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View Diary: Obama Should Agree to Modify Obamacare in Return for Ending the Bush Tax Cuts for Top 2% (76 comments)

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  •  Is there no cost associated with the public (0+ / 0-)

    option?  Your proposal is completely illogical otherwise.

    •  Actually, a public option would reduce the debt (10+ / 0-)

      According to CBO studies.

      Republicans are far more socialist than Democrats. Just because they want to redistribute the wealth upwards does not make it any better.

      by MrAnon on Mon Nov 26, 2012 at 07:42:18 PM PST

      [ Parent ]

      •  By how much? At what cost? (0+ / 0-)

        Obamacare reduces the deficit in its present form, so ...

        •  68 billion through just 2020 (3+ / 0-)
          Recommended by:
          KenBee, corvo, qofdisks

          The cold passion for truth hunts in no pack. -Robinson Jeffers

          by Laurence Lewis on Mon Nov 26, 2012 at 08:05:56 PM PST

          [ Parent ]

          •  Is that 68 billion *more* than (1+ / 0-)
            Recommended by:
            wwjjd

            Obamacare in its present form, or 68 billion in savings?

            I'm sure the public would reduce the deficit.  My original point is that the proposal to substitute a public option for the current mechanism is meaningless if the public option costs more to administer and/or doesn't cut the deficit by much more than current law.

            •  CBO estimates the ACA would save $84B thru 10 yrs (2+ / 0-)
              Recommended by:
              fou, corvo
            •  even if it cuts the deficit exactly the same (3+ / 0-)
              Recommended by:
              ManhattanMan, corvo, qofdisks

              it provides more coverage options to more people, and reduces their costs, which makes it a good deal. of course the gop wouldn't ever go for it, but it's still a clever idea, for political framing.

              The cold passion for truth hunts in no pack. -Robinson Jeffers

              by Laurence Lewis on Mon Nov 26, 2012 at 08:29:41 PM PST

              [ Parent ]

              •  Actually, the proposed framing is that the (1+ / 0-)
                Recommended by:
                charliehall2

                public option would cost less.  That framing is probably incorrect. Your argument seems to be that even if it costs the government the same or a little more, it still lowers people's costs and provides them more options.  My question is does it provide more and better options at a lower cost than the present mechanism?

                •  the cbo didn't score that (2+ / 0-)
                  Recommended by:
                  KenBee, corvo

                  but there is no question that a public option provides more and better options, and for some if not most at a lower price.

                  The cold passion for truth hunts in no pack. -Robinson Jeffers

                  by Laurence Lewis on Mon Nov 26, 2012 at 08:40:15 PM PST

                  [ Parent ]

                    •  more options at lower overhead- (6+ / 0-)

                      no profit motive surcharge. and actually the cbo did score it- lowers premiums across the board:

                      http://www.cbo.gov/...

                      http://voices.washingtonpost.com/...

                      The cold passion for truth hunts in no pack. -Robinson Jeffers

                      by Laurence Lewis on Mon Nov 26, 2012 at 08:48:33 PM PST

                      [ Parent ]

                      •  The present mechanism lowers (2+ / 0-)
                        Recommended by:
                        KenBee, agent

                        premiums as well.  And again, there may be other "surcharges" associated with government-run health insurance.

                        Look, if a public option works better than the present mechanism, then let's have it by all means.  But I'm wary of the idea that it's better simply because there's no profit.  The government is not any more or less ethical than a private entity simply because it is not in the business of making a profit providing health insurance.  Nor would a public option provide better quality care for those reasons.  Indeed, as Mitt Romney demonstrated with his Son of Boss scheme, it is entirely possible to corrupt government-run health insurance.

                        I think the ACA is a big leap forward because it prohibits discrimination and other adverse incentives for profit.  Now, if it can be shown that a lack of profit incentive and a centralized federal program will provide better quality care at lower cost than regulated private insurance, then great; but thus far I'm not convinced either way.

                        •  so you're opposed to a public option. Ok. (1+ / 0-)
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                          corvo

                          I don't know why but for some reason you react negatively to it. I can guess but it'd just be a guess. Probably right, though.

                          •  I'm not opposed to a public option. (0+ / 0-)

                            Not at all.  I am skeptical of the idea that non-profit health insurance is ipso facto better than regulated, for-profit insurance.

                          •  Of course it is -- profit is only acceptable when (3+ / 0-)
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                            Karl Rover, corvo, qofdisks

                            the profit motive adds value to the enterprise -- there is absolutely no reason for profit in financing health care.

                          •  Again, this is a simplistic, ideological view (0+ / 0-)

                            of a complex problem.  You can't make the claim that non-profit health insurance is better and cheaper simply because you don't like profit.  Obviously, non-profit insurance is not free.  What are the costs associated with its implementation?  Why would tax-subsidies produce better care than well-regulated competition between private entities?

                            I'm not saying that a for-profit system is better.  I'm simply saying that without a meaningful discussion of the costs and incentives associated with centralized, government-run health insurance, you can't really say that it's better than that produced by for-profit companies in a competitive marketplace.

                          •  We are not talking aout non-profit insurance. (0+ / 0-)

                            We are talking about a public option to pay premiums to basically opt into medicare.

                          •  Non-profit is bogus (0+ / 0-)

                            I belonged to a "nonprofit" HMO for healthcare many years ago.  I did get great healthcare but I was not sick or have any particularly pressing medical conditions.  If I had been sick it could have been a very different story.  

