Another article that doesn't mention how much these programs cost - how the costs are exploding every year and taking more and more of state and federal budgets.
Of course people are going to approve of these programs, they think they're free.
Once again Dems have a policy problem, Reps help ease with their lousy messaging. Medicaid and Obamacare are popular, because they are free or heavily subsidized. If DC handed out free cars based on income, those cars would also be popular.
Increasingly, healthcare is a game of 3 card monty, with vast costs being moved around the table in a manner that precludes Americans from knowing what their healthcare actually costs. The system appears to purposefully camouflage costs, so Americans have no idea what part of their payments provide their own healthcare, and what part provides healthcare for someone else, paying nothing. When people need an oil change, they can call 3 businesses and know the least expensive. That is not possible for most routine healthcare.
Moreover, imagine the cost of oil changes, if they were free for 1/3 of drivers, and the remaining 2/3rds had to cover their own oil changes, and the cost of the 1/3 who pay nothing. 40% of Californians and 36% New York residents, our 1rst and 4th most populace states, are enrolled in Medicaid.
In less the last 25 years, US Medicaid enrollment has more than doubled. In the not too distant future, Medicaid enrollment is expected to hit 100 million. There are only 335 million people in the US. If nearly 1/3 of the US pays nothing for healthcare, the other 2/3rds have to pay much more. It is simple Math.
The focus of American healthcare, as of late, has little to do with improving anyone's health. Most effort is directed at stealthily reallocating costs, as increasingly, large swaths of of people pay little to nothing, which means fewer Americans are left to pick up the ever increasing tab.
We have morphed from providing healthcare for truly needy Americans, to paying the healthcare of people simply good at manipulating their incomes and the world's needy, who have recently arrived in the US, unable to afford our expensive American healthcare system, no matter how hard they toil. The names of particular programs have increasingly little relevance. At the end of the day, all healthcare bills must be paid by someone.
All, as overall costs grow at an unsustainable clip, aided by the DC 3 card monty game. Problems must be quantified to be fixed. Both Dems and Reps understand the problem, they are simply loathe to admit it. Nor can it be corrected, without destroying much of the current system, while introducing competition and demanding absolutely everyone, but the truly neediest Americans, have some skin in the game.
I'm surprised the Republicans haven't revived a policy from Trump's first term, expanding short term health insurance contracts. These are health insurance plans that don't require all of the bells and whistles (and cost) in a typical Obamacare plan. They were also about 60% cheaper. This type of plan was always in Obamacare; Biden sharply restricted them. The interesting thing is they were expanded by executive order, which survived the courts. Yet the Trump administration has shown no interest in action.
One could dare to dream that it’s because he wants Congress to make them long term by adding the expansion to any deal. Low cost catastrophic coverage with a HSA is probably the best option for most people. Especially if we can get price transparency into the system.
It must be a wonderful thing to align with a political party that is responsible causing massive problems being able to pin it on the other party for not fixing the problems. It makes sense though as the entire population of Democrat is prone to a feminized victim mindset. It is not THEIR fault... it is always someone else's fault. And how DARE you criticize us Democrats because everything we do is based on virtue and empathy for the downtrodden and oppressed. This is true even as the evidence keeps pouring in that everything we do causes more harm and pain to the downtrodden and oppressed.
If you want public healthcare you need to get serious about controlling the border including deportations from the interior of every non-citizen who uses any social services. Next you need to get the country on board with a massive broad based tax increase. Something along the lines of a 20-25% national VAT. Anything else is simply promising free stuff for votes with no regard to the long term consequences.
Amazingly enough, Bernie Sanders once said the same thing as you do here. He was asked if middle class Americans would have to pay similar amounts of taxes (percentage of gross income) as middle class Europeans do if the U.S. ever has a welfare state as generous as the European social democracies. To his great credit, Sanders said YES. Every other elected Democrat states or strongly implies otherwise, that just taxing "the rich" more can pay for such public generosity.
Controlling healthcare costs and undocumented immigrants have nothing to do with each other. Undocumented immigrants who stay for any length of time are not "draining the system". They pay taxes, including social security taxes from which they collect no benefits. They are thus a net profit for the healthcare system, not a loss.
