Orange Julius spent the campaign, the transition, and the first month of his occupancy of the office of president proclaiming that his great new health care plan would cover everybody, with better health care, at lower cost. Only a few fringe lunatics like Paul Krugman and Cervantes had the audacity to claim this was not possible.
After 8 years of screaming about death panels and socialism, and passing -- what was it, 36? -- bills to repeal the ACA, secure in the knowledge that president Obama would veto them, Republicans suddenly found themselves in the untenable position of actually being able to do what they had campaigned on for the past 8 years. What we learned from the exercise is that they do not in fact know anything about health care policy.
There is no such thing as a free market for health care, there are no free market solutions, and the only way to secure liberty for people is through a market that is structured and regulated by government. The best way is universal, comprehensive single payer national health care; but some countries manage to do it with kludgier solutions. Switzerland, for example, has Obamacare +. It has private insurance companies competing for customers, selling tightly regulated policies. They cut out the middleman with the individual mandate and subsidies, and instead give everybody a voucher to buy insurance, funded by taxes. Britain has real socialized medicine, with physicians as government employees. Canada's physicians are mostly private entrepreneurs, but their customers have insurance provided by the government.
There are a few ways to do it but the reality is:
- Every affluent, capitalist democracy on earth spends less -- a lot less -- on health care than the U.S.
- Every one of them covers 100% of their citizens and legal residents, with good, comprehensive insurance.
- Their populations are healthier than ours and live longer.
- Their people are more content with their health care systems than we are.
- They all enjoy freedom or liberty or whatever you want to call it more than we do, because they don't live in perpetual fear of being wiped out by serious illness or dying on the street.
1 comment:
This failure of the Republicans to pass the AHCA demonstrates the party is a coalition party with different factions and is not one monolithic governing body in lockstep which is better for democracy, but makes it more difficult for the party to effectively govern.
It also demonstrates the politics involved when this same party was able to vote umpteen times to repeal ACA and now, when they have the majority, can't seem to muster the balls to do it one more time.
2017 is the year in which the ACA's "shared responsibility" penalties (SCOTUS says taxes) will go into overdrive and the premiums and deductibles will rise dramatically. Time, Inc. projects that about one third of the counties will have only one healthcare.gov insurance provider in 2017.
Regardless of which side you're on, it's pretty clear that the ACA, as it stands, is in deep trouble.
So, NOW who will take the blame if this thing goes tits up?
Republicans for not passing an unpopular bill, or the Democrats for passing an unpopular bill?
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