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Establishment looks to crush liberals on Medicare for All

Surrealistik

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https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215

The united front that helped Democrats save Obamacare just a year ago is falling apart over single-payer health care.

Deep-pocketed hospital, insurance and other lobbies are plotting to crush progressives’ hopes of expanding the government's role in health care once they take control of the House. The private-sector interests, backed in some cases by key Obama administration and Hillary Clinton campaign alumni, are now focused on beating back another prospective health care overhaul, including plans that would allow people under 65 to buy into Medicare.

This sets up a potentially brutal battle between establishment Democrats who want to preserve Obamacare and a new wave of progressive House Democrats who ran on single-payer health care.



Unfortunate but expected; can't say that this at all came as a surprise.

I can only hope that progressives in the party push back against their establishment, insurer bought colleagues given the popularity of this core platform measure, particularly given that Medicare for All is currently polling at ~70% (https://thehill.com/hilltv/what-ame...blicans-say-the-support-medicare-for-all-poll | https://www.reuters.com/investigates/special-report/usa-election-progressives/ ).
 

Oborosen

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https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215





Unfortunate but expected; can't say that this at all came as a surprise.

I can only hope that progressives in the party push back against their establishment, insurer bought colleagues given the popularity of this core platform measure, particularly given that Medicare for All is currently polling at ~70% (https://thehill.com/hilltv/what-ame...blicans-say-the-support-medicare-for-all-poll | https://www.reuters.com/investigates/special-report/usa-election-progressives/ ).

Hopefully they can explain how they will pull it off this time around and keep the premiums from skyrocketing all over again.
 

Xelor

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I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.
 

Surrealistik

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I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.

I can only assume it has to do with fear of the federal government's not inconsiderable negotiating power in a MFA scenario depleting profit margins/demanding compensation more in line with the rest of the developed world. I would also assume that said hospital lobbies opposing MFA are no monolith as, yes, I can see it also benefiting private hospitals through elimination of administration expense, and federal government pressure on suppliers to cut margins.
 

Kal'Stang

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https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215





Unfortunate but expected; can't say that this at all came as a surprise.

I can only hope that progressives in the party push back against their establishment, insurer bought colleagues given the popularity of this core platform measure, particularly given that Medicare for All is currently polling at ~70% (https://thehill.com/hilltv/what-ame...blicans-say-the-support-medicare-for-all-poll | https://www.reuters.com/investigates/special-report/usa-election-progressives/ ).

Ok, I was able to sit through 10 minutes of that. I can't stand Cenk's voice for too long. I used to like TYT. And then they became completely bat **** crazy.

That said, I actually agree with them on this one. At least on the basic issue of corruption in Congress and insurance companies/pharma companies etc etc and on single payer.
 

Surrealistik

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Ok, I was able to sit through 10 minutes of that. I can't stand Cenk's voice for too long. I used to like TYT. And then they became completely bat **** crazy.

That said, I actually agree with them on this one. At least on the basic issue of corruption in Congress and insurance companies/pharma companies etc etc and on single payer.

It depends on what they're covering/discussing TBH; I generally don't really watch too much of the ID politics stuff as it can get unbearable/cringy at times, and the Trump related speculation is excessive (but it draws eyeballs so I get it), but in terms of domestic political analysis/breakdown/predictions they're usually spot, Cenk in particular.
 

MTAtech

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Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.
 

Surrealistik

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Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

The public support/movement definitely wasn't there for MFA at the time Dems controlled all chambers of govt, so I can understand Obamacare's drafting and passage then. In the end sadly, Obamacare couldn't even deliver on the much desired (and talked about) public option thanks to the insurance lobby's influence, particularly with regards to that snake Joe Lieberman.

These days, yes, despite the overwhelming popular support, we will need to take back all the other chambers to make MFA a possibility, but that's besides the point that establishment interests are actively working to get Dems to collectively backpedal and abandon it as a long term ambition, and are otherwise attempting to erode the momentum and foundation required for its passage if/when the party ends up in a position to enact it.
 

American

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Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

Sure, with massive bribery. Remember the Cornhusker Kickback, Louisiana Purchase and the Florida Flim Flam?

https://www.cbsnews.com/news/tallying-the-health-care-bills-giveaways/

The last statement by Harry Reid is a beauty.
 

Lovebug

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I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.

