice exists. People don't, because it's expensive and they can't afford it.
This is exactly like the US, except in the US you just don't get healthcare at all and die instead.
The "backlog" in any public healthcare system is a triage line. If you actually need care, you get it immediately. If you can live with it but keep it monitored, you might not for longer then is optimally comfortable if you can't afford private consults.
In the US, again, you just don't get anything.
Unless you have good insurance, and then you get everything, the best, the quickest. Australia is a joke compared to healthcare in the US with good insurance.
Now, the US sucks really bad if you don't have good insurance / any insurance....
Such as? Have you ever had a major medical event using your health insurance in America?
"We have the best!". But like, so do dictators of 3rd world countries. Do you actually have access to the best care? Are you sure? Because about 1 in 10 Americans are uninsured[1] and a substantially larger percentage are underinsured[2].
Meanwhile Australian life expectancy is higher then America[3] (I mean let's be fair: most of the western world's life expectancy is higher then America...I wonder what common trait most of those places have...)
[1] https://www.kff.org/uninsured/key-facts-about-the-uninsured-...
[2] https://www.forbes.com/sites/joshuacohen/2024/01/01/us-healt...
[3] https://www.psu.edu/news/research/story/australia-offers-les...
I don’t disagree about the overall healthcare system being broken in the US, but I find it pretty funny that you replied to that person with more arguments about how healthcare sucks for the average person… When they were discussing healthcare being excellent for folks with great insurance.
you two are talking past each other, and talking about two different cohorts of people.
The person talking about "good insurance" provided no examples of even what that statement is meant to mean, or what they actually expected to get from it.
Just "the best care ever", no qualifiers, examples and no indication of costs.
Just what does "good healthcare" in America get you, that you imagine people in other countries do not get?
"good" is a relative term. In health care insurance world, it's the expensive plans, with broad coverage, and the best facilities in network (who participate in research and are at the forefront of treatment - MD Anderson, Mayo, Cleveland, Sloan Kettering etc). You get fast access to the best facilities with the best doctors and best treatments.
Maybe look at the rankings of best treatment facilities globally. Here is the list for oncology. Choose any dropdown you like. You are going to see a lot of "US" at the top.
https://rankings.newsweek.com/worlds-best-specialized-hospit...
Good question. I actually think the US should have a healthcare system more like other countries, don’t get me wrong. But I can directly answer your question, as someone who lives in the U.S. and is very happy with the care i receive.
In the U.S. i’d consider good health insurance to be:
- low monthly premiums (majority of cost is covered by a generous employer). Say $30-50 per paycheck for a single adult.
- A PPO plan, not an HMO (HMO limits your options when picking doctors).
- A plan that does NOT require pre-authorizations for most procedures and tests. They are a pain in the butt. And many crappy insurance companies like United Healthcare tend to auto-deny many things as “not medically necessary”.
- A medical plan that covers almost every non-experimental drug prescription, at low cost ($30 or less). Including antibiotics, EpiPen, GLP-1 (Ozempic), inhalers, etc.
- A reasonably low annual out-of-pocket max, say $2,500 or less? ALL costs after that max are fully covered by insurance. So you have peace of mind if something really bad happens.
- $0 or very low deductible for seeing your doctor. Also a very low coinsurance rate, say 20% or less. Coinsurance is the % of the bill you pay before your insurance covers the remainder.
All the above basically means, “low stress” when you get sick or into an accident, or get pregnant.
What does good “care” look like? I think we all know. In the U.S. this is _very_ region dependent. Most people don’t consider this when buying a home for some reason lol.
There are many cities with excellent hospitals and medical centers and also some top notch hospitals GLOBALLY. And then there are many “medical deserts”, typically cheaper areas to live, where care is harder to come by.
Examples of good care:
- QUICK access to your primary doctor/PCP (within 1-2 weeks)
- ability to get care urgently, within a days notice, from another doctor. urgent care, etc.
- ability to see a specialist within 3 months, ideally less than 1 month. Yes this is possible in some parts of the U.S. believe it or not.
- Living near (45 min or less) a major, well-rated hospital, in case you have a heart attack, get into a nasty car accident, etc.
The unfortunate truth is a LOT of americans are in a “healthcare desert”, or they are poor and can’t afford care, or their employers are not generous and offer them crappy plans. For example where the out of pocket max is $15k lol. Or where monthly premiums for a single person are $400.
The US is not a fun place to live if you’re lower class or lower-middle class. And our healthcare system is a confusing mess. :)
Yes, I'm sure I do. Yes, several, both in the US and Australia.
You seem to not understand what "good" is. You do at least seem to agree with my second point....