If they are paying social security taxes then they have committed identity theft and done a gross injustice to whoever’s social security number they have stolen. Social Security payments also have nothing to do with funding healthcare.
It’s simple basic math that any welfare system needs more people paying more money into it than there are people taking money out of it. The vast majority of illegals fall into the latter. You can either have a relatively open immigration system or a robust welfare state. Pretending otherwise is either delusional or fraudulent.
actually, the data show that the majority of illegals are putting more money into the system than they are taking out. Because they are illlegal, It is difficult, usually impossible, for them to collect any benefits from the system they are putting money into. The withholding taxes taken from paychecks go into both Medicare and Social Security.
The question of identity theft has moral implications, of course, but that has nothing to do with the financial impact of illegal immigrants. The government benefits financially from this particular kind of identity theft, as does the person whose identity is stolen, because they end up getting higher benefits based on work they didn’t do. If you wanna start another discussion about the moral implications of identity theft, feel free. But don’t mix it up into questions about the financial viability of health services.
The data you cite ignore both the services they use up for their anchor babies and states using joint funding to provide Medicare to illegals. Something Newsom was recently bragging about to The NY Times. Again it’s simple math you cannot import a large underclass and provide generous benefits. Even the Euros are discovering that their welfare states are draining their treasuries due to their decision to import a fraction of the underclass Biden waived in.
Thanks for this link. This is a more nuanced issue thanI realized, and I appreciate the things I learn from reading this article. I t clearly shows that identity theft hurts many innocent people in ways that didn’t occur to me. The govt clearly need to go back to sending out “no match letters” and do whatever else is necessary to catch who is ever doing this. However, there is nothing in this article that shows that identity, theft, or anything else done by illegal immigrants is jeopardizing our healthcare system. In fact, the article says that people using stolen Social Security numbers contribute approximately $26 billion to the healthcare and Social Security system, none of which they can collect on.
your other argument seems to be that illegal immigrants drop their butts down on American soil, and then do nothing but collect welfare checks. I don’t think that’s true, but I would be willing to look at whatever evidence you have supporting that position.
I think healthcare is to many Republicans what border control is to many Democrats--voters by and large want the party to exhibit better stewardship over the issue, and too many in the party have instead brushed it aside, usually with bad reasoning. (i.e. "people who want any kind of border control at all are racist" or "people who want the government to do anything at all to improve the administration of health care are leeches/socialists/welfare queens/etc.")
Republicans may well have to be shellacked at the ballot box, like the Democrats were, before they realize voters don't like their concerns being brushed aside. And honestly, if both parties cooperated on getting Obamacare working as smoothly as possible, you could have what Mitt Romney successfully implemented in Massachussets, which is an unusually good compromise between state- and market-based healthcare solutions. (something which is hard to pull off, because health care and health insurance are the top items on that slim but important list of things markets oftentimes aren't terribly efficient at allocating)
I don't think either party is really set up to deal with the issue.
Democrats make the out of pocket costs go away while allowing widespread crazy over charging. Republicans want to take health care away from the non rich. Eventually the government is going to have to take over. Already most of the money is coming from the government via taxes without any effective oversight.
Well, take the current conundrum. Huge tax breaks for the wealthy were offset by cuts to people who by definition aren't wealthy, medicaid and income based premium assistance to ACA enrollees. Not sure what else to call it, and the voters probably see it similarly, and without knowing the cuts are to the ACA and Medicaid, now every privately insured person who gets a premium increase at work will blame the GOP, and premiums do go up and employers do shift premiums to employees. Whatever the intent, the GOP will be blamed.
The Medicaid “cuts” were the addition of work requirements and removal of loopholes that allowed states to cover illegals, and they were only projected to decrease the rate of increase.
The cuts to the ACA subsidies were due to Democrats initially enacting them as temporary measures due to COVID and had nothing to do with making the 2017 tax cuts, which among other things doubled the standard deduction finally putting renters on par with modest homeowners.
So those evil Republicans want poor people to die while they laugh, don their beaver fur top hats, adjust their monocles and twirl their handlebar mustaches?
