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Old 09-15-2020, 11:32 AM   #3241
Greedy,Greedy,Greedy
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Re: Swing State Blues

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Originally Posted by sebastian_dangerfield View Post
Bending the cost curve was part of it. But since the days of Ted Kennedy seeking a HC bill, the primary aim was getting HC to those who couldn't afford it. A huge percentage of that category is people who could not make any meaningful payment toward it. So they were near entirely subsidized.
This dog don't hunt.

Huge portions of the bill related to controlling costs and bringing costs down for everyone. Some of those provisions never got to be fully implemented because of Republican challenges or failures to fund. But you find that growth in healthcare costs in 2013-14, the years when ACA provisions were most robust, had been cut by 50% over the immediately preceding years.

The goal has always been threefold: affordable, quality, universal coverage. All three are reflected in the bill.

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If we could have focused primarily on lowering premiums for people able to pay something and willing or already doing so, without using those dollars to subsidize care for people paying nothing, you could have put a lot of money back in working middle class peoples' pockets or given them far more bang for their HC dollar.
It is actually much, much harder to cut costs without also addressing the uncovered. What made ACA work was increasing the total pool size nationally; without that increase in pool size, controlling premiums is much more difficult. That cuts costs in the insurance component of care rather than in the care itself, so it gets you cost cuts without affecting quality. Now, if you want to regulate for-profit hospitals like utilities, eliminate patent protection for drugs, or cap physician salaries, you may be able to cut costs without a pool expansion, but those things are not only politically challenging, they are also constitutionally questionable and can have direct impacts on quality of care.

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Now, of course, there are social reasons not to do this. But the question at hand was whether the ACA was primarily aimed at helping the middle class. I think it was secondarily aimed at helping them.
You know repeating something wrong won't make it right? But thanks for playing.

Quote:
That's your view. I think the labor market changes afoot, which I mentioned, were #1, then the economic crisis was #2, then inequality caused by policy reactions to the financial crisis was #3, then the environment was #4, then HC was #5.
That's just your view, and one not shared by many people. Meh.
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Old 09-15-2020, 01:59 PM   #3242
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Re: Swing State Blues

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Originally Posted by sebastian_dangerfield View Post
Bending the cost curve was part of it. But since the days of Ted Kennedy seeking a HC bill, the primary aim was getting HC to those who couldn't afford it. A huge percentage of that category is people who could not make any meaningful payment toward it. So they were near entirely subsidized.
Your claim was that the Democrats "focus" on the poor. That claim was wrong. What you say here doesn't help.

Quote:
If we could have focused primarily on lowering premiums for people able to pay something and willing or already doing so, without using those dollars to subsidize care for people paying nothing, you could have put a lot of money back in working middle class peoples' pockets or given them far more bang for their HC dollar.

Now, of course, there are social reasons not to do this. But the question at hand was whether the ACA was primarily aimed at helping the middle class. I think it was secondarily aimed at helping them.
The reason that healthcare is one of the leading issues for Democrats is not because they are consumed by a burning passion to redistribute to the poor, something you ordinarily say they are too cynically focused on serving corporate masters to do, but because the issue affects so many people in the middle class. Indeed, guaranteeing that everyone has coverage is a guarantee that means a lot to the middle class, because it removes the threat of becoming uninsured.

But it is delightful to hear you identify a real difference between the two parties, something you are usually hellbent on ignoring. Democrats have a real commitment to trying to use the government to improve the lives of all citizens, and Republicans don't. I feel you.

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That's your view. I think the labor market changes afoot, which I mentioned, were #1, then the economic crisis was #2, then inequality caused by policy reactions to the financial crisis was #3, then the environment was #4, then HC was #5.

You don't get to dictate what is the most important policy issue at any given time. People disagree about that endlessly. You may think HC was in Obama's term. Others, like me, think different issues were more important.
It's not my subjective view of what mattered, it's a objectively realistic view of what the two parties spend their time fighting about. In retrospect, pandemic readiness was clearly more important than State Department email security, but our late understanding doesn't change what was actually fought about at the time.
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Old 09-15-2020, 05:33 PM   #3243
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Re: Objectively intelligent.

So right now the Trump ads I'm seeing are what I feared: If you elect Biden we are getting shut down again and thousands of small businesses will be shut. Michigan is 1: already carrying a pretty tight lock down. We don't need to be threatened. and 2: people are over it.

Meanwhile Biden's ads are focused on Covid too. Young people are done, very much so. Biden will not be seeing big youth turnout if this is the message. Young families are struggling with remote schools and how tough it is to make that go. Trump will pull a bunch of people that are sick of him back. He will seem the best of two awful choices. And I honestly can't help but think Biden is only speaking to votes he already has.

Not good.
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Old 09-15-2020, 06:12 PM   #3244
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Re: Objectively intelligent.