>Unless you have good insurance
This magical "good insurance" doesn't exist, because it's not up to the insurance company.
Scheduling is controlled by the hospital. Right now american hospitals are insanely booked out, and have been for many years. There's no magical insurance that bumps someone else out of the line.
If you aren't experiencing 3 month delays for non-emergency medicine, it's not that you have "good insurance", it's that you live in a place where the local medical infrastructure is seriously underutilized. This might mean you just live in a rich enough place where more hospitals than needed were built, or it could mean that a lot of your neighbors just aren't getting the healthcare the local hospitals were expecting to serve.
Or maybe what you are hinting at is that in your state, the affordable health insurance for most people doesn't actually get them any real treatment options, so only very wealthy people can afford to actually get treated, so hospitals around you don't do much healing.
And that's fucking ghastly and should be seen as the abhorrent thing it is. You have hospitals around you that are not treating people even though there are plenty of people needing healthcare. A lot of resources were already spent building that hospital and training doctors and we are not utilizing those resources because of some abhorrent "but then I might have to wait a month for a completely non-threatening medical concern" ideology. Yes, that's called efficient use of resources. Triage is a core part of healthcare. Sometimes that means someone else gets treated before you, and that's because they need it more than you do.
So you agree that people with good health insurance have access to insanely good health care.
I didn't say "affordable". I said good.
> We wouldn't have this problem if we have universal healthcare in America, no?
No. Try living in Quebec.
US healthcare is such a pain -- very high premiums, high deductibles, tons of paperwork, no price transparency.
My wife is from mexico, so while her visiting familly there I've had some opportunity to interact with and observe their system.
It seems better!
There are public hospitals which are open to all. The quality and wait times are reasonble, not fantastic. There is very little paperwork. (You don't have to jump through hoops like signing up for Medicaid or something.)
Alongside that, you can buy private insurance and go to private hospitals, which, in my (admittedly limited) experience, are very good -- efficient and reasonably priced. I would _guess_ because of less regulation and because they have to provide value above and beyond the free healthcare that's available?
In the US we seem to have created sort of the opposite incentive structure -- public healthcare is only available to a limited set of people, and everyone else is more or less forced into the private healthcare system (or "private", since it seems heavily intertwined w/ govt -- e.g., standard govt websites to pick a povider, tax penalty (tho since lifted) if you aren't signed up).
Somehow there's always a mountain of paperwork and bills that dribble in over months, and you never know how much the final cost is going to be.
Another seemingly-insane feature of the US system is if I pay for a service w/o insurance, I'll be billed some crazy rate. With insurance, I'll copay some reasonable-ish rate, and the insurance company will also pay some reasonable rate, often at like a 90% discount to the "quoted" rate. It feels like I'm coerced into insurance because I can't out-of-pocket pay the actual real reasonable rates.
Another annoyance is it also doesn't seem possible to buy insurance that just covers accidents, which I would personally do if I could...
> In the US we seem to have created sort of the opposite incentive structure -- public healthcare is only available to a limited set of people, and everyone else is more or less forced into the private healthcare system (or "private", since it seems heavily intertwined w/ govt -- e.g., standard govt websites to pick a povider, tax penalty (tho since lifted) if you aren't signed up).
There is no “we”. The rich and influential people that run the US _designed_ the system this way on purpose. To extract as much money from citizens. We didn’t reach this point by accident. Is there a presidential party or candidate that’s running on “tear the whole stupid system down and rebuild it to be simple and affordable”? Little baby steps like obama care don’t count in my opinion. No reasonable person would design a healthcare system where a hospital charges $500 for dispensing ibuprofen for example. Or a system where it’s impossible to predict how much you’ll pay as a patient. And they call it a “marketplace” lol. That’s lunacy.
If you know someone running on that as their campaign, please let me know. I’d be happy to vote for them. I’ll even donate to their campaign!
> Another annoyance is it also doesn't seem possible to buy insurance that just covers accidents, which I would personally do if I could...
That sounds like an interesting concept. Travel insurance is sort of like that, but not the same thing obviously.
Democrats should lean on this hard for 2026 midterm elections.
They created it. Remember Democrats voted down Nixon's Medicare for All THREE TIMES.
Democrats voted against universal health insurance. Note I said Insurance, not health care. Big difference.
Lots of Doctors are moving to Direct Pay, I never hear people complain about that. They don't take insurance PERIOD.
Lots of that type of practice Europe folks.
meh it doesnt matter. Biden tries "government that delivers", it didnt' work. instead his VP lost to one that promised cruelty. I used to be a what's good for type person. Now im just slowly giving up, and adopting a "eff you, I got mine" attitude.
