OK, you oppose mandates. What's your alternative?

[damonm]

How do you bend down the cost curve and NOT trigger adverse selection?
Single payer WOULD do it, but it's off the table - simply WILL NOT HAPPEN with this Senate.

[krawhitham]

1. They would like the Gov to pay for it without raising taxes

[TreasonousBastard]

2. Magic money trees.

[damonm]

3. Wow - unrecced already.

I feel all tingly...

[Jim Sagle]

4. Medicare for All.

[damonm]

6. Single-payer. Not on the table.

SHOULD be, but isn't - nor do I see any hope of it in the immediate future.
So realistically, how?

[Jim Sagle]

9. Not my problem. And it's not unrealistic because the people reject it,

but because the Beltway rejects it. So let's get a new Beltway.

[damonm]

10. Go to it - and it IS your problem,

...inasmuch as you're the one positing the solution. You say "get a new Beltway" - do you have the organization and voting blocs in place to do that this year? If not, when?

[Jim Sagle]

11. I'm ON Medicare, so it's NOT my problem. I just want everyone else to have it too.

Your trollery bores me.

[damonm]

12. Fine. We agree on that - medicare for all WOULD be best.

But how do you realistically propose we accomplish that, and when do you see it happening? Because without SOME kind of plan, it's wishful thinking, and that's no help to anybody.

[Jim Sagle]

13. Not my job alone to make it happen; it's everyone's job.

[Sherman A1]

14. Agreed

[damonm]

31. OK, same question.

I agree that Medicare for all is THE BEST WAY to accomplish this.
Now, how do we get there?
Because, as I told the guy you agree with, wishing doesn't feed the proverbial bulldog.
Right now, it seems the rethugs and blue dogs would block such an attempt. How would you get around that, and how long do you think it would take to do so?

[Sherman A1]

48. Simple

The sales pitch has been all wrong and the debate controlled by our Esteemed Republican Colleagues with their pals Rush, et al (who don't want a solution but the continued controversy).

The sell has to be on the merit of the benefit (Medicare is simply less expensive) Therefore why would not business, government, the citizenry want something that provides them with their Health care at a better price?

Yes, it would require a restructuring of the Insurance industry, taxes, Health care, etc, but the benefit is lowered expense in the long run. There would have to be a time of transition for all parties, but again the Sell has to be on the ultimate goal of lowered costs for everyone.

You have to sell the premise of lower operating costs or more bang for the buck and that simply has not happened.

[yurbud]

5. bend the cost curve for the consumer or insurance companies?

[damonm]

7. Consumer.

[brand404]

8. X-Mas comes early for Insurers: Mandate stocking stuffers.

[rug]

15. Declare health care a matter of national security.

Then apply martial law to the insurance companies.

[area51]

16. luv it.

After all, a healthy populace is important to national security. Just what are our soldiers fighting for if they come back to a dead populace?

Obama saw what the mafiosi for-profit, unregulated insurance companies did to his mother during her illness; now he wants to fuck all of us over that same way too?

We can decide as a nation to cut back on the insane amount of military spending, and we can afford single-payer. If single-payer is good enough for fire and police protection, and is good enough for libraries, schools and roads, it's good enough for the most precious resource of all -- humans.

[rug]

18. The school lunch program was prompted by national defense concerns.

When the draft started in 1940 the government was alarmed at the condition of the draftees who grew up in the Depression.

[depakid]

17. Like a majority of the electorate, I'd support a mandate with the choice of a robust public option

Then take names and dare corrupt Senators like Ben Nelson side with abusive health insurers.

[damonm]

23. And if they DO as they likely will - where are we?

And how many die for want of access to health care while we wait for another election cycle (which may - or may NOT - turn out how we'd like)?

[joeybee12]

45. Likely? I really doubt that...n/t

[Bluenorthwest]

19. If we must have mandates, then like our peer nations who do so

it must be against the law to profit from providing those mandated services. If mandates are as you say, the key to making it work, clearly profits are not the key. In the Netherlands and other nations which mandate purchase, all providers of that Insurance are by law non profit.
So I assume you are not promoting mere mandates, but mandated purchase of private and for profit products, because you conflate the two issues as if they were one.

[damonm]

21. I refer to the mandates as they exist in the Senate Bill.

And I DO like this idea - I think it's Switzerland that does this?
So how do we get THIS past the blue dogs? (I discount the goppers - they're worthless)

[M155Y_A1CH]

33. I was thinking that too

If you mandate coverage you must make sure no entity profits by the mandate.
It would be like a reverse Robin Hood.

