Originally Posted by The Rani

Great, let's see you do the math and prove your point.
And no, your original point was this, which was and still is an absolute falsehood:

Wow, your intellectual laziness is even beyond what I imagined! You williully go only as deep as what appears to support your viewpoint. And you open yourself up completely to being called on it. That's not ignorance, deary, that is sheer stupidity.

Before the quote you noted, there was this -

Originally Posted by playwrite

Yes, and I've been bringing this up over and over again. It is why a number of the hospitals that serve the lower middle class and below are freaking out in Texas, Florida, and other states that did not accept the Medicaid Expansion. And it's not only those hospitals but nearly the entire system in the state because this puts tremendous pressure on the entire system.

The Medicaid expansion was to far exceed any loss of the DHS payments, but no one foresaw what the SCOTUS was going to do. Behind closed doors, there are many GOP governors that will confess that John Roberts put them in an impossible situation of having to choose between their rabid t-bagger base and the moral correct choice of helping the most needy in their states while bringing billions in economic activity. Being both ethical dirtbags and economic morons, we see what they decided to do,

Their actions, the ones that really matter on this issue, are very much intended with known consequences. It's just that too many people want to ignore that because it doesn't fit their worldview of being Obama haters - something you and more that just a few others here well know.

Let me take this slowly and step-by-step for you to give you every advantage to comprehend -

Let's assume that you grasp that the ACA allows for moving millions of people currently uninsured to being covered under Medicaid. This is what is referred to as the "Medicaid Expansion" - Google it if you need more to comprehend.

Some states have decided to do the Medicaid Expansion, i.e. move people from being uninsured to Medicaid. In those states, the hospitals are not screaming much about the loss of DSH payments (again, if needed, more googling)

Other states have decided NOT to accept the Medicaid Expansion, i.e. NOT move people from being uninsured to Medicaid. In those states, the hospitals are SCREAMING VERY LOUDLY about the loss of the DSH payments (again, if needed, more googling).

Knowing that, what is your logical basis for believing that the hospitals are primarily upset about having to deal with a larger Medicaid gap????????

Let's go to the very own reference you quoted -

The 2010 U.S. health care reform law--the Patient Protection and Affordable Care Act-intends to redirect a substantial amount of Medicaid DSH payments to provide subsidies to aid individual purchase of health insurance (Berenson et al. 2009; Hall 2011; Katz 2010). Specifically, under the ACA, federal allotments for Medicaid Disproportionate Share Hospital payments will be reduced by $18.1 billion for the years 2014-2020 (CMS 2010; Kaiser 2010a, 2010b). Although safety-net hospitals will have fewer uninsured patients, the ACA will not eliminate all uninsured people and all uncompensated care. In particular, CMS (2010) estimated that 23 million individuals would remain uninsured if all ACA provisions were enacted nationwide, and Holahan and Garrett (2010) estimated that the costs of hospital uncompensated care in this case would equal $46.6 billion in 2019. The recent U.S. Supreme Court ruling, which gives states greater flexibility in deciding whether to expand Medicaid coverage, will likely result in greater numbers of residual uninsured people and higher hospital uncompensated care than previously predicted. Overall, the net effect of a reduced uncompensated care burden due to fewer uninsured people and reduced DSH dollar support is unclear.

If history is any guide, I've doubt you either read or comprehended what I wrote here, so let's just leave it at -

Duh.

Originally Posted by The Rani

Yes, let's do:

So where's your mathematical evidence that clears it all up for us?

Okay, sounds like you're coming around.

The precise final combined impact is unclear. What we do know is it will be "+n" more of a problem in those states without the Medicaid Expansion.

If the impact in Expansion states is zero, then it will still be a '+n" problem in non-Expansion states. It would have to be generally a positive in Expansion states at least greater than 'n' to not be a problem in the non-Expansion states.

The thing about this is the hospitals ran the numbers and were supporters of the ACA overall and the DSH tradeoff specifically. They didn't start to go crazy about this until the SCOTUS decision followed by the GOP gov's deciding not to do the Expansion - that should provide us lesser beings with a clue of what the big boys believe will be the real problem and where.

http://washingtonexaminer.com/the-ne...rticle/2540022

The new healthcare.gov error screen

Healthcare.gov is having problems handling the new influx of users who are flocking to the website to shop for Obamacare.

