Sen. Bernie Sanders told CBS News he's "very disappointed" by the bill to end the government shutdown, calling a planned vote on health insurance subsidies "meaningless."
Can someone explain to me simply (and I’m assuming the answer to that is “no”), why they can’t force the insurance companies to compete with each other on price. That would seem to be the obvious “free market republican” thing to do, and a prerequisite for removing the fat subsidy to the insurance companies that they’re currently trying to remove.
So insurance companies have to pay back out to their insured 85% of all money they collect each year. Been that way since the 1970’s.
What this means is that they WANT medical costs to be as high as possible. 15% of a $2,000 ambulance ride is a lot more than 15% of a $500 ambulance ride.
So the insurance companies have spent decades forcing hospitals to increase costs (charge more or we’ll make your hospital out of our network and no one will come to your hospital).
What this means is that as long as insurance companies exist, there isn’t really a “compete on costs” possibility. They’re already paying back out 85%. At most they might be able to make things 5% cheaper. There’s no competition because there’s no real areas to cut costs, by design.
The only fix is to eliminate insurance all together and go single payer, or to legally force hospitals to drop all their billing costs down to levels on par with the rest of the world, and both those options will be fought tooth and nail by insurance companies, since one would make their business disappear and the later would make their 15% cut for profits and overhead vastly smaller.
It wasn’t the best that could get passed. The Dems had a super majority during Obama’s 1st two years and could have gotten us Medicare for all, but Rahm Emmanuel blocked it.
Rahm wasn’t the bad guy. He was one of many bad guys. The list of Democrats (politicians, not voters) who were actually for Medicare for all was smaller than the list who were actually against it. Not because it would be bad policy, but because $$$$.
Joe Lieberman blocked it. Rahm Emanuel was just the president’s chief of staff who tried to talk him out of it. Joe Lieberman was the senator from Connecticut, where all the old money lives.
B) are only half the problem (the other half being hospitals and pharmaceutical companies cranking prices up)
C) Most Americans get their insurance through their employer
and
D) Healthcare costs are complicated because they’re split between insurance premiums and out of pocket expenses and typically raising one lowers the other and vice versa
Insurance was always a terrible way to handle healthcare expenses because healthcare costs are generally non-discretionary and have far too many moving parts and payers.
Those are all caused by them not needing to compete. Throw a few execs in jail for collusion to defraud their clients (the employers), and the other issues all go away.
Only the first one can be fixed by competition, the rest aren’t impacted by that at all. There are too many moving parts for it all to magically go away by just saying “make them compete”. For instance what happens when insurance companies compete to offer the best deals on group rates to employers but then charge exorbitant premiums to employees? Or what if insurance premiums all magically came down but pharmaceutical prices kept skyrocketing?
Medical costs are an inelastic demand as well as a non-discretionary expense. That’s an absolutely terrible combination which means they’re almost entirely isolated from market forces.
Consider for instance a situation I find myself in. I need a certain medication for a permanent medical condition. Fortunately there are multiple medications available (often due to patents there’s only a single option). Unfortunately I’m allergic to all but one of them. That means it doesn’t matter if the pharmaceutical company is charging $5 or $5000 I’m paying for it. I literally have no choice. Whether my insurance pays for 100% of that or 0% doesn’t change what the pharmaceutical company is charging. Further for insurance I was offered a choice of about 5 different plans through my employer (which is a lot by most standards, often employers only offer one or two plans). My insurance is by all metrics terrible, I pay thousands of dollars every year in deductibles, but once I hit those deductibles it covers everything at 90% which with my medical expenses save me tens of thousands of dollars a year. There are cheaper plans of course, but then the tradeoff is that I’m restricted to a tiny handful of doctors who are all terrible and every single medical decision has to be pre-approved by the insurance company or they don’t cover it and I’d rather pay the extra thousand dollars a year to keep those decisions between me and my doctors.
The US medical system is a hydra and fixing any one part doesn’t actually solve anything. The entire system needs to be overhauled top to bottom. Switching to a single payer system is just the first step in that process but it’s a necessary one because otherwise the problem is intractable. It’s likely the patent system is going to need to be overhauled at least with regards to medications before it’s fixed as well.
The Republicans know the free market is a myth and the only way to win in a capitalist system is to start rich and cheat. This involves convincing the plebs to believe in a free market.
The simple answer is that they would make less money if they did that, so it’s very important to convince the American public that it isn’t necessary and we should vote for people who will not enact it.
Can someone explain to me simply (and I’m assuming the answer to that is “no”), why they can’t force the insurance companies to compete with each other on price. That would seem to be the obvious “free market republican” thing to do, and a prerequisite for removing the fat subsidy to the insurance companies that they’re currently trying to remove.