If health care is mandated, it would mean that I will be seeking public assistance
or breaking the law.

How many in this economy are getting by with family help or doing without many things?

Folks may qualify for assistance yet not apply for it because they have found other more independent ways to get by.
Mandate additional expenses and the house of cards comes crashing down.

Expect the welfare rolls to increase greatly if this mandate becomes law.

[bornskeptic]

50. It's not true that Dutch mandated insurance is all nonprofit.

Some insurers are operated for profit, while others are nonprofit, The same would be the case in the US if the Senate bill passed, as each exchange would be required to include at least one not-for-profit plan. It is true that the mandated insurance in Switzerland has to be nonprofit, but most people also purchase supplemental insurance, which may be for-profit.

The Netherlands operates a national insurance market for its 16 million residents. Plans may operate on a for-profit or nonprofit basis. The insurance market is highly concentrated, with the top five plans accounting for 82 percent of enrollment. Plans typically offer coverage in all areas of the country and include all providers, although selective contracting is allowed. Children are covered in full through public funds. Premiums charged for adults represent 50 percent of the expected annual costs. In addition, plans receive allotments from a national risk equalization fund, financed by income-related contributions. The allocation uses a sophisticated range of risk factors. As a result of this process, the premiums facing Dutch adults when selecting a plan vary within a narrow range.

http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/Jan/The-Swiss-and-Dutch-Health-Insurance-Systems--Universal-Coverage-and-Regulated-Competitive-Insurance.aspx

[Clio the Leo]

20. I've always liked an attempt at engaging in intellectual debate...

... thanks for posting.

:popcorn:

[uponit7771]

22. Have people buy into medicare, not single payer and cost effective. Those who aren't paying

...now wont pay later either and we're already taking care of them so the cost IMHO isn't going to be a huge issue for that system after we stop giving away the farm to doctors.

Folk who pay into medicare HAVE to go to CHC's first for treatment and open "urgent care" offices around the country to keep people out of the emergency rooms...

[damonm]

25. OK, I like this too.

I gotta wonder what the doggies would make of that.
The only problem I can foresee is that it's not 100% coverage, and as such there would tend to be some adverse selection, which would drive costs up, no?

[Romulox]

24. If the "free market" can't provide a solution, it has NO RIGHT to demand a seat at the table.

The only thing the insurance companies bring to this "negotiation" is bribe money used to re-elect politicians.

I think focusing on defeating incumbent politicians who support private insurance mandates is the logical move for we the voters. :hi:

[damonm]

26. OK - time frame for getting what you want passed?

[Romulox]

27. That's not a terribly fair question since my position hasn't even been allowed in the debate

Basic negotiation tactics demand that one start a negotiation demanding MORE than you are willing to accept. You want me to posit an alternative reality to the one in which the President opened the negotiations with what he claimed in his campaign was unacceptable--namely mandates and no PO.

So it's not a useful question right now. The current process is tainted, and needs to be rebooted.

[damonm]

29. You are positing a solution, so it is a VERY fair question.

Without a path to get there, it's wishful thinking. That doesn't feed the proverbial bulldog.
Wishing Washington would change isn't a plan. We are dealing here with the real world, in which rethugs and blue dogs, unfortunately, exist.
Any alternative has GOT to have a real-world chance of getting done, and should have a time frame for when it can, so stopgap measures can be put in place if necessary.

[Romulox]

32. I would START the negotiations with Single Payer.

Gimmeabreak on the "real world" stuff--in the "real world" corporations don't contain costs because the government mandates purchase of their products.

That's not even logical. And you're representing it as the only "realistic" solution? Again, gimmeabreak. :hi:

[damonm]

34. Right back atcha

...on "gimme a break" - they DO - when their rate structures are regulated. The current proposed legislation does that.
I live where that sort of thing is happening - and has been happening since 1988 - so don't try to tell me it doesn't work, as facts blatantly contradict such an assertion.

And I've noticed you have a very bad habit of putting words in other peoples' mouths - at no point have I presented the current bill "as the only 'realistic' solution". It is one realistic solution, and not the best at that. But for those who oppose mandates as you do, I'm asking for alternatives to the mandates that actually have a chance of getting done.

Starting the negotiation with single-payer makes sense - but where's your bottom line?