Early Monday morning, the site's navigation was smooth and functional, but by mid-morning, I was getting a green loading wheel at every step of the sign-up process.

Currently, however, there are so many users on the site, that it is displaying a new error screen.

The site puts users into a waiting line to use healthcare.gov until it can again handle a large amount of users.

Error screen:

[see the link - I'm getting to lazy]

If you believe the Administration's 50K at-any-time capacity or the 800K/day capacity; we could have a couple million signed up for the exchanges/expansion by mid-week.

This is where we should have been 2 months ago.

-----------------------------------------
For the unofficial total enrollments count, as of the 3rd week in Nov., we're well past the 1 million mark and rapidly approach the 2 million mark

http://acasignups.net/

That's a growing number that the GOP will need to "repeal and replace" or more likely apply the "get sick and die" approach to.

I realize it will never be as much fun as reading about the misery caused by Obamacare (OMG, someone's premium is going up! That has never happened before, before Obamacare! Mafusa! Benghazi! IRS! IRS!), but in the spirit of this time of year, maybe take a peak?

http://capsules.kaiserhealthnews.org...ealthcare-gov/

Many Consumers Report Improvements With Healthcare.gov

- funny, how that works out.

http://capsules.kaiserhealthnews.org...ealthcare-gov/

Why some states pay less for Obamacare

How much you'll pay for Obamacare could partly depend on how much your state fought for you.

In Oregon and Maryland, state regulators challenged the premiums that insurers wanted to charge for Obamacare policies, forcing the companies to lower their rates.

But in states like Florida and Texas, regulators took a hands-off approach, allowing the premiums insurers filed to sail through.

Like most things Obamacare, the treatment was laced with politics.

Several states run by Democrats were active and public about negotiating with insurers.

Some Republican-led states disassociated themselves from the process, sending the filings to the federal government, which does not have the authority to disapprove of rates.

Rate reviews by states have proved effective in lowering premiums, according to a study last year by the Kaiser Family Foundation. The average rate allowed after a review was 2.6 percentage points lower than the average rate initially requested in the individual market, though there was a wide variation between states.

"If states were more aggressive in reviewing rates, you saw more of a decrease," said Cynthia Cox, policy analyst at Kaiser.

Oregon fell into this category. While reviewing rate filings submitted for its state exchange earlier this year, Oregon's insurance commissioner peppered the 14 insurers with questions in writing and at public hearings to justify their proposed premiums. In some cases, regulators contested the assumptions the insurers used for allowing everyone to apply for coverage regardless of pre-existing conditions. At least one insurer made a mathematical error, and others didn't adequately document their projections for the rise in medical costs.

Ultimately, the commissioner lowered rates for individual plans up to 30%. The average premium for a mid-range plan for a 40-year-old in Portland is $201 before federal subsidies, according to Kaiser.

"It's important that there is someone really looking at these rates to see that they are justified and reasonable," said Laura Cali, the state's commissioner.

Florida, meanwhile, took the opposite approach. Legislators, who defied the governor and refused to extend Medicaid to all poor adults, passed a bill that suspended the insurance commissioner's power to approve rates for two years. So the insurers pretty much got to charge whatever they wanted since the federal government can't argue about the premiums either. The average mid-range plan premium is $269 for a 40-year-old Miami resident.

State regulators said that Florida has a very competitive insurance market and that the rates came in close to one another and in line with national figures. And because insurers had to create new products that met Obamacare standards, the insurance department had little experience to go on.
"It would have been very hard for us to challenge a company's rate filings," said Wences Troncoso, deputy commissioner in the state's Office of Insurance Regulation.

But other experts said that the state missed a chance to secure a better deal for its residents.

"Florida consumers could conceivably end up paying unreasonable rates that may have been reduced or withdrawn had they been reviewed by Florida's own OIR," wrote Sally McCarty, senior research fellow at Georgetown University Health Policy Institute, in a blog post

So what do you think about North Carolina's political leadership - more like Maryland/Oregon or more like Texas/Florida?

