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View Diary: Does Washington State's experience with healthcare reform have national implications? (52 comments)

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  •  I agree.. (0+ / 0-)

    ACA should have been some sort of single-payer system, not the piece of crap it ended up being.

    •  Jerry - (1+ / 0-)
      Recommended by:

      Do you believe it was possible to pass single payer? To dismantle an entire private insurance system right out of the gate? If you do I really want to hear how you think it was going to happen.

      Republican Family Values: Using the daughters from your first wife to convince everybody that your second wife is lying about your third wife.

      by jsfox on Tue Jun 19, 2012 at 01:28:27 PM PDT

      [ Parent ]

      •  In a modified form (0+ / 0-)

        I think it could have.

        There is no reason single payer could not also work through private insurers.

        The Dutch system has basic health care, but it is managed through private insurers.  Those insurers then try to sell you supplemental insurance to cover gaps or benefits not covered in the base system.

        A hybrid system like that would have, in my opinion, been widely accepted.

        And even a more modest system, as I mentioned above, which only covered catastrophic costs could work exactly the same.  The private insurers could provide gap coverage for modest premiums.  And..  the government would pick up this gap insurance for low income people - at a much cheaper rate than it would have under ACA.  Under ACA the government was going to laying out as much as $7000 per family per year!  Even if they were healthy and used healthcare sparingly.  That's just crazy.

      •  By that name? (0+ / 0-)

        Of course not.  But a slow progressive creep could accomplish miracles if we would just will ourselves to be sneaky.  The most important part of the ACA in my book was/is the expansion of Medicaid coverage to a huge number of people previously unqualified.  If we just worked to expand Medicaid and Medicare (and fund them) a LITTLE BIT every couple of years, we could reach a point where we effectively have a full public safety net within thirty years or so, and private insurance is a glossy add-on for those with the money.  I'm not talking about top-of-the-line, best-in-the-world all-options-covered insurance for everyone, mind you.  I'm talking about getting basic acute care needs met, modest prescriptions that have a high cost-benefit ratio, and assuring that all pregnant mothers and newborns have adequate care to prevent grossly preventable birth defects and lifelong chronic care resulting from them.  Best of all, by extending BASIC care to all we could avoid a lot of the overpriced catastrophic care that we now pay for, keeping the overall bills down.

        Funding could be assisted by adding some small excise taxes on medical providers of over certain (high) income thresholds, medical equipment manufacturers, drug companies, etc. -- increase some user fees, licensing fees, interstate transit fees or licenses for biological products (such as high-tech drugs built with recombinant dNA, blood products, etc.), things that can be buried in the middle of 400-page bills.  If we stopped trying to charge the barricades with moral crusades, we could essentially change the way the entire system works from the sidelines.

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