The winds may change. The media was campaigning super hard for Trump, and still refuses to cover him fairly and hold him to task for the things he does, but the results are already so awful that people see through the fawning media coverage of Trump.
Don't give up hope, don't give up caring for your fellow person. A lot of fools made really bad choices, but it doesn't take many people to smarten up to drastically improve the system. You wouldn't see the Texas redistricting that's going on right now if Trump didn't know that he's completely screwed in next year's election. It's a desperate attempt to hold onto power, even if they media won't say that outright, or even dare to criticize Trump.
I’m a center/right voter.
I try to read a balanced set of news sources, but to me you seem to view things from a much different perspective. I guess it depends on what you consider ‘the media’, for one.
Take for example two basic proposals: Harris's housing proposals, which were widely misreported inserting right-wing misinformation and assumptions about them to denigrate the proposals.
Compare that to Trump's tariff proposals, which most media just assumed he'd not be so stupid as to actually implement, and never reported on critique of them. I've talked to so many center-right people that thought "oh I didn't know this would happen. Oh well I guess it's going to be ok because it's Republicans in charge."
The media covers for Trump's weakness and Trump gives them so many things to critique that never even get discussed. Very serious things. Meanwhile the media has to make up things about Democrats in order to criticize them. It's all hugely biased.
I wonder what would happen if every last social program were repealed. People would be screwed and angry. Would they push for real change then? Are all these programs keeping America just below boiling point?
It took 1 out of every 5 americans being unemployed and starving and dying for like a decade to elect FDR and a cadre of Democrat congresspeople who promised to build a mild welfare state.
We aren't even close to that, so uh, don't expect progress anytime soon. It will take basically an entire generation growing up with a clear (clear as in impossible to disagree with and still be considered mentally sound) failure of Republican policy. It took decades of suffering and failure and maybe even world war and that was before the moronic "But Stalin did horrible things so providing for your neighbor must be a terrible thing because stalin promised that" trading cards were printed.
So yeah, strap in. We aren't all going to make it to the other side.
> Now im just slowly giving up, and adopting a "eff you, I got mine" attitude.
well, that stinks. that's exactly why we have this problem to begin with.
FWIW this is about a pandemic era subsidy expiring. It sucks that a seemingly “temporary” subsidy was holding things together for folks
> The credit was a pandemic-era relief measure that has contributed to record enrollment in the insurance sold through the Affordable Care Act marketplaces.
Is there any republican justification for this, other than, by the time people notice it will be too late / we will try to blame it on the other party? Are they expecting the states to step up and pay instead?
The justification is the expiration of what they say is an emergency subsidy from the pandemic.
I’m not saying that makes it good (IMO society would benefit from this subsidy being permanent). But that’s their justification.
Were premiums that high pre-pandemic?
The premiums were high, but reduced temporarily for people who otherwise would not get generous subsidies.
The pandemic era extra funds are now expired, those people will now pay a price similar to what they paid pre pandemic.
For the least wealthy people, the amount of subsidy provided will not change.
They're setting the ACA up to "naturally" fail anyway, so this doesn't matter to them, or is even a step in the right direction.
They kicked out one of its three "legs" (the "individual mandate") so this right-wing heritage foundation promoted healthcare scheme is now guaranteed to face a price death-spiral anyway, unless that changes.
They gave up on repealing it, because it was so popular, and have settled for breaking it in ways that most folks will have trouble figuring out they should blame Republicans for (those chickens won't come home to roost for years, and I guarantee it's only a tiny minority of voters who understood the necessity of the mandate for the whole thing to work, anyway), so eventually it'll be popular to get rid of it.
They're expecting bondage and excuse to "crack down" where they wish.
Think of republicans now as a party creating excuses to itch their desire to look at female genitals.
> by the time people notice it will be too late / we will try to blame it on the other party?
This is it.
A lot of the things that the Republicans are doing that will completely fuck the lower/middle class don't actually take effect until after the mid-terms. This is an insurance policy so that if they get absolutely wrecked in the mid-terms, they can point to Democrats having the majority push blame onto them. On the flip side, if Republicans maintain control after mid-terms, by the time the next election takes place, people will have forgotten who it was that screwed them over.
Alternatively, they can just keep saying it's all Obama/Biden's fault. That still works.
> if Republicans maintain control after mid-terms
Is that still possible? I guess I'd assumed that they were set to lose, but I haven't been keeping up with the overall picture.
The Texas House just approved redistricting that will effectively give them +5 R seats.
Absolutely still possible.