If you don't know the answer to that without giving it a moment's thought - you are the sheeple that will continue to bend over and vote for your freedom fries overlords.

Don't worry too much, Obamacare has the MLR limitation that will likely result in rebates next year. Imagine the political ads next year in Florida, Texas and North Carolina next year - your state GOP let the insurers ream you but Obama got it back to you with a rebate! Pretty cool.

They should call it the GOS party; the grand old shills.

- smiles in his grave

http://crooksandliars.com/karoli/cal...gop-astroturfs

CA Assembly GOP Puts Up Fake California Health Exchange Site

California Republicans are desperate and shameless. In the past two weeks, GOP Assembly members have sent mailings out on what appears to be the state's dime to their constituents about health insurance. Only, they don't direct those people to CoveredCA.com to sign up. Instead, they send them to their own astroturf version with the url CoveringHealthCareCA.com.

On their version, there are links to negative articles and twisted messages intended to sour people on signing up for health insurance before they ever land at the official health exchange site.

For seniors, this message:

Seniors on Medicare may not see changes immediately to their benefits or coverage. Down the line, however, the erosion and accessibility of care may become a problem.

To pay for other components of the Affordable Care Act such as expanding Medicaid and creating state health exchanges, Medicare providers will see rate cuts nearing $200 billion over the next decade. These cuts could potentially result in the exodus of doctors from the Medicare system and force Medicare recipients to find new providers, possibly facing longer wait times for care as that pool of doctors shrinks.

Eek! Rationing!

Likewise, the tab for "young adults" says this:

Young adults will end up paying for much of federal health care reform by subsidizing the cost of sicker people, or by paying a tax penalty if they do not obtain health insurance under the provisions of the individual mandate, which requires all Californians to have coverage beginning in 2014.

If you click on the "Don't have health insurance" tab on the front page, you're taken to a page that puts all the focus on the penalty and none on the benefits. In fact, they have a "penalty calculator" on that page, rather than a premium calculator.

And of course, they also manage to twist what is actually available on the exchange:

overed California: Covered California offers four qualified health plans similar to those available on the private market today. These plans comply with the Affordable Care Act.

Not so much, Assembly Republicans. There are four levels of coverage, but inside those levels, there are many, many plans available. So many it takes some time to figure out which one works the best.

What we have here are elected officials intentionally trying to make California's health exchange fail, and using taxpayer dollars to misinform taxpayers, using the standard fear and loathing tactics as their linchpin. While I expect nothing less from Republicans in general, it does gall me that they're using "official mailings" to misdirect constituents and Assembly resources to register and build the website.

Just more proof Republicans don't give a damn about anything but their own bad selves.

Dr. Belk points out that medicine is much cheaper if you buy it directly, and not through an insurance plan.

http://truecostofhealthcare.org/

http://youtu.be/r9q1Id41wGo

Originally Posted by Eric the Green

Dr. Belk points out that medicine is much cheaper if you buy it directly, and not through an insurance plan.

http://truecostofhealthcare.org/

http://youtu.be/r9q1Id41wGo

It's the for-gain (which includes profits and executive compensation) bureaucracies of the insurance companies that load costs onto physicians that makes American medicine so expensive.

Originally Posted by pbrower2a

It's the for-gain (which includes profits and executive compensation) bureaucracies of the insurance companies that load costs onto physicians that makes American medicine so expensive.

The profit margin for insurers is 3.7%; hospital slightly beat them at 3.9% It will be interesting to see if they can maintain those rather lackluster profits once the ACA fully kicks in and the temporary bump from more people having access smooths out; from there, their profit growth will come solely from population growth and be hampered by the limits the ACA places on them such as the MLR limitation.

Part of the misdirection on this is a result on how the hospitals have tried to proportion out their costs across everything they do; people get stuck on the ridiculous (but superficial understanding) of $250 catheters and the $10 rolls of toilet paper without ever asking really why that happens. If we want to really do something about healthcare costs, we need to get past that as well as the mythology of high profiteering by the insurers.