                            Regarding its non-profit status: I paid 500/month for a premium and this was back in 1988, I can't imagine what it would cost now, and I was single.  They were a non-profit, they gave out huge bonuses every year.  A friend worked there as a check in type person and she received 5K per year in bonuses.  Great for her but considering her position with the organization her bonus was low but that was how they maintained "non profit" status.

                            So, in my opinion, nonprofit, so what.

                        •  um (4+ / 0-)

                          the profit motive adds a surcharge by itself that isn't present in a government run program. in our system, a multi-billion dollar surcharge that serves no public or health care interest. and the aca has huge holes in it, such as erisa 514, which should have been eliminated but wasn't, and which provides a mechanism that allows insurers to deny treatment even if they can't deny coverage- the difference between guaranteed insurance and guaranteed health care.

                          The cold passion for truth hunts in no pack. -Robinson Jeffers

                          by Laurence Lewis on Mon Nov 26, 2012 at 09:19:46 PM PST

                          [ Parent ]

                          •  Well duh. (3+ / 0-)
                            the profit motive adds a surcharge by itself that isn't present in a government run program.
                            Yes Laurence, but there might be other "surcharges" that are present in a government-run program versus a private one.  
                            in our system, a multi-billion dollar surcharge that serves no public or health care interest
                            Well, the ACA has just re-calibrated the market incentives such that they now serve a public interest.  Now, insurance costs less because healthy people are required to buy it, and taxpayers pay less because they're not having to subsidize the cost of emergency care for the uninsured.  The whole point of the ACA was to incentivize private insurers to serve the public interest.
                            and the aca has huge holes in it, such as erisa 514, which should have been eliminated but wasn't, and which provides a mechanism that allows insurers to deny treatment even if they can't deny coverage- the difference between guaranteed insurance and guaranteed health care.
                            ERISA was enacted in 1974 and is not part of the ACA.
                            http://en.wikipedia.org/...

                            A public option wouldn't guarantee health coverage or care because it doesn't require people to purchase insurance through its program.  The public option would lower the cost of insurance presumably through tax subsidies, but it wouldn't guarantee anything.

                          •  you're missing the point (3+ / 0-)
                            Recommended by:
                            james321, corvo, qofdisks

                            the continuing existence of erisa 514 is a hole in the aca large enough to drive countless deaths by denial of treatment through. it renders the requirement of insurance coverage to people with preexisting conditions practically meaningless, because insurers can just take the money and then refuse to pay for expensive treatments.

                            a public option, with a mandate (which most hardcore obama supporters considered unacceptable in 2008), and a repeal of erisa 514 would lower costs and expand actual health care (as opposed to healh insurance) coverage, at lower costs to consumers, while also lowering the deficit. it would be as close to single payer as you could get without it being single payer. the aca will help a lot of people, but don't for one minute pretend it is anything but one step on a still long path toward a comprehensive solution. a path that the aca itself does not necessitate we ever take.

                            The cold passion for truth hunts in no pack. -Robinson Jeffers

                            by Laurence Lewis on Tue Nov 27, 2012 at 03:01:05 AM PST

                            [ Parent ]

                        •  Government is more ethical in the sense that (0+ / 0-)

                          a government agency does not have any civil servant looking to get stinking rich.  Civil servants draw a dignified paycheck.  
                          Huge profit taking and executive salaries inherently have unethical profit taking and denying of care as an incentive.
                          So, this statement is nonsense.
                          "The government is not any more or less ethical than a private entity simply because it is not in the business of making a profit providing health insurance. "

                    •  No spending on... (2+ / 0-)
                      Recommended by:
                      corvo, qofdisks

                      ...Advertising.
                      Bloated CEO salaries.
                      Dividends to shareholders.
                      Interest payments.

                      •  All minor contributors to the cost of health care (0+ / 0-)
                        •  Hell, no! (1+ / 0-)
                          Recommended by:
                          qofdisks

                          Take United Health Care (ticker: UNH) for example.

                          They collected $101 billion in premiums last year and spent $19 billion on "administration". Their shareholders pocketed $5 billion (after taxes). Bondholders got $500 million.

                          Financials are here.

                          Only about $74 billion went to actual healthcare! And even that number is suspect because the company can embed internal costs (like the commissions for the salesmen who sell policies) in this number.

                          For every $1.00 policyholders pay UNH, they get back less than 75 cents in medical care.

      •  So will (1+ / 0-)
        Recommended by:
        qofdisks

        the ACA.

        What makes you think logical argument with statistics will persuade the gop to go along?

        Change will not come if we wait for some other person or some other time. We are the ones we've been waiting for. We are the change that we seek. Barack Obama

        by delphine on Mon Nov 26, 2012 at 08:38:54 PM PST

        [ Parent ]

        •  Well the public option + ACA (1+ / 0-)
          Recommended by:
          corvo

          Will reduce the deficit even more. But as you see in my comment below, I don't think the GOP will go along with this until hell freezes over. I was just answering the question of deficit reduction. In a rational discussion, something like a public option would be a great thing to keep on the table. But we are not negotiating with rational people.

          Republicans are far more socialist than Democrats. Just because they want to redistribute the wealth upwards does not make it any better.

          by MrAnon on Mon Nov 26, 2012 at 10:08:47 PM PST

          [ Parent ]

        •  It won't persuade them. (2+ / 0-)
          Recommended by:
          bluezen, corvo

          It will just make them look stupid.

          It will also make them chew up a few more days until The Fiscal Cliff.

          The goal is to run down the clock until the last minute.  At that point, whoever has the better issue framing will win.  Let's hope it's us...

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