I have no doubt that many voters are stupid enough to buy into that, but if you make just a tiny bit of effort to understand WHY they might not want this country to fall off of a fiscal cliff, you might actually stumble onto a logic-based argument that would help those who need help the most AND help avoid the fast-approaching fiscal collapse. Mindless partisanship helps no one but mindless partisans.
Teed, I never said they aren't hypocritical idiots. This about ascribing evil intent.
Democrats have been working relentlessly to deprive us of our Second Amendment rights. Are they doing it because they want to impose an Orwellian dictatorship over us? Or, could they be doing it in a misguided attempt to create a safer society? As strongly as I oppose those efforts, I prefer to be generous with my assumptions about their intent.
There's an old saying that you should never assume evil intent when simple stupidity is the most likely culprit.
Rarely disagree, but I do not believe most Reps want to take healthcare away from anyone. They want all those able to contribute to do so, and everyone to have some skin in the game.
Per the WSJ, nearly 50% of Medicaid appointments are no shows, without cancellations, because there is no fee, for no shows. That means no one else can use that appointment. Walk in clinics would cure that problem, but Dems refuse, because asking Medicaid enrollees to wait in line at a clinic is demeaning and wasteful of the patient's time. So we continue a program where nearly 1/2 of all appointments are paid, but go unused. It is insanity, but any type of reform is deemed punitive by Dems.
Sorry, my disparaging remarks were perhaps an oversimplification.
I'm aware of the medicaid no shows, nurses hate them with a passion, they shuffle people all day trying to squeeze in patients to doctors that are booked out 2 months only to be left with a empty block of time due to a medicaid no show.
I've been to hospitals in the developing world that function as clinics. We also have large populations here that can't read or write. There's little harm from waiting an hour, there are chairs.
Those of us who do pay taxes will pay one way or another, and it's maybe time to work at making the system more efficiently and less profit driven. Profits paid for with taxes.
Hospitals and clinics lose money on Medicaid patients. The profits come from patients with good employer provided insurance.
I can certainly get on board with requiring insurance companies to operate like non-profits as opposed to publicly traded companies, but the lack of cost transparency in our current system is a major if not the largest driver of costs.
The WSJ ran an editorial a few months ago. Unless I misunderstood, nearly 1/2 of Medicaid appointments are paid by taxpayers, but no one sees a doctor. Because no one bothers to cancel in advance, the appointments are just wasted, because there is not time to fill the slot with someone on a wait list. That is mind blowing.
I do not want anyone taking care of a physically challenged kid to be charged $50 bucks when they can't make their Medicaid appointment last minute for a good reason, but neither am I thrilled about eating the cost of an unemployed 24 year old Medicaid enrolled gamer who misses an appointment ,because he is close to hitting a new high score on his video game. Surely there has to be a better way.
neither medicaid nor medicare pay for no shows. They only for provided care. It's considered part of operating costs, so I guess we all pay. It pisses off nurses and nurses are one bunch you don't want to anger.
On huge messaging mistake the GOP made was in redesigning the work requirements for Medicare reform rather than using the exact same verbiage as Bill Clinton’s welfare reform bill. The latter is still viewed favorably and was I think even more restrictive.
I would note that because OBBBA cut the *federal* share of Medicaid spending, the ultimate cost of Medicaid cuts will come down to individual *state* decisions about how much they want to make up the gap. I would expect more conservative states to make up less of that gap than liberal ones, meaning the pain will largely be felt in red states, specifically blue cities in red states. The OBBBA Medicaid cuts are not cuts to eligibility per se, but rather to financing mechanisms, and of course the addition of work requirements, but those are an administrative burden. Thus, drops in Medicaid enrollment will come primarily from eligible Medicaid beneficiaries failing to meet the new administrative requirements. The full force of OBBBA will come in the form of reduced services via smaller state budgets and fewer Medicaid providers because they aren't being paid as well.
Republicans would be more intellectually honest to simply clarify that they oppose public health care of any kind
Health care is a commodity , not a right.
Morevover, public health care is fundamentally a moral hazard. It creates consumption of health care without having to pay for it.
Democrats are just as intellectualy bankrupt. If health care is a right, then it has to be publicly funded. That will mean the rich and talented will pay those that are too poor to pay for health insurance or fundamentally uninsurable.