Don't get me wrong; I'm still an advocate for single payer (I just have a different tactical approach for getting there), but no one should believe that single payer's elimination of the insurer's profit is gong to put even a dent in health care costs that are approaching $3 TRILLION a year. What single payer really does is put the one entity that can afford that, the U.S. government, as the check writter, but that raises a host of other issues (ones that most people get ass-backwards by the way).

Here's a listing of the industries in the Health sector by their financials -

http://biz.yahoo.com/p/5qpmd.html

Obviously, 10-20% profit margins of the drug and medical device industries are a prime target, but that raises the issue of how to continue incentives for R&D.

This is not an easy issue even for those whose life's work is focused solely on researching and understanding it. For most, it is just an emotional one, for everyone has either faced these costs themselves or has had a loved one who has.

It's going to require a lot of adults in the room, and it's going to take a long time.

Originally Posted by The Rani

The one Obamaphile that I know called me up last night to complain about his old insurance company and his inability to find a new one. He has a pre-existing mental health condition, but apparently isn't seeing the new benefits that he is supposed to be getting ... yet? Ever?
Karma's a bitch, I suppose. It looks like people are going to find out the hard way.

And playdude, before you spin off into crazy-town again, no he does not live in a Red State. Unless Illinois went Red all of a sudden.

You think that's bad?! I have an uncle who has a friend whose brother saw an alien from outer space scouting out all the grocery stores.

Karma is a bitch; I guess we all need to head to the hills and grow our own!

Now, Rani, don't spin off into crazy town again, my uncle's friend's brother says the invasion will not be limited to just Blue states, unless Idaho went Blue all of a sudden!

__________________________________

I guess we're going to have to endure these "man bites dog" stories until researchers do a retrospective and actually come out with validated numbers, but by then the Krotch Brothers' Sheeple (KBS, trademark pending) will have been moved on by the Faux News and Rush Limbaugh machine. Hopefully, you all can raise your game in the meantime. How about a psychopath didn't get coverage and was released from a state instititution and proceeded to disfigure farm animals who were not covered by the ACA for cosmetic surgery? Hey, its a start!

Originally Posted by The Rani

So much for avoiding crazy-town.

You really thought you had the place all to yourself?

There are several tons of good and wannabe fiction writers; I'm just suggesting you should raise your game a little.

Sorry for already taking the space alien choice. Vampires not getting covered under Obamacare for blood transfusions might be one direction, although vampires have gotten a little passe. Zombies are always good; could you make your next Obamacare suffering friend a zombie? Maybe he got bite on the leg and Obamacare wouldn't cover the amputation; now he's in his mom's basement and the moaning is keeping her up all night and that too isn't covered by the evil Obamacare. Now that's getting pretty cool.

Originally Posted by The Rani

Your compassion for others, as usual, is most remarkable.

We NYers don't buy the Brooklyn Bridge, we sell it to others.

It wasn't even a nice try, Rani; I'm just asking for a little more razzle-dazzle on your next try.

There were 1 million visitors to HealthCare.gov Monday. And there have been 380,000 visitors to HealthCare.gov as of noon today. This is slightly higher traffic than Monday, when 375,000 visitors came to the Web site by noon.

"We know that consumers are actively shopping and enrolling in coverage every day," Medicare spokeswoman Julie Bataille said. "We believe there's an indication that these will grow over time."

But, of course, what we heard all day yesterday was how the site was being overwhelmed, couldn't handle 50k at at time, only 35K; and horrors, so many got an 'error page' telling them they would have to wait on-line or wait for an e-mail notification to come back on. Horrors, I tells ya!

So, just how many millions were turned away like Joseph and Mary?

Approximately 13,000 shoppers Monday ended up in the queuing system. The system began queuing, as we learned Monday, when there were 30,000-some visitors on the Web site. All had the option to drop in their e-mail address and get a note from HealthCare.gov about when would be a good time to return.

OMG! OMG! Let me do the math for you - 13000/1000000 - OMG! OMG! that 1.3%!!!! OMG! It's over! The government cannot govern!!! Head for the hills!!! You know the zombies are coming next!!! OMG! Benghazi! IRS! IRS! Syria! Syria! Mufasa! Mufasa!