They would have to charge equally and account for it, is my guess. Right now it seems to be a bit more for profit to make up for the ones who can't pay. What people, esp those who are against a single payer system, don't understand is that they are already paying for the next guy.
We need to have this settled once and for all.

For the OP, establishment...as in keeping both sides of the aisle important and in power?
 

Lovebug

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Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

If that is true, why do you think Republicans are so against it?
 

Renae

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Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

Oh dear, the old "It's a conservative plan" because some group years ago suggested it as an Idea... doesn't make it a conservative plan or a good one.
 

MTAtech

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MTAtech said:
Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.
If that is true, why do you think Republicans are so against it?
First, it is true. See: https://www.forbes.com/sites/theapo...invented-the-individual-mandate/#6e31fed56187

Second, I think it all had to do with the fact that the Democrats were pushing it and anything that Obama did the Republicans were against. They even voted against a proposal that they initiated when Obama said he would back it.
 

Obscurity

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I can only assume it has to do with fear of the federal government's not inconsiderable negotiating power in a MFA scenario depleting profit margins/demanding compensation more in line with the rest of the developed world. I would also assume that said hospital lobbies opposing MFA are no monolith as, yes, I can see it also benefiting private hospitals through elimination of administration expense, and federal government pressure on suppliers to cut margins.

More like then not it would expose the entire rotten structure of healthcare mergers, one of the largest, undiscussed issues as it relates to the ballooning cost of healthcare.

This country has less choice than ever before in terms of who actually owns what you buy - mergers and acquisitions is the biggest destructive force against capitalism and is ensuring monopoly.
 

MTAtech

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Oh dear, the old "It's a conservative plan" because some group years ago suggested it as an Idea... doesn't make it a conservative plan or a good one.
Yeah, just "some group years ago." Except that "group" was the most influential Republicans in Congress.

Conservatives Sowed Idea of Health Care Mandate, Only to Spurn It Later

The individual mandate, as it is known, was seen then as a conservative alternative to some of the health care approaches favored by liberals — like creating a national health service or requiring employers to provide health coverage.

“In 1993, in fighting ‘Hillarycare,’ virtually every conservative saw the mandate as a less dangerous future than what Hillary was trying to do,” Newt Gingrich, the former speaker of the House, said at a debate in December, casting his past support of a mandate as an antidote to the health care overhaul proposed by Hillary Rodham Clinton during her husband’s administration.

Since then the politics of health care have grown more twisted and tangled than the two snakes entwined around the staff in a caduceus, which is sometimes used as a symbol of medicine. It is now Republicans and conservatives who oppose the individual mandate, arguing that it is unconstitutional, while Democrats, who were long resistant to it, are its biggest defenders.
...
To combat President Clinton’s proposal, a large group of Republican senators, including the minority leader at the time, Bob Dole, and several who are still in office, proposed a bill that would have required individuals, and not employers, to buy insurance.
 

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The cynical and/or conspiracy theory level reactions to mainstream Democrats not throwing their support behind vague Medicare For All ideas is pretty tiresome.

Time to resurrect an important thread on this subject, started by Greenbeard.

https://www.debatepolitics.com/gene...all-isn-t-solution-universal-health-care.html

Given the likelihood this will be a key issue for the Dems over the next few years, it's worth starting to consider some of the challenges behind the Medicare-for-all slogan. A provocative article in The Nation this week gets the ball rolling: Medicare-for-All Isn’t the Solution for Universal Health Care.

Some of the factors considered are: Medicare has a private option that's been growing in popularity every year; most people in employer-based insurance have coverage that's more generous than traditional Medicare (sometimes folks overcompensate for this fact by suggesting single-payer coverage be more generous than coverage that exists anywhere in the world); the (big) issues inherent in rapidly transitioning from here to there remain largely unaddressed; loss aversion suggests that forcing everyone off their coverage is politically fraught.

Of particular note is a bit on international comparisons and the often related assumption that adapting some other nation's model implies enjoying that nation's health care cost structure:

“For the most part, these countries were spending maybe 2 or 3 percent of [their economic output] on health care when they set up these systems after World War II,” says Dean Baker, co-director of the Center for Economic and Policy Research. “Most of them are spending 8 or 9 or maybe 10 percent of their [output] now, and this is 70 years later.”

In 2015, the United States spent 17.8 percent of its output on health care. The highest share ever for an advanced country establishing a universal system was the 5 percent that Switzerland spent in 1996, and they set up an Obamacare-like system of heavily regulated and subsidized private insurance. (They also spend more on health care today than anyone but us.)