And even more transformative - access will be on the basis of need not ability to pay.
Access will be rationed.
Bureaucrats and an imperfect political process will determine aggregage health spending.
Single payer will be profoundly un-American.
But at least logical.
Obamacare is unsustainable. It was never capable of "squaring circles".
The need for expanded subsidies is evidence of that.
So, some intellectual honesty, please. And more will come the right than devious left.
Great comments here - at the end of the day, enlarging the safety net forever will always be cheaper (and preferred) to paying the working poor a living wage. If they had the income (and the employer-based coverage or - even better - access to a well-managed state-level healthcare funds) to not need these entitlement programs, many problems would be solved. But we can't grouse about how expensive it's getting without addressing the larger issue - if good-paying jobs are gone forever (and the markets wouldn't have it any other way), then more and more people needing Medicaid, SNAP, SSI, are simply the rest of that equation.
Here is the most salient political point for this issue of health care. A large percentage of Americans justifiably fears that if a serious medical event occurs in their families they will either: (a) Not receive necessary medical care, or (b) They will be financially ruined - medical bankruptcy - if they do receive necessary medical care.
If the private sector can't alleviate this fear - and by itself it can't - then people will demand that government do so. All political debate among realistic people - i.e. not including ideologues of any stripe - recognizes this reality. Just saying that government should get out of the health care space is a political non-starter. The big question is what is the most pragmatic way to achieve what a huge majority of Americans wants: necessary medical care for everyone without anyone being financially ruined.
While you’re correct about the libertarian right, they aren’t a large enough block to stop much of anything. The real obstacle is the left’s insistence that “necessary medical care” includes everything the left deems proper and “everyone” includes anyone who crosses our borders. All of this coupled with the idea that it will be paid for by someone with more money than them. a.k.a. “The Rich”
Another article that doesn't mention how much these programs cost - how the costs are exploding every year and taking more and more of state and federal budgets.
Of course people are going to approve of these programs, they think they're free.
Perfectly on point.
Once again Dems have a policy problem, Reps help ease with their lousy messaging. Medicaid and Obamacare are popular, because they are free or heavily subsidized. If DC handed out free cars based on income, those cars would also be popular.
Increasingly, healthcare is a game of 3 card monty, with vast costs being moved around the table in a manner that precludes Americans from knowing what their healthcare actually costs. The system appears to purposefully camouflage costs, so Americans have no idea what part of their payments provide their own healthcare, and what part provides healthcare for someone else, paying nothing. When people need an oil change, they can call 3 businesses and know the least expensive. That is not possible for most routine healthcare.
Moreover, imagine the cost of oil changes, if they were free for 1/3 of drivers, and the remaining 2/3rds had to cover their own oil changes, and the cost of the 1/3 who pay nothing. 40% of Californians and 36% New York residents, our 1rst and 4th most populace states, are enrolled in Medicaid.
In less the last 25 years, US Medicaid enrollment has more than doubled. In the not too distant future, Medicaid enrollment is expected to hit 100 million. There are only 335 million people in the US. If nearly 1/3 of the US pays nothing for healthcare, the other 2/3rds have to pay much more. It is simple Math.
The focus of American healthcare, as of late, has little to do with improving anyone's health. Most effort is directed at stealthily reallocating costs, as increasingly, large swaths of of people pay little to nothing, which means fewer Americans are left to pick up the ever increasing tab.
We have morphed from providing healthcare for truly needy Americans, to paying the healthcare of people simply good at manipulating their incomes and the world's needy, who have recently arrived in the US, unable to afford our expensive American healthcare system, no matter how hard they toil. The names of particular programs have increasingly little relevance. At the end of the day, all healthcare bills must be paid by someone.
All, as overall costs grow at an unsustainable clip, aided by the DC 3 card monty game. Problems must be quantified to be fixed. Both Dems and Reps understand the problem, they are simply loathe to admit it. Nor can it be corrected, without destroying much of the current system, while introducing competition and demanding absolutely everyone, but the truly neediest Americans, have some skin in the game.
Ronda - could you please apply to be White House spokesperson for healthcare? It's insane how horrible the messaging is.
"He who robs Peter to pay Paul can always count on Paul's support."