Wait a minute, there's more horrors!

"All were invited to come back on the next day," Bataille said. "Sixty percent who received an e-mail did return to the Web site. We had high levels of engagement."

Okay, okay, were now down to 0.5% that were traumatized so much they didn't come back the next day (of course, it might be because they got on with their second try on Monday and didn't need to come back today, but that's not as much fun). Well, that doesn't mean the zombies aren't just down the road!

I return you to your program -

OMG! Benghazi! IRS! Mufasa! Mufasa!

The problem with expecting doctors to be God almighty perfect. We don't want it for teachers but we do for doctors. Something might just be very wrong with that type of thinking.

"There is no debate as to the motivation behind the satisfaction-survey obsession. Administrators and businessmen seeking profits drive it. Period. The sky is blue. The sun sets in the West. Again, we all want our patients leaving our care happy, healthy and satisfied, if at all possible."

"This can make some feel very demoralized, and even cause some to leave the specialty of emergency medicine or medicine in general. Unfortunately, so far, the system which is linked to higher patient death rates has been perpetuated due to the great power imbalance between hospital-based physicians and their much more powerful corporate employers. Hopefully for our patients’ sake, there will be much greater opportunity for positive change in the future."

The focus on patient satisfaction is enough to make you sick

All patients should be treated with professionalism and respect. We all want our patients leaving our care happy, healthy and satisfied, if at all possible. However, sometimes patients don’t leave an emergency department very happy or satisfied. Sometimes the doctor could have prevented it, but many if not most times, such dissatisfaction has little if anything to do with what the treating physician did, or didn’t, do.The reasons for a patient being dissatisfied with a particular healthcare encounter can be very complex. It’s not so simple as to just include a line in a survey such as, “Were you satisfied with your doctor?”


Who should be held responsible for the results of these surveys, is where the crux of this debate lies.
So why are hospitals obsessed with patient satisfaction?


It’s the same reason Walmart puts greeters at the front door (the ED), not the back door (inpatient floors), and the same reason the government collects taxes and not sea shells: money. The question we really need to be asking is: Why is the obsession with patient satisfaction in the ED so soul-crushing to those that work there?

Conclusion:

In a nationally representative sample, higher patient satisfaction was associated with … increased mortality.”

More: http://www.kevinmd.com/blog/2013/11/...tion-sick.html

Originally Posted by Deb C

The problem with expecting doctors to be God almighty perfect. We don't want it for teachers but we do for doctors. Something might just be very wrong with that type of thinking.

"There is no debate as to the motivation behind the satisfaction-survey obsession. Administrators and businessmen seeking profits drive it. Period. The sky is blue. The sun sets in the West. Again, we all want our patients leaving our care happy, healthy and satisfied, if at all possible."

"This can make some feel very demoralized, and even cause some to leave the specialty of emergency medicine or medicine in general. Unfortunately, so far, the system which is linked to higher patient death rates has been perpetuated due to the great power imbalance between hospital-based physicians and their much more powerful corporate employers. Hopefully for our patients’ sake, there will be much greater opportunity for positive change in the future."

This is the same sentiment that workers in most occupations at almost all levels have voiced about their own situations. Eventually, there will be a backlash ... but when?

Originally Posted by Marx & Lennon

This is the same sentiment that workers in most occupations at almost all levels have voiced about their own situations. Eventually, there will be a backlash ... but when?

I would imagine more than a few elected officials feel the same way, particularly the one in the WH.

Interesting to see who is bringing this up.

Originally Posted by Marx & Lennon

This is the same sentiment that workers in most occupations at almost all levels have voiced about their own situations. Eventually, there will be a backlash ... but when?

Your so right. So many people are living in fear of losing their jobs, so they become servants to the corporate masters. But there comes a time, the backlash you mentioned, when they will realize that there's strength in numbers. There will always be the Norma Rae's in times of oppression who will eventually surface to encourage others to band together as one strong voice of dissent.



About the brave woman who put her job on the line to organize others to unionize.

