I don’t remember where I said it, but I wish I hadn’t. In some thread on FtB about the republicans’ attempts to come up with a health program, I opined something like, “I wonder if their strategy is going to be putting up a few trial balloons and then shrugging ‘we tried’ and repealing obamacare without a replacement.”
Senate majority leader Mitch McConnell has announced that the Senate will vote on a clean repeal of Obamacare without any replacement, after two Republican senators broke ranks to torpedo the current Senate healthcare bill. [guardian]
That was the plan all along, wasn’t it?
Some good news: that may not work. [the hill]
Over on backstory radio (one of my favorite podcasts) Brian Balogh runs through some of the crucial decision-points that brought about the American health care system the way it is, and how each one forced the next one, etc. It’s brilliant and fascinating and I encourage you to give it a listen. His piece starts at 17:00 [backstory]
Balogh’s theory is that all the key decisions that can be made about healthcare in its current form have been made in the last 70 years and all that remains is arguing vociferously about the placement of the deck chairs on the sinking ship. Once the US adopted an inadvertent approach based on corporate-provided insurance, or union-provided insurance, we had a divide between the insured and uninsured and it was part of their value-proposition.
Health care is difficult, but especially so when your country’s economy is predicated on spending $900 billion dollars a year on wars. I don’t believe that ratcheting that back and spending it on medicine would do anything more than make our medical system more expensive and bloated. So: burn it to the ground. I’d favor a government controlled medical system in which allowed services and fees are highly regulated. One of the problems we’ve got here is that unregulated capitalism will always pocket any excess profit (after all, that’s what they do!) – I’m quite sure that there are plenty of doctors and hospitals that the invisible hand of the market would provide, who would be comfortable working for a nice healthy profit. Note that under the current system they don’t see the profits, anyway, they’re captives, too. The people who’d get hurt are already rich as fuck and, screw them, frankly: they’ve already demonstrated that our lives mean nothing to them if they can make enough to buy another mansion by throwing us individually on the trash-heap. Martin Shkreli has become the poster-child for medical greed, but it’s Shkrelis all the way up.
It’s going to be a progressive state that first offers comprehensive health care to its citizens, I think. And then other states will adopt it. That’s sort of how Canada ended up with their system.
I think you may be being overly-generous here. I’m not convinced that they had a plan at all, and the “repeal without replacement” option is just where they’ve ended up, like a drunk at the bottom of a flight of stairs.
Yeah, but it’s not that difficult. Every other country in the “civilised” world has managed to come up with a better solution.
Health care is difficult, but especially so when your country’s economy is predicated on spending $900 billion dollars a year on wars.
Spending lots of money on military isn’t the cause of USA problems. It’s only an excuse. This planet is full of countries, which are a lot poorer than USA yet still manage to provide decent healthcare for their poor citizens. Even when you subtract all the money USA wastes on wars, USA still has more money left compared to most other countries in this world.
I’d favor a government controlled medical system in which allowed services and fees are highly regulated.
Yes, that would certainly improve things.
But I’d still favor a state owned medical system. One where doctors are educated for free in state owned universities and they work in state owned hospitals, where patients don’t have to pay anything. The current USA medical system has to support countless billionaires who all want their profits. The result is unnecessarily inflated costs. The private university where doctors learn has to make lots of profit. The bank, which provides the student loan, has to make their profits. The insurance company, the private hospital, the bank, which provides a loan whenever insurers refuse to pay for some treatment… Everything is owned by some billionaire who wants profits. Once you cut out the billionaires, everything gets cheaper.
Personally I prefer the state to provide all the necessities (healthcare, education, tap water, electricity, housing for the poor, public transportation etc.). I’m willing to leave to private businesses only those things, which are nice to have but not absolutely necessary (smartphones, movies, literature etc.). If I believe that an iPhone is too expensive, I can live without a smartphone or I can buy some cheap Chinese phone instead. If I believe that a surgery in my local hospital is too expensive, I cannot live without it (death occurs) nor can I cheaply fly to China to get my surgery there instead, because medical tourism is limited only for those who can afford to pay for airplane tickets in the first place.
The problem for Republicans, I think, is that the ACA is a Republican plan, but the Democrats passed it. They can’t let the Democrats have a win, so they have to destroy it. But since it was the only workable plan they could come up with in the first place, they have nothing left. Quite the conundrum, if you are a Republican for whom the ultimate goal is “winning” and damn the consequences.
Obama, for all his sins, really did leave a turd in the punchbowl for the Republicans. If they repeal the ACA and come up with some sort of half-assed plan (which seems unlikely), premiums and fees will skyrocket. If they just repeal the ACA with no replacement, premiums and fees will skyrocket. Both of these options will leave many of their own people without insurance. But if they do nothing, they are going back on years of promises and will look weak in front of their voters. They can’t even amend the ACA to fix some of its problems for the same reason. All of these options are likely to piss off large portions of their constituencies. As I said, it’s a conundrum. If you are a Republican.
I just wish I could believe this will translate into Democratic victories in 2018, but Republicans seem to be rewarded for their failures. That’s a conundrum for Democrats.
The Republicans’ problem is that they control both Congress and the presidency. Which means they can’t trust that someone else will save them from the outcomes of their posturing, they have to do it themselves.