---Unknown
I'm surprised the Republicans haven't revived a policy from Trump's first term, expanding short term health insurance contracts. These are health insurance plans that don't require all of the bells and whistles (and cost) in a typical Obamacare plan. They were also about 60% cheaper. This type of plan was always in Obamacare; Biden sharply restricted them. The interesting thing is they were expanded by executive order, which survived the courts. Yet the Trump administration has shown no interest in action.
One could dare to dream that it’s because he wants Congress to make them long term by adding the expansion to any deal. Low cost catastrophic coverage with a HSA is probably the best option for most people. Especially if we can get price transparency into the system.
It must be a wonderful thing to align with a political party that is responsible causing massive problems being able to pin it on the other party for not fixing the problems. It makes sense though as the entire population of Democrat is prone to a feminized victim mindset. It is not THEIR fault... it is always someone else's fault. And how DARE you criticize us Democrats because everything we do is based on virtue and empathy for the downtrodden and oppressed. This is true even as the evidence keeps pouring in that everything we do causes more harm and pain to the downtrodden and oppressed.
If you want public healthcare you need to get serious about controlling the border including deportations from the interior of every non-citizen who uses any social services. Next you need to get the country on board with a massive broad based tax increase. Something along the lines of a 20-25% national VAT. Anything else is simply promising free stuff for votes with no regard to the long term consequences.
Amazingly enough, Bernie Sanders once said the same thing as you do here. He was asked if middle class Americans would have to pay similar amounts of taxes (percentage of gross income) as middle class Europeans do if the U.S. ever has a welfare state as generous as the European social democracies. To his great credit, Sanders said YES. Every other elected Democrat states or strongly implies otherwise, that just taxing "the rich" more can pay for such public generosity.
Controlling healthcare costs and undocumented immigrants have nothing to do with each other. Undocumented immigrants who stay for any length of time are not "draining the system". They pay taxes, including social security taxes from which they collect no benefits. They are thus a net profit for the healthcare system, not a loss.
If they are paying social security taxes then they have committed identity theft and done a gross injustice to whoever’s social security number they have stolen. Social Security payments also have nothing to do with funding healthcare.
It’s simple basic math that any welfare system needs more people paying more money into it than there are people taking money out of it. The vast majority of illegals fall into the latter. You can either have a relatively open immigration system or a robust welfare state. Pretending otherwise is either delusional or fraudulent.
actually, the data show that the majority of illegals are putting more money into the system than they are taking out. Because they are illlegal, It is difficult, usually impossible, for them to collect any benefits from the system they are putting money into. The withholding taxes taken from paychecks go into both Medicare and Social Security.
The question of identity theft has moral implications, of course, but that has nothing to do with the financial impact of illegal immigrants. The government benefits financially from this particular kind of identity theft, as does the person whose identity is stolen, because they end up getting higher benefits based on work they didn’t do. If you wanna start another discussion about the moral implications of identity theft, feel free. But don’t mix it up into questions about the financial viability of health services.
The data you cite ignore both the services they use up for their anchor babies and states using joint funding to provide Medicare to illegals. Something Newsom was recently bragging about to The NY Times. Again it’s simple math you cannot import a large underclass and provide generous benefits. Even the Euros are discovering that their welfare states are draining their treasuries due to their decision to import a fraction of the underclass Biden waived in.
Identity theft is in no way a benefit to its victims.
https://www.thefp.com/p/immigrant-crisis-identity-theft
Thanks for this link. This is a more nuanced issue thanI realized, and I appreciate the things I learn from reading this article. I t clearly shows that identity theft hurts many innocent people in ways that didn’t occur to me. The govt clearly need to go back to sending out “no match letters” and do whatever else is necessary to catch who is ever doing this. However, there is nothing in this article that shows that identity, theft, or anything else done by illegal immigrants is jeopardizing our healthcare system. In fact, the article says that people using stolen Social Security numbers contribute approximately $26 billion to the healthcare and Social Security system, none of which they can collect on.
your other argument seems to be that illegal immigrants drop their butts down on American soil, and then do nothing but collect welfare checks. I don’t think that’s true, but I would be willing to look at whatever evidence you have supporting that position.
