It starts with a nice, but misleading idea.."All other things being equal, public, nonprofit insurance can be cheaper than for-profit insurance"
Wrong. Because Public insurance has to be fairer. The private insurance we all know is profitable and expensive, right? The catch is "if all other things are equal". The problem is they wont be equal.. They will be extremely unequal.. Of course, the insurance companies figured out long ago, they need to apply reverse psychology to get what they want. The trick is to play Brer Rabbit and the Briar Patch.. They cant let on that they want public option, to kill single payer... They can't let on that they know how and why it will die! They have to say the opposite. So they lie now about how the public option has an "unfair advantage" - The opposite, true reality is that there is actually a disadvantage that we hope public option bears, and the "disadvantage" is caused by the public option doing the right thing- now. That "right thing" is community rating. By accepting the sick.. they accept that the plan will have higher costs than the private plans. Their risk pool will be sicker. Thats Adverse selection.
"you make a set of assumptions about a non profit option which are just talking points- ie, you say that it will soon cost more than private. how is that even possible? you assume that healthy people will not want to go with the non profit carrier?"
Read a little bit about insurance risk pools and adverse selection..
"Death spiral is a term used to describe an insurance plan whose costs are rapidly increasing as a result of changes in the covered population. It is the result of adverse selection in insurance policies where lower risk policy holders choose to change policies or be uninsured."
There are a number of editorials in papers this week making the same point that I have been, that Obama is deceiving Americans on his health care program, trying to imply that it will make healthcare affordable, when in fact it wont do much to improve most people's situation, and may actually accelerate the explosion in costs in that the cartel was probably on their best behavior UNTIL they realized that Obama was giving them almost a green light to continue their pillage.
Obama can't have it both ways, he can't prevent a health care option from being too attractive - the health cartel's goal, AND make healthcare affordable.
By adopting the BAD fit represented by Medicaid as his model of helping the poor (and "recently made poor by healthcare costs") Obama seems to be on track to be the worst Democratic president for healthcare affordability, ever.
Medicaid also wont prevent healthcare bankruptcies, at all, because it doesn't kick in until AFTER somebody has been impoverished.
I was under the impression that people could not get it and have any real income, and that they attached people's homes, if they used it enough to make them seek repayment.
Also, the way that they treat single people or childless people or people with no children or people with low paying jobs may be very different than the way they treat a disabled person, with a life threatening, permanent illness.
by improving people's overall health because both inflammation (in lots of different ways)
and stress KILL, stress damages the brain, causing huge problems. That right there should argue persuasively enough for universal healthcare.
To get back to my point, they cause people to put on pounds in similar ways.
PubMed various permutations of "allostatic load", Stress, amygdala, hippocampus, allostasis, "psychosocial stress", etc.
You'll see what I mean.
BTW, if Obama continues to allow these situations to continue to rape Americans security, without doing EVERYTHING they can to REVERSE it.. (single payer SHOULD BE A NO BRAINER) the net effect will eventually be a breakdown in public safety and the social contract, just one of whose effects will be many, many people will be forced to stay at home, indoors, because it wont be safe on the streets. Just imagine how bad our health will be THEN.
Single payer is the ONLY way to make healthcare AFFORDABLE FOR ALL OF US.
For the first thing, NOWHERE do I see a single indication that anything that is happenng now is leading to AFFORDABLE healthcare for ANYBODY!
Obama is trying to sell us on an insurance of last resort (public option or whatever) for the well to do, and an expanded loan program (Medicaid) for the very, very poor, which will for the most part only help hospitals and insurers, because people have to be indigent to get help.
What about the huge number of people in the middle who are being KILLED by huge uncovered costs, can't afford to go to the doctor or buy drugs, and often, can't buy insurance because they might have high blood pressure or ADHD or diabetes or something-
Kids have often been depending on the peace of mind that comes with thinking they are going to inherit something, then, poof.
I don't have any kids, Ive been terrified to have any ever since the first time I got sick.
One thing we dont discuss about single payer is the incredibly far reaching implications of such a large, substantiative improvement in our national stress level.
I would not be surprised if we had a real period of national renewal.
The alternative is a steady deterioration in the social fabric and our ability to live the way we are accustomed to, we dont notice until we see others who dont have the burden.
We dont realize how much we take for granted that is the legacy of our egalitarian past,
If the looting of America continues, people will eventually have to devote a large amount of energy to security related activity.
It will effect everyone. The middle class will grvitate towards the way the poor live now, people will have bars on their windows, they wont be able to go out for a walk, they will find it hard to get enough exercise and fresh air..
The affluent will have to budget for bodyguards, and even the middle class wont be able to go on vacations, or allow teenage children to travel unattended. Even the best security systems wont be able to address the kinds of changes we could easily see.. For example, corruption.
That is what happens in highly stratified nations.
Also, look at the amount of time that our system saves people. We take it for granted, but its hard to build up the kind of trust that makes that possible, and its easy to destroy it.
many people take many things for granted that we really cant if we allow the random drive by shootings of healthcare bankruptcy to pick people off one by one..
I have been analyzing the 63 page PDF and I suddenly was striken with admiration for Obama's genius in helping the insurance companies wth their biggest problem, that of free riders getting free medical care after they have spent everything they have on bills and declared bankruptcy.
Can't let that happen, can we?
No, Well, guess what, Obama can help! The Obama administration is planning an expansion of the Medicaid low income medical loan problem so that the poorest can be helped with a loan before they become a drain on insurers.
Then, when they get better, they can repay ther debt in installments, for example, an ectopic pregnancy costs $126,000, they could pay $100 a month for.. uh.. for a while.. you know..
Obama is also going to insure anybody who can pay the premium of his high quality public option, What a great deal that is going to be for sick people, huh? Sick folks who have assets really need to be able to buy insurance so they wont end up in group #1, huh?
This will take a big weight off the insurance companies by insuring a bunch of sick folks who COST THEM A LOT OF MONEY!!! along with any healthy folks who can pay the premiums, who want to help lighten their load.
Somehow, Obama is going to wave his magic wand and make that PROFITABLE! Wow!
What could be a bigger sign of hs loyalty than that!? If I were a right-winger, I would count my blessings. Obama is truly a genius, because he is not going to waste a single penny on the middle class.
But when sick people drop below the poverty line, after their assets have been spent down, he will be there for them with a loan, to prevent them from taking hard earned dollars away from the insurance companies, raising their rates for the profitable healthy customers.
Ending free riders!
Also, he is planning a new public option that will pay for itself, even though it will insure a market not currently served, sick (or well) people who can afford any premium that is asked of them.