Tag: SINGLE PAYER

Again with the Middle Class

It’s almost as if our media aristocracy of inbred Serious People have a vested interest in seeing to it that the middle class, and only the middle class, gets soaked in any economic “compromise.” Amidst reacting to a particularly poor NYT Magazine piece, Dean Baker nails it:

…the piece too quickly dismisses the possibility of getting substantial additional tax revenue from the wealthy. It presents the income share for those earning more than $1 million as $700 billion, saying that if we increase the tax rate on this group by 10 percentage points (from roughly 30 percent to 40 percent), then this yields just $70 billion a year.

However, if we lower our bar slightly and look to the top 1 percent of households, with adjusted gross incomes of more than $400,000, and update the data to 2012 (from 2009), then we get adjusted gross income for this group of more than $1.4 trillion. Increasing the tax take on this group by 10 percentage points nets us $140 billion a year. If the income of the top 1 percent keeps pace with the projected growth of the economy over the decade, this scenario would get us more than $1.7 trillion over the course of the decade, before counting interest savings. Of course there would be some supply response, so we would collect less revenue than these straight line calculations imply, but it is possible to get a very long way towards whatever budget target we have by increasing taxes on the wealthy.

Shocking. And but also, Baker smartly includes the most important issue in any truly serious discussion of American economics and the proper balance of same: the cost of health care:

We pay twice as much per person as people do in other wealthy countries. Since more than half of the tab for our health care is paid by the government, our broken health care system becomes a budget problem. If we paid the same amount per person for our health care as people in other wealthy countries, we would be looking at long-term budget surpluses rather than deficits. The reason that we pay so much more is not that we get better outcomes – we don’t generally. Rather it is that we pay too much to drug companies, hospitals, medical specialists, and others in the health care industry.

Baker’s being generous. We spend as much as five times more per capita than the best performing countries do, all of which achieve uniformly better outcomes than we do. Obviously, the only possible answer here is just get Big Guvmint out of the way so the poor can kindly go die in the streets. It’s the only serious answer to the problem. Well, that and lowering taxes on the wealthiest 1% of the country.

Read the whole thing.

Again with the Middle Class

Death-spiral Escape Hatch

Paul Starr of the American Prospect provides a way to lose the mandate and but also not destroy the private insurance system:

The law could give people a right to opt out of the mandate if they signed a form agreeing that they could not opt in for the following five years. In other words, instead of paying a fine, they would forgo a potential benefit. For five years they would become ineligible for federal subsidies for health insurance and, if they did buy coverage, no insurer would have to cover a pre-existing condition of theirs.

Fine by me. However, I can state categorically that the GOP will be against this, against the mandate (originally their idea anyway), and thus are implicitly for the destruction of the current insurance-based system and its inevitable replacement with single payer. But let’s not talk about that. Shrill.

Death-spiral Escape Hatch

Poison Pill Revisited

Jonathan Gruber sums up the wages of partial repeal (be it legislative or judicial) of the Affordable Care Act:

Removing the Affordable Care Act’s mandate would eviscerate the law’s coverage gains and greatly raise premiums. And going further by only keeping the market reforms and the small business tax credit would virtually wipe out those coverage gains and cause an enormous premium spike.

Oh, and it would totally destroy the existing insurance company-based system of coverage within a very few years. They’d be the first ones screaming for some replacement for the mandate; they’d have to be, because without it, and in the continued presence of the rest of the reforms, they’d be out of business.

But, by all means, GOP: herald in the era of single payer, finally a true government takeover of healthcare funding in this country by launching relentless attack on the less popular but absolutely critical parts of the package. Said it before, will likely say it again: bad policy is absolute catnip to the GOP and their Tea Klan enablers. They cannot resist it. Forget testing proposed legislation; just see if the GOP/Tea Klan is for it. If so: it is at best a singularly bad and more likely an utterly catastrophic policy.
With that useful razor in hand, it’s easy to see that with a policy outcome as catastrophic (to the insurers) as removing the mandate and but also leaving the popular stuff like the community rating, no lifetime limits, and etc… in there, the GOP and Tea Klan are and will forever be like moths to the flame until such time as they see their particular foolishness accomplished. And before we know it, President Palin will be signing the new American Homeland Patriotic Healthfulness Imbuement and Embiggening Flag Act of 2013, handed to her by a slothful yet resolutely responsive GOP rubber-stamp of a Congress.