"The story is based on Crystal Lee Sutton's life as a textile worker in Roanoke Rapids, North Carolina, where the battle for the workers union took place against a J.P Stevens Textiles mill. Her actual protest, in the mill, is the scene in the film where she writes the sign "UNION" and stands on her worktable until all machines are silent. Although Sutton was fired from her job, the mill became unionized, and she later went to work as an organizer for the textile union"

- you all are going to get sick of this, but it's going to keep a-coming!

http://videocafe.crooksandliars.com/...-healthcaregov

Consumer Reports gives thumbs up to Healthcare.gov
By scarce

Back in October right wing pundits of all shapes and sizes, most notably Sean Hannity on Fox News, was crowing that Consumer Reports had thrown in the towel on Obamacare, fed up with an unworkable website. And while that part was a lie, they did advise waiting a month or so while the website was fixed. Today though they're singing a completely different tune, calling the new site at HealthCare.gov "terrific".

After advising consumers to steer clear of Healthcare.gov in October, Consumer Reports health care expert Nancy Metcalf told MSNBC’s Chuck Todd Tuesday morning that the federal health care exchange website was improved enough following the Obama administration’s frantic month of repairs that users could confidently use it. […]

“Now we’re saying, ‘it’s time,’” Metcalf said, in particular praising the new window-shopping function, in which users can peruse health plans without registering with the site. The requirement to make an account before viewing options was considered one of the main causes for the site’s initial traffic bottleneck. “It’s terrific, I’ve tried it, it was working yesterday through the busiest times,” Metcalf said.

http://www.youtube.com/watch?v=DkJ6OScQshI

cue the crickets.

Traffic to HealthCare.gov is still higher than normal. The site had 310,000 visitors Wednesday morning, which is 80 percent higher than where things were last Wednesday morning, Medicare spokeswoman Juile Bataille said.

The site has been pretty stable with error rates of 0.6 percent and pages loading in 630 milliseconds.

But to show I care for the handwringers and naysayers, I'll feed you the emerging 'crisis' to get all foamed up again -

Health reporters still want more 834 data. Three reporters, including myself, made another attempt to get information on errors effecting the 834 transmissions, the files the exchange sends to insurance plans when someone signs up for their plan. We know there have been some problems with these transmissions, but don't have a great sense of how many problems -- or how quickly those problems are getting fixed.

"I can appreciate the frustration," Bataille told Bloomberg's Alex Wayne when he brought up the issue. "We believe the vast majority of the fixes are now in place."

Louise Radnofsky from The Wall Street Journal followed up, asking for a reason why the error rate would not be shared. "As I just mentioned, we are actively working with issuers to assess the fixes and validate the numbers," Bataille said.

"We've heard numbers like 80 percent [of the errors were from one bug]," Radnofsky pressed. "There must be a number out there."

"What we've reported on there was that we believed there to be a transaction issue causing those inaccuracies," Bataille responded. "As we validate the assessment of the fixes, we will report on our progress."

"So it's a validation issue?" Radnofsky asked.

Medicare spokesman Richard Olague cut in.

"We’ll have to move on to the next question," he said.

Looks like the website people are going all Nixonian (18.5 minute tape gap) or Clintonian (depends on the definition of "is")!!!

Now come on folks, let's start foaming!

Benghazi! IRS! 834! 834! Mufasa! Mufasa!

The Good, the Bad and the Ugly.

The real fix for Obamacare's flaws: Medicare for all

There's no reason to rollback the progress the ACA has made. But we should go all the way and dump the for-profit system

The ACA tackles some of the most egregious inequities: lack of access for many of the working poor who will now be eligible for Medicaid or subsidies to offset some of their costs for buying private insurance through the exchanges, a crackdown on several especially notorious insurance abuses, and encouragement of preventive care.But the law actually further entrenches the insurance-based system through the requirement that uncovered individuals buy private insurance. It's also chock full of loopholes.


Some consumers who have made it through the website labyrinth have found confusing choices among plans which vary widely in both premium and out of pocket costs even with the subsidies, a pass through of public funds to the private insurers.


The minimum benefits are also somewhat illusory. Insurance companies have decades of experience at gaming the system and warehouses full of experts to design ways to limit coverage options.


