2016 Postmortem
Related: About this forumBernie flipped from "state-" to "federal-administered" health care plan. So Clinton was right ...
So it does seem that her criticism of his health care plan in the last debates was spot on.
Glad that Sanders has been learning from Clinton during these debates
Waiting for the admission that Clinton was right from the Sanders supporters ...
https://berniesanders.com/wp-content/uploads/2016/01/Medicare-for-All.pdf
Bernies plan would create a federally administered single-payer health care
program. Universal single-payer health care means comprehensive coverage for all
Americans. Bernies plan will cover the entire continuum of health care, from
inpatient to outpatient care; preventive to emergency care; primary care to
specialty care, including long-term and palliative care; vision, hearing and oral health
care; mental health and substance abuse services; as well as prescription
medications, medical equipment, supplies, diagnostics and treatments. Patients will
be able to choose a health care provider without worrying about whether that
provider is in-network and will be able to get the care they need without having to
read any fine print or trying to figure out how they can afford the out-of-pocket
costs.
JonLeibowitz
(6,282 posts)1StrongBlackMan
(31,849 posts)Armstead
(47,803 posts)As for health casre it will NEVER be totally efficient and cost effective. Things like health, disease, accidents and death dop not adhere to "market principles" or the dictates of green eyeshade accountants.
But given that reality, pretend you're trying to explain the logic of our current system to a visiting martian who is doing a sytudy of the huamn race.
Explain how it is most workable to force people to pay money they cannot afford for coverage -- but then have to rely on the kindness of those large ruthless insurance corporations to toss a few crumbs their way.
The business model of a successful insurance company is not to provide services. It is to deny them.
That is totally unworkable, if one takes the quaint notion that the goal of health care is actually providing health care.And that it is preferable not to bankrupt people in the process.
1StrongBlackMan
(31,849 posts)I believe this change to the plan is a good one, as it prevents what happened in Arizona and is happening in Kentucky.
Armstead
(47,803 posts)The ACA is the policy that pushed for state plans. "If states want to try it, go ahead. But we're not going to do it on the Federal level. That will remain as is, with a few tweaks."
My larger point was that the details can be worked out. But too many are saying that any move towards public coverage is "unrealistic."
1StrongBlackMan
(31,849 posts)The concern is the how. And without the realistic how ... it is a wish, not a plan.
Agschmid
(28,749 posts)IMO that's the only way to go, not state by state.
dsc
(52,166 posts)Under the current SCOTUS we can't make the states expand Medicaid. Thus the program couldn't be state administered without leaving out a whole bunch of states.
Warren Stupidity
(48,181 posts)I think this change is good too. I welcome constructive changes to any proposal.
hill2016
(1,772 posts)Lots of the hard unanswered questions like:
- how is he going to implement cost control on both providers and patients? All single payer systems implement some form of cost control on patients: if you're 90 years old you're not going to have this procedure even if it saves your life...
- is private insurance still allowed? How does he prevent there from being two separate tiers (public vs private)? People who have the money would just pay for additional insurance and there would be a network of doctors who only accept private insurance
- are his funding and cost savings assumptions realistic? No offense to his team but I would like it scored by CBO. I don't believe you can save every household $5k and cover everyone, no deductibles or co-pays
- how do you encourage people from using the least expensive health care (PCP instead of ER, stop using ambulances to get a free ride to the hospital, etc)
- how do you move the system away from procedure-based reimbursements to outcome-based?
Seems like he just wants to punt the hard questions down the road. It would be much more honest to have a discussion of the pros and cons before voting.
Warren Stupidity
(48,181 posts)on the wall to see if it will stick. Got it.
hill2016
(1,772 posts)I'm saying that I want to see the details before making a decision whether or not to support it.
It's like going to a car dealership and the dealer tells me all about this BMW without telling me the price.
99th_Monkey
(19,326 posts)Keystone XL pipeline, TPP, same-sex marriage, etc. etc.
I've been saying for some time that Bernie's new sing'e-payer plan would embrace and/or
factor-in the state-by-state critique: http://www.democraticunderground.com/?com=view_post&forum=1251&pid=1011473
And low & behold, that's what he did. Facts matter:
1) Bernie has been beating the drum for single payer for decades,
2) Bernie frankly never expected his campaign to skyrocket like it has, putting his proposals
under a microscope,
3) Bernie's single-payer plans (prior to his recently released one) were bills he'd introduced
over his decades in Congress,
4) He has kept his word, getting his new plan out 2 weeks earlier than he said he would ("by
the time of the Iowa Caucuses" , and
5) Bernie made revisions based no doubt on how he's seen the state-by-state issues come up
in implementing ACA, and wants to avoid those issues with his updated single-payer plan.
Now it may ALSO be true, that Bernie to some extent took-to-heart Hillary's criticisms about
the states issue, as one factor among many, and I see no shame in that.
hill2016
(1,772 posts)for restructuring trillions of dollars of annual expenditures.
I've written term papers much longer on much more frivolous subjects.
My question is: what gives you the confidence he knows what he is doing (as opposed to just plain talk) and that his proposal is realistic in light of actual fiscal realities?
Has he sent it to CBO for scoring?
99th_Monkey
(19,326 posts)An 8-page Single-payer plan does spell out who pays for it, and how; which was the big
bugaboo question that Hillarians kept harping on. Of course Bernie knows what he's doing,
he helped write ACA in Congress as part of the committee that wrote it, and is well versed
in the issues involved, not to mention that he voted for the ACA.
As far as I can tell, ALL Hillary has said is she wants to "build on the ACA", period. Not even
8-pages, not that I've seen anywhere. So I'll take 8 pages of Bernie's single-payer before
I'll take Hillary's vague promise to "build on ACA".
Those 29 million UN-insured Americans deserve no less from any Democratic candidate for POTUS.
NCTraveler
(30,481 posts)"what gives you the confidence he knows what he is doing?"
Live and Learn
(12,769 posts)administered by the states under federal rules. But keep up the nit picking.
hill2016
(1,772 posts)was big enough that Sanders felt he had to change it from his previous proposal