They're misinformed voters that will be told that their food is more expensive because of Bidenflation, not because ICE arrested and deported the farm workers. As health care gets more expensive, they just get told it's because of ObamaCare.
When in doubt, just cry "WOKE!" and "DEI!" and they'll bend over for Trump and any Republican that claims to be friends with him.
Just blame Obama/Biden for it and move on ! I am not kidding that's what you will hear.
I have an ACA plan and am going to take a giant hit when the tax subsidies end.
At the same time, I wonder if it might be not such a bad thing.
Yes, I and millions will suffer higher premium costs.
Yes, many people will drop insurance or take bad plans.
Yes many more people will die because of this.
But ultimately, prices for health care must come down. If we continue to route infinite tax dollars towards the price setters (hospitals and doctors) then why would they change?
The only way they would reduce prices is if less people will pay. The only way that happens is if there is some pain, somewhere.
I don’t want people to suffer, but we have been headed in the wrong direction for so long… something needs to shake things up.
And ultimately, if this means some MAGA voters question their vote because they cannot get health care due to this change, then extra good.
But then again, it’ll still be Obama’s fault somehow.
There used to be a popular meme claiming that anything private tends to get cheaper over time, while anything regulated or run by the government keeps getting more expensive. But is that really true for all goods? If it is, then why do so many countries choose to adopt universal healthcare systems with tightly regulated insurance?
Maybe the more relevant question is: why is healthcare so expensive in the United States? It can’t just be because the U.S. is more advanced or developed. After all, one of the hallmarks of an advanced country should be making essential services affordable, if not cheaper.
The article is surprisingly unclear about this, but the enhanced subsidies that are expiring apply to households making over 4x the Federal poverty level ($62,600 for a single person or $128,600 for a family of 4). Subsidies for those making less remain intact.
paying $400 for health care out of pocket was already a lot. Paying 2800/month for healthcare is absurd. You may as well just foot the entire hospital bill yourself.
and I thought this would be in a high CoL area. But the woman quoted lives in West Virginia. How is she paying 2-3x her rent for healthcare? For eyedrops of all things too.
Honestly the story gets sadder the farther I read:
>Like an asthma medication [that] can run $700 a month. There's an eye drop medication that can be $800 a month... "Luckily I can do that, but that's money I won't be able to save for investing in my 401(k) for retirement,"
They are going to kill ACA, all of it is timed to kick in after the elections next year. They cannot really kill it because its a law, so they make it unaffordable and essentially be useless and unused
Cheaper to leave the country if you can.
and go where?
Mexico or Europe, depending on your skills or pension income. /r/AmerExit on Reddit for more info.
"Every country has the government it deserves." - Joseph de Maistre
All the people saying "Government is inefficient". Come on, do you think the CEOs who only work for quarterly returns are going to provide great healthcare? No, they are going to use every opportunity and propaganda to keep ripping you off.
The United States of Ferenginar
Even the Ferengi are wiser I'm afraid.
Rule of Acquisition #10: A dead customer can't buy as much as a live one.
We need to stop paying doctors millions of dollars. That’s the only way it’s going to come down. Half a million, whatever they get paid is making it so people have to do without decent insurance. That’s the biggest variable I see in the US vs other countries (not to mention bogus drug pricing, but there are controls hopefully being implemented for that.
s/doctors/private equity. The CEOS who keep acquiring hospitals and running them to the ground are the real ones at fault. We can definitely pay doctors a good salary after 10+ years of post-secondary schooling.
>not to mention bogus drug pricing, but there are controls hopefully being implemented for that
not really much "hope" for this administration. Especially when it comes to doing things that benefit the working class.
TL;DR it's not doctor salaries. Fortunately, there has been much expert research on this, for example:
https://www.commonwealthfund.org/publications/issue-briefs/2...
That "administrative costs" line item is closing in on $1 trillion annually, and its main purpose is to prevent people from getting healthcare.
Cut wages, subsidise schooling properly. Send them straight to med school. Why would a blue collar job need more education than is actually needed.
What it amounts to is a Covid era subsidy expiring. The article title makes it seem like ACA health insurance is going up 5x but in reality the expectation is 75%, this particular case must be an outlier. The person in the article even laughs it off since she turns 65 soon and will then switch to Medicare.
> The person in the article even laughs it off since she turns 65 soon and will then switch to Medicare.
You might be surprised how few Americans can ‘laugh off’ even a one-time payment increase of $2,300–let alone a monthly recurring one.
I'm also an "outlier", I guess. But I'm on a marketplace plan. Currently I pay $25 for my monthly premium. Next year it'll be $132. And I'm under 40.