There’s a common perception that because single-payer systems cost so much less than ours, passing such a scheme here would bring our spending in line with what the rest of the developed world shells out. But while there would be some savings on administrative costs, this gets the causal relationship wrong. Everyone else established their systems when they weren’t spending a lot on health care, and then kept prices down through aggressive cost-controls.

“Bringing costs down is a lot harder than starting low and keeping them from getting high,” says Baker. “We do waste money on [private] insurance, but we also pay basically twice as much for everything. We pay twice as much to doctors. Would single-payer get our doctors to accept half as much in wages? It could, but they won’t go there without a fight. This is a very powerful group. We have 900,000 doctors, all of whom are in the top 2 percent, and many are in the top 1 percent. We pay about twice as much for prescription drugs as other countries. Medical equipment, the whole list. You could get those costs down, but that’s not done magically by saying we’re switching to single payer. You’re going to have fights with all of these powerful interest groups.”

Baker is himself a single-payer advocate, and he’s worked with various groups that advocate for it, but, he says, “I don’t think you can get there overnight. I think you have to talk about doing it piecemeal, step-by-step.”

That's an important point that needs to be contemplated under any effort to move toward Medicare-for-all or single-payer or anything similar. No more magic asterisking away the U.S. cost structure if the debate is about to turn serious.

Anyway, I endorse the underlying message:

Understanding that other countries’ schemes vary significantly in the details—and that in the United States, the cost of care would remain a serious challenge under any system—should lead to a different conversation among progressives. Rather than making Medicare-for-All a litmus test, we should start from the broader principle that comprehensive health care is a human right that should be guaranteed by the government—make that the litmus test—and then have an open debate about how best to get there. Maybe Medicaid is a better vehicle. Perhaps a long phase-in period to Medicare-for-All might help minimize the inevitable shocks. There are lots of ways to skin this cat.

At a minimum, it’s time to get past the idea that anyone who doesn’t embrace Medicare-for-All, as it’s currently defined, must be some kind of neoliberal hack.
 

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Yeah, just "some group years ago." Except that "group" was the most influential Republicans in Congress.

It wasn't a conservative plan and they dropped the idea. That card is so over played.
 

year2late

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I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.

Reimbursements for medicare is low. Reimbursement for private insurance is much higher.
 

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It wasn't a conservative plan and they dropped the idea. That card is so over played.

First sentence like a Trump comment: “I didn’t pay the women and when I did it wasn’t illegal.” Anyway, why did they drop the idea, the one they never had?
 

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The public support/movement definitely wasn't there for MFA at the time Dems controlled all chambers of govt, so I can understand Obamacare's drafting and passage then. In the end sadly, Obamacare couldn't even deliver on the much desired (and talked about) public option thanks to the insurance lobby's influence, particularly with regards to that snake Joe Lieberman.

These days, yes, despite the overwhelming popular support, we will need to take back all the other chambers to make MFA a possibility, but that's besides the point that establishment interests are actively working to get Dems to collectively backpedal and abandon it as a long term ambition, and are otherwise attempting to erode the momentum and foundation required for its passage if/when the party ends up in a position to enact it.

The problem there is the damn lobbying. So many dems are up to their eyeballs in it and unfortunately the ACA just gave strength to the insurers. They dont want UHC and will fight it. No doubt there will be huge money spend in 2020 so nobody that wants it will get near the finish line. I think those that want MFA will either have to wait 30 years or so or try to find a third party way forward. Neither of the two parties is going to dare take this up. They talk about it but then come time its all "pie in the sky."
 

OscarLevant

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Hopefully they can explain how they will pull it off this time around and keep the premiums from skyrocketing all over again.


Well then, allow me to explain it.

In a river, water flows. Partitioning part of the river into another direction does not add water to it, it merely redirects part of it. The sum total of flows is not increased.


But, when you redirect money that is already being spent into a more efficient system, LESS overall, not more, is spent.

That is the premise I would make, that would be the objective I would assert, if I were a congressman or senator.

The debate, therefore, about medicare for all, is whether or not the above premise can be achieved, and whether or not medicare for all is more efficient. We do have evidence: of the 50 or so western nations that have some variation of UHC, the avergage cost per capita in those countries is roughly half of that of the United States. This suggests the system is more efficient. Granted, those countries are more stingy with their health care dollars than America. But, it certainly proves it is not more costly, despite this fact.