The ACA allows insurers to cherry pick healthier enrollees by the way benefit packages are designed, and as a Washington Post article noted on 21 November, consumers are discovering insurers are restricting their choice of doctors and excluding many top ranked hospitals from their approved "network".


The wide disparity between the healthcare you need, what your policy will cover, and what the insurer will actually pay for remains.


Far less reported is what registered nurses increasingly see – financial incentives within the ACA for hospitals to prematurely push patients out of hospitals to cheaper, less regulated settings or back to their homes. It also encourages shifting more care delivery from nurses and doctors to robots and other technology that undermines individual patient care, and that may work no better than the dysfunctional ACA websites.


Is there an alternative? Most other developed nations have discovered it, a single-payer or national healthcare system.

Entire article: http://www.pnhp.org/news/2013/decemb...dicare-for-all

Originally Posted by Deb C

The Good, the Bad and the Ugly.

The real fix for Obamacare's flaws: Medicare for all

There's no reason to rollback the progress the ACA has made. But we should go all the way and dump the for-profit system




Entire article: http://www.pnhp.org/news/2013/decemb...dicare-for-all

I'd like this to happen in the long run, too.

Originally Posted by annla899

Originally Posted by Deb C

The Good, the Bad and the Ugly.

The real fix for Obamacare's flaws: Medicare for all

There's no reason to rollback the progress the ACA has made. But we should go all the way and dump the for-profit system

I'd like this to happen in the long run, too.

If this will ever happen, it will be a two step affair.
Step 1: mandate the inclusion of a public option on all exchanges. As an alternate - bring them all together under a national exchange and just add the option directly.
Step 2: Wait for the pricing power of the public option to drive most of the other options out of the market, then offer the insurance companies a choice to exit the exchanges and go into supplimental insurance (see Medicare) or stand and fight.

That should do it.

Originally Posted by Marx & Lennon

If this will ever happen, it will be a two step affair.
Step 1: mandate the inclusion of a public option on all exchanges. As an alternate - bring them all together under a national exchange and just add the option directly.
Step 2: Wait for the pricing power of the public option to drive most of the other options out of the market, then offer the insurance companies a choice to exit the exchanges and go into supplimental insurance (see Medicare) or stand and fight.

That should do it.

I think there's a few steps in between.

We need a couple small states (e.g., Vermont, so far) or a medium size state (KY would be incredible good choice) to test the waters with the public option and be successful (or near successful but obvious that a helping hand from the feds would put them over the top). Sub-step here will be the Dems somehow sneaking that support into some unrelated bill with a little backroom horse trading.

Then it needs to entice either CA or NY, preferable both, to start moving in that direction and having their powerful national delegates put the pressure on for US Congressional support.

At the same time, before or after these states move on single payer, they need to be moving on making inter-state pacts to combine their exchanges with a couple other states and with public option coming along for the ride.

Then we move into nationalizing it.

These steps are all dependent on a Dem in the WH in 2016 and a majority in the Senate. With a Dem House majority as well and we could skip my steps and go into yours directly; but without that, my steps are basic requirements.

It's gonna happen.

Originally Posted by playwrite

I think there's a few steps in between.

We need a couple small states (e.g., Vermont, so far) or a medium size state (KY would be incredible good choice) to test the waters with the public option and be successful (or near successful but obvious that a helping hand from the feds would put them over the top). Sub-step here will be the Dems somehow sneaking that support into some unrelated bill with a little backroom horse trading.

Then it needs to entice either CA or NY, preferable both, to start moving in that direction and having their powerful national delegates put the pressure on for US Congressional support.

At the same time, before or after these states move on single payer, they need to be moving on making inter-state pacts to combine their exchanges with a couple other states and with public option coming along for the ride.

Then we move into nationalizing it.

These steps are all dependent on a Dem in the WH in 2016 and a majority in the Senate. With a Dem House majority as well and we could skip my steps and go into yours directly; but without that, my steps are basic requirements.

It's gonna happen.

Do any of you feel that with more support from Congress Obama would have pushed, and probably even won, single payer healthcare? After all, isn't that what he campaigned on in 2008?