I think healthcare is to many Republicans what border control is to many Democrats--voters by and large want the party to exhibit better stewardship over the issue, and too many in the party have instead brushed it aside, usually with bad reasoning. (i.e. "people who want any kind of border control at all are racist" or "people who want the government to do anything at all to improve the administration of health care are leeches/socialists/welfare queens/etc.")
Republicans may well have to be shellacked at the ballot box, like the Democrats were, before they realize voters don't like their concerns being brushed aside. And honestly, if both parties cooperated on getting Obamacare working as smoothly as possible, you could have what Mitt Romney successfully implemented in Massachussets, which is an unusually good compromise between state- and market-based healthcare solutions. (something which is hard to pull off, because health care and health insurance are the top items on that slim but important list of things markets oftentimes aren't terribly efficient at allocating)
I don't think either party is really set up to deal with the issue.
Democrats make the out of pocket costs go away while allowing widespread crazy over charging. Republicans want to take health care away from the non rich. Eventually the government is going to have to take over. Already most of the money is coming from the government via taxes without any effective oversight.
"Republicans want to take health care away from the non rich."
Attributing evil intent to those you disagree with is always a losing argument.
Well, take the current conundrum. Huge tax breaks for the wealthy were offset by cuts to people who by definition aren't wealthy, medicaid and income based premium assistance to ACA enrollees. Not sure what else to call it, and the voters probably see it similarly, and without knowing the cuts are to the ACA and Medicaid, now every privately insured person who gets a premium increase at work will blame the GOP, and premiums do go up and employers do shift premiums to employees. Whatever the intent, the GOP will be blamed.
The Medicaid “cuts” were the addition of work requirements and removal of loopholes that allowed states to cover illegals, and they were only projected to decrease the rate of increase.
The cuts to the ACA subsidies were due to Democrats initially enacting them as temporary measures due to COVID and had nothing to do with making the 2017 tax cuts, which among other things doubled the standard deduction finally putting renters on par with modest homeowners.
So those evil Republicans want poor people to die while they laugh, don their beaver fur top hats, adjust their monocles and twirl their handlebar mustaches?
I have no doubt that many voters are stupid enough to buy into that, but if you make just a tiny bit of effort to understand WHY they might not want this country to fall off of a fiscal cliff, you might actually stumble onto a logic-based argument that would help those who need help the most AND help avoid the fast-approaching fiscal collapse. Mindless partisanship helps no one but mindless partisans.
If they really thought that way, they wouldn't have approved all the recent tax cuts.
Teed, I never said they aren't hypocritical idiots. This about ascribing evil intent.
Democrats have been working relentlessly to deprive us of our Second Amendment rights. Are they doing it because they want to impose an Orwellian dictatorship over us? Or, could they be doing it in a misguided attempt to create a safer society? As strongly as I oppose those efforts, I prefer to be generous with my assumptions about their intent.
There's an old saying that you should never assume evil intent when simple stupidity is the most likely culprit.
Rarely disagree, but I do not believe most Reps want to take healthcare away from anyone. They want all those able to contribute to do so, and everyone to have some skin in the game.
Per the WSJ, nearly 50% of Medicaid appointments are no shows, without cancellations, because there is no fee, for no shows. That means no one else can use that appointment. Walk in clinics would cure that problem, but Dems refuse, because asking Medicaid enrollees to wait in line at a clinic is demeaning and wasteful of the patient's time. So we continue a program where nearly 1/2 of all appointments are paid, but go unused. It is insanity, but any type of reform is deemed punitive by Dems.
Sorry, my disparaging remarks were perhaps an oversimplification.
I'm aware of the medicaid no shows, nurses hate them with a passion, they shuffle people all day trying to squeeze in patients to doctors that are booked out 2 months only to be left with a empty block of time due to a medicaid no show.
I've been to hospitals in the developing world that function as clinics. We also have large populations here that can't read or write. There's little harm from waiting an hour, there are chairs.
Those of us who do pay taxes will pay one way or another, and it's maybe time to work at making the system more efficiently and less profit driven. Profits paid for with taxes.
Hospitals and clinics lose money on Medicaid patients. The profits come from patients with good employer provided insurance.