[Romulox]

35. I think this thread is sputtering. No new business here. nt

[damonm]

36. So, no plan. Gotcha.

[Romulox]

37. My plan is as realistic as yours at this moment. Health insurance mandates are dead.

:hi:

[freddie mertz]

28. Medicare for all. Of course.

[damonm]

30. Great. Best plan by far. BUT -

How do we get there? Do the votes exist now? If not, when will they?

[brand404]

40. I admire the republican base because when they are pissed they...

are very vocal and pick up the pitchforks and vote out their officials and put new ones in place. Sadly these same people are easily influenced and manipulated. So they tend to work against their best interests due to lack of knowledge or fear. The problem with the democratic base is their is no real fire to take to the streets...and so dem officials eagerly do what republicans do which is to sell out to lobbyists.

Medicare for All...or better put: Single-Payer is the ONLY solution and simplest and most cost-effective. Any other plan will inevidably fail....Every 1st world country has single payer except America and america is the one with the highest cost for healthcare and the highest mortality rate (compared to the others). So America has the highest cost and least effective system.

How do we get there? Emotionally charge the dem. base to take to the streets and immediately vote out current officals...Most of them are selling their vote to corporations (that includes Obama). Vote more progressives like Anthony Wiener and Alan Grayson....they stand up for the core democratic principles of "For the People". Without this kind of republican emotional mindset to get out their and vote these corruptors out there is very little chance Medicare for All will EVER happen in our life time (and that even includes a Public Option).

[freddie mertz]

42. Vote against those who have blocked it. Support single-payer candidates.

March and organize.

We are on our own now.

[Chisox08]

49. Medicare for all can be passed through reconciliation

So all we need is 50 senators plus VP Biden. They don't 60 votes to make changes to Medicare.

[OneTenthofOnePercent]

38. I think tax credits for people with insurance. Don't PUNISH people... REWARD them.

Make the tax credit large enough to cover the cost of basic healthcare - if you don't buy insurance, you don't get a credit. Insurance companies whom accept govn't tax credit dollars are subject to government regulation. This way, even without a public option in the market, the feds can have some control over insurance markets and make sure they aren't behaving in a predatory manner.

This gets around all the questionable constitutionality of mandating people to buy products. For the record, I oppose mandates as I disagree with the concept of being forced to buy a product. I don't believe there's any constitutional question of rewarding beneficial behavior with tax credits. Make healthcare free or extremely affordable (with credits) and it becomes common sense to get it. If people decide not to get it, it would not be because of money. People who are interested in coverage "above and beyond" typical coverage can still purchase it if they want.

--> This option makes healthcare affordable or free to ALL who want it.
--> Those who do not want to be FORCED to buy/receive healthcare do not have to. There is no incentive to do this.
--> People who want a more comprehensive level of healthcare can purchase extra coverage.
--> Ins. companies accepting federal credits also accept fair government regulation.

[Armstead]

39. SIMPLE -- OFFER GODDAMN PUBLIC INSURANCE

Sorry, but I am getting sick of this argument that we have to have mandates but we cannot offer a public coverage program.

If mandates are accompanies by an option that EVERYONE cold sign up for Medicare or some equivalent plan with payments BASED ON INCOME they might make sense.

Otherwise, this is nothing more than embedding private insurance as the only source of health coverage and making everyone prisoners of a shitty private monopolistic system.

[damonm]

46. Thank you - something that might actually be workable now.

[LatteLibertine]

41. Mandates are fine with me IF

they strongly regulate premium increases and even cap them in some cases.

Over the past year or so there have been huge hikes in anticipation of possible HCR. Those should be rolled back and temporarily frozen.

[timeforpeace]

43. You're being told repeatedly what the alternative is and you're rejecting it. Starting over with

Medicare for all as the plan is the alternative.

[damonm]

44. Haven't rejected it at all.

Try rereading what I've said. You might note I actually FAVOR Medicare for all.

My ONLY issues with it are (a) how long is it gonna take to get that given the current political climate, and (b) what, if any stopgap measures should be put in place until then.
For the most part, these 2 issues are met with noticable silence.
There's a reply upthread that starts to address the first point, but ZIP on the second.

44,000 people will die this year for want of access to healthcare. SOMETHING has to be done while we get the nest ready for Medicare for all.

[LSK]

47. which mandates??

The one that everyone needs to buy insurance??

Or the mandates that the plans must have a basic level of coverage?

[damonm]

51. The former.