So insurance companies have to pay back out to their insured 85% of all money they collect each year. Been that way since the 1970’s.
What this means is that they WANT medical costs to be as high as possible. 15% of a $2,000 ambulance ride is a lot more than 15% of a $500 ambulance ride.
So the insurance companies have spent decades forcing hospitals to increase costs (charge more or we’ll make your hospital out of our network and no one will come to your hospital).
What this means is that as long as insurance companies exist, there isn’t really a “compete on costs” possibility. They’re already paying back out 85%. At most they might be able to make things 5% cheaper. There’s no competition because there’s no real areas to cut costs, by design.
The only fix is to eliminate insurance all together and go single payer, or to legally force hospitals to drop all their billing costs down to levels on par with the rest of the world, and both those options will be fought tooth and nail by insurance companies, since one would make their business disappear and the later would make their 15% cut for profits and overhead vastly smaller.
Because insurance doesn’t work like a normal product or good.
What ends up happening is they charge as much as they possibly can. The book “an American sickness” explains all the problems if you’re interested.
The ACA was never going to be great. It was the best that could get passed.
It wasn’t the best that could get passed. The Dems had a super majority during Obama’s 1st two years and could have gotten us Medicare for all, but Rahm Emmanuel blocked it.
Rahm wasn’t the bad guy. He was one of many bad guys. The list of Democrats (politicians, not voters) who were actually for Medicare for all was smaller than the list who were actually against it. Not because it would be bad policy, but because $$$$.
Joe Lieberman blocked it. Rahm Emanuel was just the president’s chief of staff who tried to talk him out of it. Joe Lieberman was the senator from Connecticut, where all the old money lives.
Lieberman blocked the public option
Fuckin’ jowely Joe. Fucked us.
Nope. Even for the ~60 days they technically had it, they still had to contend with Senator Byrd being out of session due to health issues.
PBMS was a cool invention – for corporate healthcare.
Cuz health insurance and health care are both very expensive fields, and they’re in opposition to each other, so they both tend towards monopoly.
And from the consumer’s perspective:
Mostly because:
A) Insurance companies collude with each other
B) are only half the problem (the other half being hospitals and pharmaceutical companies cranking prices up)
C) Most Americans get their insurance through their employer
and
D) Healthcare costs are complicated because they’re split between insurance premiums and out of pocket expenses and typically raising one lowers the other and vice versa
Insurance was always a terrible way to handle healthcare expenses because healthcare costs are generally non-discretionary and have far too many moving parts and payers.
Those are all caused by them not needing to compete. Throw a few execs in jail for collusion to defraud their clients (the employers), and the other issues all go away.
Only the first one can be fixed by competition, the rest aren’t impacted by that at all. There are too many moving parts for it all to magically go away by just saying “make them compete”. For instance what happens when insurance companies compete to offer the best deals on group rates to employers but then charge exorbitant premiums to employees? Or what if insurance premiums all magically came down but pharmaceutical prices kept skyrocketing?
Medical costs are an inelastic demand as well as a non-discretionary expense. That’s an absolutely terrible combination which means they’re almost entirely isolated from market forces.
Consider for instance a situation I find myself in. I need a certain medication for a permanent medical condition. Fortunately there are multiple medications available (often due to patents there’s only a single option). Unfortunately I’m allergic to all but one of them. That means it doesn’t matter if the pharmaceutical company is charging $5 or $5000 I’m paying for it. I literally have no choice. Whether my insurance pays for 100% of that or 0% doesn’t change what the pharmaceutical company is charging. Further for insurance I was offered a choice of about 5 different plans through my employer (which is a lot by most standards, often employers only offer one or two plans). My insurance is by all metrics terrible, I pay thousands of dollars every year in deductibles, but once I hit those deductibles it covers everything at 90% which with my medical expenses save me tens of thousands of dollars a year. There are cheaper plans of course, but then the tradeoff is that I’m restricted to a tiny handful of doctors who are all terrible and every single medical decision has to be pre-approved by the insurance company or they don’t cover it and I’d rather pay the extra thousand dollars a year to keep those decisions between me and my doctors.
The US medical system is a hydra and fixing any one part doesn’t actually solve anything. The entire system needs to be overhauled top to bottom. Switching to a single payer system is just the first step in that process but it’s a necessary one because otherwise the problem is intractable. It’s likely the patent system is going to need to be overhauled at least with regards to medications before it’s fixed as well.
Cause then those companies would have less to kickback to their government cronies
This was my first guess also. “Legalized Lobbying”
The Republicans know the free market is a myth and the only way to win in a capitalist system is to start rich and cheat. This involves convincing the plebs to believe in a free market.
The simple answer is that they would make less money if they did that, so it’s very important to convince the American public that it isn’t necessary and we should vote for people who will not enact it.