I can certainly get on board with requiring insurance companies to operate like non-profits as opposed to publicly traded companies, but the lack of cost transparency in our current system is a major if not the largest driver of costs.
The WSJ ran an editorial a few months ago. Unless I misunderstood, nearly 1/2 of Medicaid appointments are paid by taxpayers, but no one sees a doctor. Because no one bothers to cancel in advance, the appointments are just wasted, because there is not time to fill the slot with someone on a wait list. That is mind blowing.
I do not want anyone taking care of a physically challenged kid to be charged $50 bucks when they can't make their Medicaid appointment last minute for a good reason, but neither am I thrilled about eating the cost of an unemployed 24 year old Medicaid enrolled gamer who misses an appointment ,because he is close to hitting a new high score on his video game. Surely there has to be a better way.
neither medicaid nor medicare pay for no shows. They only for provided care. It's considered part of operating costs, so I guess we all pay. It pisses off nurses and nurses are one bunch you don't want to anger.
On huge messaging mistake the GOP made was in redesigning the work requirements for Medicare reform rather than using the exact same verbiage as Bill Clinton’s welfare reform bill. The latter is still viewed favorably and was I think even more restrictive.
I would note that because OBBBA cut the *federal* share of Medicaid spending, the ultimate cost of Medicaid cuts will come down to individual *state* decisions about how much they want to make up the gap. I would expect more conservative states to make up less of that gap than liberal ones, meaning the pain will largely be felt in red states, specifically blue cities in red states. The OBBBA Medicaid cuts are not cuts to eligibility per se, but rather to financing mechanisms, and of course the addition of work requirements, but those are an administrative burden. Thus, drops in Medicaid enrollment will come primarily from eligible Medicaid beneficiaries failing to meet the new administrative requirements. The full force of OBBBA will come in the form of reduced services via smaller state budgets and fewer Medicaid providers because they aren't being paid as well.
Republicans would be more intellectually honest to simply clarify that they oppose public health care of any kind
Health care is a commodity , not a right.
Morevover, public health care is fundamentally a moral hazard. It creates consumption of health care without having to pay for it.
Democrats are just as intellectualy bankrupt. If health care is a right, then it has to be publicly funded. That will mean the rich and talented will pay those that are too poor to pay for health insurance or fundamentally uninsurable.
And even more transformative - access will be on the basis of need not ability to pay.
Access will be rationed.
Bureaucrats and an imperfect political process will determine aggregage health spending.
Single payer will be profoundly un-American.
But at least logical.
Obamacare is unsustainable. It was never capable of "squaring circles".
The need for expanded subsidies is evidence of that.
So, some intellectual honesty, please. And more will come the right than devious left.
Great comments here - at the end of the day, enlarging the safety net forever will always be cheaper (and preferred) to paying the working poor a living wage. If they had the income (and the employer-based coverage or - even better - access to a well-managed state-level healthcare funds) to not need these entitlement programs, many problems would be solved. But we can't grouse about how expensive it's getting without addressing the larger issue - if good-paying jobs are gone forever (and the markets wouldn't have it any other way), then more and more people needing Medicaid, SNAP, SSI, are simply the rest of that equation.
Here is the most salient political point for this issue of health care. A large percentage of Americans justifiably fears that if a serious medical event occurs in their families they will either: (a) Not receive necessary medical care, or (b) They will be financially ruined - medical bankruptcy - if they do receive necessary medical care.
If the private sector can't alleviate this fear - and by itself it can't - then people will demand that government do so. All political debate among realistic people - i.e. not including ideologues of any stripe - recognizes this reality. Just saying that government should get out of the health care space is a political non-starter. The big question is what is the most pragmatic way to achieve what a huge majority of Americans wants: necessary medical care for everyone without anyone being financially ruined.
While you’re correct about the libertarian right, they aren’t a large enough block to stop much of anything. The real obstacle is the left’s insistence that “necessary medical care” includes everything the left deems proper and “everyone” includes anyone who crosses our borders. All of this coupled with the idea that it will be paid for by someone with more money than them. a.k.a. “The Rich”
For $100 or less a month you can buy supplemental insurance that pays out $100k for a major heart or cancer event.
Nice to see the "Liberal" in Liberal Patriot for Change.