Ourguy 2020!
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Old 09-15-2020, 07:14 PM   #3245
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Re: Swing State Blues

Quote:
Originally Posted by Greedy,Greedy,Greedy View Post

It is actually much, much harder to cut costs without also addressing the uncovered. What made ACA work was increasing the total pool size nationally; without that increase in pool size, controlling premiums is much more difficult. That cuts costs in the insurance component of care rather than in the care itself, so it gets you cost cuts without affecting quality. Now, if you want to regulate for-profit hospitals like utilities, eliminate patent protection for drugs, or cap physician salaries, you may be able to cut costs without a pool expansion, but those things are not only politically challenging, they are also constitutionally questionable and can have direct impacts on quality of care.
This is why, heartless bitch that I am, I want to yank those 18 to 26 year olds off of their parents' ERISA plans and put them in the pools where they belong, subsidizing the older folk.
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Old 09-15-2020, 08:55 PM   #3246
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Re: Swing State Blues

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This is why, heartless bitch that I am, I want to yank those 18 to 26 year olds off of their parents' ERISA plans and put them in the pools where they belong, subsidizing the older folk.
It was a popular provision in the bill, and one we've used with our kids. They're still in the pool, and their parents coverage gets more expensive because of them, but yeah, it's a lesser contribution.
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Old 09-15-2020, 08:58 PM   #3247
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Re: Objectively intelligent.

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Originally Posted by Hank Chinaski View Post
So right now the Trump ads I'm seeing are what I feared: If you elect Biden we are getting shut down again and thousands of small businesses will be shut. Michigan is 1: already carrying a pretty tight lock down. We don't need to be threatened. and 2: people are over it.

Meanwhile Biden's ads are focused on Covid too. Young people are done, very much so. Biden will not be seeing big youth turnout if this is the message. Young families are struggling with remote schools and how tough it is to make that go. Trump will pull a bunch of people that are sick of him back. He will seem the best of two awful choices. And I honestly can't help but think Biden is only speaking to votes he already has.

Not good.

This may look a little different after a few more big universities shut down and send people home because of an outbreak.

On the one hand, I'm glad my kid is having a first year of college on campus. On the other, I'm scared shitless about it. I think I'd go with acknowledging this is hard and trying to deal with it in all its complexities rather than lining up one "side" or another. But that's me.
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Old 09-16-2020, 02:14 PM   #3248
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Re: Objectively intelligent.

Quote:
Originally Posted by Hank Chinaski View Post
So right now the Trump ads I'm seeing are what I feared: If you elect Biden we are getting shut down again and thousands of small businesses will be shut. Michigan is 1: already carrying a pretty tight lock down. We don't need to be threatened. and 2: people are over it.

Meanwhile Biden's ads are focused on Covid too. Young people are done, very much so. Biden will not be seeing big youth turnout if this is the message. Young families are struggling with remote schools and how tough it is to make that go. Trump will pull a bunch of people that are sick of him back. He will seem the best of two awful choices. And I honestly can't help but think Biden is only speaking to votes he already has.

Not good.
The Biden ads here, at least during baseball, are about making sure everyone has health care.

ETA: latest poll showed Biden up 16 points (which is likely too high) in MN, where 45 was hoping to compete.

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Old 09-16-2020, 04:22 PM   #3249
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Re: Objectively intelligent.

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The Biden ads here, at least during baseball, are about making sure everyone has health care.

ETA: latest poll showed Biden up 16 points (which is likely too high) in MN, where 45 was hoping to compete.
Here's an interesting twist I got from Single Payer Newsletter

https://www.commondreams.org/views/2...payer-surprise
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Old 09-16-2020, 04:48 PM   #3250
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Re: Objectively intelligent.

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Here's an interesting twist I got from Single Payer Newsletter

https://www.commondreams.org/views/2...payer-surprise
Any version of single payor pushed by Trump would shut down all choice. He can't, politically, push a single payor plan that would fund any abortion in any circumstance.
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Old 09-16-2020, 05:28 PM   #3251
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Re: Objectively intelligent.

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Any version of single payor pushed by Trump would shut down all choice. He can't, politically, push a single payor plan that would fund any abortion in any circumstance.
There won't be any draft legislation by election day, just a promise to do it.
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Old 09-16-2020, 06:53 PM   #3252
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Re: Objectively intelligent.

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Originally Posted by Hank Chinaski View Post
There won't be any draft legislation by election day, just a promise to do it.
I'm just glad Trump got us health care reform.
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Old 09-16-2020, 07:08 PM   #3253
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Re: Objectively intelligent.

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Originally Posted by Hank Chinaski View Post
There won't be any draft legislation by election day, just a promise to do it.
He's been telling people that he's about to unveil a health plan for something like a year.

It's political vaporware.
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Old 09-17-2020, 10:54 AM   #3254
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Re: Objectively intelligent.

Quote:
Originally Posted by Icky Thump View Post
Here's an interesting twist I got from Single Payer Newsletter

https://www.commondreams.org/views/2...payer-surprise
Anyone who believes that the GOP will pass single payer healthcare has not been paying attention.

ETA: https://twitter.com/realdonaldtrump/...714008579?s=21

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Old 09-18-2020, 02:27 PM   #3255
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Re: Objectively intelligent.

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