Cannot wait.

Poison Pill Revisited

Death Spiral

It occurs to me that:

  1. The GOP categorically cannot resist getting behind bad policy with economically destructive end results, especially if and when they also increase suffering in the interim. It’s like their catnip.
  2. The Democrat wants to crawl out from under insurance reform with “popular” sub-measures, the community rating being among the very most popular.
  3. It is widely accepted that forcing a community rating in the absence of the individual mandate will extinguish health insurance as a profitable concern in this or any country

So here’s the plan. Figure out a way to pass the community rating. Fuck yeah, health insurance reform! Nobody can be denied coverage, 4EVA!!!!

Then: Healthy people stay out of insurance pools until they are genuinely sick, the insurance companies soon enough find they cannot continue to make money at that, prices and premiums spasmodically but systematically rise. Lather, rinse, repeat for 5-10 years. And then: BOOM. The system finally collapses utterly. President Palin is forced to do, uh, somethin’ or ‘nuther, doncha know? About all that health stuff and whatnot?

The GOP will have ushered in single payer.

And, no, I’ve not gone around the bend. Various conservatives are already making the connection:

the country will face a choice: allow the numbers of uninsured to continue shooting up, or enroll more and more people directly in taxpayer-funded government insurance plans.

I say, if nothing else, Democrats should be doing whatever possible to accelerate the arrival of that day. Think of it as the reverse Grover Norquist. And, rest assured, given the rampant fucktardia emanating from DC Democrats over the last few days, I think they are, uh, going as fast as they possibly can on this plan.

This needs to stop

ryking:

“In 2003, a young Illinois state senator named Barack Obama told an AFL-CIO meeting, “I am a proponent of a single-payer universal healthcare program…” There was only one thing standing in the way, Obama said six years ago: “All of you know we might not get there immediately because first we have to take back the White House, we have to take back the Senate and we have to take back the House.”

This sort of gotcha line, utterly excerpted from its context is flatly ridiculous and, frankly, right out of the GOP playbook. Certainly has the ring of straight up PUMA-style astroturfing. Either way, it’s the typical, feckless DCCC circular firing squad stuff that the very same people screaming about it all claim to hate so much.

But wasn’t this Obama’s position? Didn’t he say it? Yes he did. Frequently. But it also matters what he always said next:

‘If you’re starting from scratch, then a single-payer system would probably make sense. But we’ve got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off. So we may need a system that’s not so disruptive that people feel like suddenly what they’ve known for most of their lives is thrown by the wayside.’

He’s always said it that way during the campaign and after winning the election. I’ve never once heard him say it otherwise, or even with a particularly different wording. I’m quite sure if I could dig up the full text of the specific speech above, he said something like it then too. At any rate, here’s Obama directly addressing this quote back during the campaign. Notice what he says?

I don’t think we’re going to be able to eliminate employer coverage immediately. There’s going to be potentially some transition process. I can envision a decade out, or 15 years out, or 20 years out.

Hey, what do you know. That’s pretty much the way things are going. Start somewhere. Make improvements for 40 million uninsured in this country. Come back and fix the rest later. Move forward on the main substance.

It’s almost as if Obama campaigned on several issues, like focusing on the war in Afghanistan, improving health insurance, and, in sharp contrast to the Bush administration, actually bothering to hunt for bin Laden and shut down the various operational al Qaeda training facilities in various far-flung corners of the world (yes, even if that means putting a missile into Yemen). Now that he’s actually, you know, doing those things, various segments of the democratic party are shocked, shocked, and retiring to the nearest fainting couch or agitating that these things be undone. If you really feel this way, methinks you thought you were voting for Kucinich. Not that there’s anything wrong with that, but, honestly. What did you expect?

By all means, keep parroting the right-wing’s nonsense. Keep acting like poorly informed reactionaries. Just what they’re hoping for.