Reply #29: You can't generalize about what DU would accept. [View All]

[clear eye]

I would accept the 4% income tax increase that PNHP says would be the cost of single payer health care because the costs wouldn't spiral out of control like those generated by this bill would. (This bill doesn't negotiate w/ Big Pharma or providers, it sets % of revenue spent on "medical loss", which means for patient benefits, at even lower than it is now, and specifically prevents the "public option" from paying providers less than private insurers do whatever that turns out to be. The political will for keeping up in subsidies w/ spiraling premium costs makes it questionable that expenses for non-wealthy individuals will remain affordable. Even at the outset, some analysts figure that the permitted deductibles, copays, and unsubsidised premiums would make medical care a hardship for many. There would have to be effective political will in the same Fed gov't that is getting its campaigns paid by private insurers to bring anti-trust cases when price fixing occurs.)

Medicaid already makes health care for the truly poor almost free in exchange in many areas for a shortage of doctors, especially specialists, and in many cases second-rate care. This bill mandates the uncovered near-poor also enroll in Medicaid unless they are exempt from filing taxes. It doesn't prevent important abuses like mischaracterizing expensive essential treatments as "experimental" as a way of denying them. Most of the uninsured will be covered by law or fined, but the real question is covered for what? In MA a similar law led to pseudo-insurance masquerading as "catastrophic coverage". Medical bankruptcy is still significant.

You won't always be young. When this program degenerates as the private insurers become even wealthier as a result of the mandate and more important as campaign financers, how will your generation of then 40-somethings exercise any leverage to improve things?