But, "medicare for all" is a misnomer and suggests a totalitarian solution.

In my view, it should be medicare for anyone who opts for it.

It was supposed to be "the public option", remember?

That above message is for dems, keep it as an option, not as a totalitarian solution, which the right will slam dems for.
 
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I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.

They would have to charge equally and account for it, is my guess. Right now it seems to be a bit more for profit to make up for the ones who can't pay. What people, esp those who are against a single payer system, don't understand is that they are already paying for the next guy.

We need to have this settled once and for all.

For the OP, establishment...as in keeping both sides of the aisle important and in power?

Red:
Hugh? I'm not sure what you mean. I don't understand how the "red" remark relates to doubtful accounts (bad debt) expense.

Hospitals/care providers generally do charge the same price. What they get paid may vary depending on what organization/person pays.
  • For procedure X or item Y, hospital H has "rack rates" (list prices) of XRR and YRR, respectively. Those prices are what they charge everyone; however, because of the provider's having, with the payer, agreed to accept a given discount off the list price -- perhaps XRR - .20(XRR) for payer A; XRR - .22(XRR) for payer B; and so on -- different payers may remit different sums to the provider. As a result of the reimbursement rate agreements, different care receivers (folks who have different insurers) may see in their statements from their insurers different list price amounts. Obviously hospital P may charge completely different-from-hospital-H "rack rates" for procedure X and item Y.



Blue:
Care providers' definitely do factor their "allowance for doubtful accounts" into their pricing strategy. They don't share their methodology for doing so, but they definitely do so. Generally, however, they use that factoring only to ensure they're not "losing out" due to bad debt; they don't use that factoring as a way to "goose" their profits.
 

Phys251

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https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215

Unfortunate but expected; can't say that this at all came as a surprise.

I can only hope that progressives in the party push back against their establishment, insurer bought colleagues given the popularity of this core platform measure, particularly given that Medicare for All is currently polling at ~70% (https://thehill.com/hilltv/what-ame...blicans-say-the-support-medicare-for-all-poll | https://www.reuters.com/investigates/special-report/usa-election-progressives/ ).

TYT is the left's version of Fox "News." Thankfully it doesn't reach as wide of an audience.
 

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First sentence like a Trump comment: “I didn’t pay the women and when I did it wasn’t illegal.” Anyway, why did they drop the idea, the one they never had?

I dunno , why DID they drop it... hmmm

Is the Affordable Care Act really the same as "the Republican plan in the early '90s?"

Short answer -- sort of. There was a Republican bill in the Senate that looked a whole lot like Obamacare, but it wasn’t the only GOP bill on Capitol Hill, it never came to a vote and from what we can tell, plenty of conservative Republicans didn’t like it.

Qualls told PunditFact that she was thinking of the Senate bill.

1993: Health care takes center stage

President Bill Clinton took on an ill-fated effort to reform health care in 1993. As the president’s task force (led by First Lady Hillary Rodham Clinton) worked behind closed doors to craft solutions to ever-rising health care costs and a growing number of uninsured families, Republicans scrambled to forge an alternative.

Republican Sen. John Chafee of Rhode Island was the point man. The bill he introduced, Health Equity and Access Reform Today, (yes, that spells HEART) had a list of 20 co-sponsors that was a who’s who of Republican leadership. There was Minority Leader Bob Dole, R- Kan., Sens. Orrin Hatch, R-Utah, Charles Grassley, R-Iowa, Richard Lugar, R-Ind., and many others. There also were two Democratic co-sponsors.

Among other features, the Chafee bill included:

An individual mandate;

Creation of purchasing pools;

Standardized benefits;

Vouchers for the poor to buy insurance;

A ban on denying coverage based on a pre-existing condition.

"You would find a great deal of similarity to provisions in the Affordable Care Act," Sheila Burke, Dole’s chief of staff in 1993, told PunditFact via email. "The guys were way ahead of the times!! Different crowd, different time, suffice it to say."

That said, the Senate plan from 1993 was not identical to the health care law that passed in 2010. The Republican bill did not expand Medicaid as Obamacare does, and it did have medical malpractice tort reform, which the current law does not. In contrast to the current employer mandate, the Chafee bill required employers to offer insurance, but they were under no obligation to help pay for it.
https://www.politifact.com/punditfa...5/ellen-qualls/aca-gop-health-care-plan-1993/
 
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