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  •  Nobody interested in SUBSTANCE? Tech trifles (1+ / 0-)
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    and snark only?

    Dare one import a little thought experiment from elsewhere, for whoops and giggles?

    The Obama Apology That Is Needed

    My fellow Americans, tonight I want to apologize for the results of my efforts in reforming US healthcare.  It is now evident from the roll-out and the technical problems that have been exposed that we have created a complex system in which these types of problems will exist, not just at the beginning in the setting up of a website to sell health insurance, but as the law takes full effect.  Therefore, tonight I am announcing my intent to work for a major but simple change in direction.

    First, I apologize because these problems should have been evident before we passed the Affordable Care Act.  Prior to the ACA, the existence of the insurance industry created tremendous bureaucracy for consumers, doctors, health providers and hospitals as well as for business and the government. It also resulted in millions of Americans not being able to get the healthcare they needed, even if they had insurance.  After the ACA we now see these problems persist.  This is not surprising.

    The ACA requires each state as well as Washington, DC and Puerto Rico to have an exchange to sell health insurance.  Each exchange has four levels of insurance – platinum, gold, silver and bronze.  Within each level there are multiple insurance companies and each insurance company puts forward multiple insurance plans. Each state has its own regulatory system for health insurance and the federal government has thousands of pages of regulations as well.  This is a very complex system not only for the purposes of selling insurance, but will remain complex throughout the system.  Doctors, health providers and hospitals will continue to need to spend more time and money managing payments for healthcare; businesses will continue to need to spend a lot of overhead figuring out what kind of insurance to have and government will have to create bureaucracy to manage thousands of insurance policies.

    Second, I want to apologize for stifling the debate we should have had in developing a national healthcare system.  When we began this process we had the opportunity to look at three very distinct systems currently operating in the United States – a market-based system dominated by the insurance industry with healthcare provided for-profit; a single payer system, Medicare, where the government is the only funder of healthcare and private providers deliver healthcare services;  and, a completely government-run healthcare system for Veterans (VA) where the doctors, hospitals and healthcare providers all work for the government.  This would have been a great debate that would have resulted in the United States putting in place the best national health plan based on our experience, and the empirical evidence, of what has worked and what has not, in US healthcare. I suspect if we had that debate the market-based system would have been shown to be the weakest of the three alternatives and a combination of Medicare and the VA would have been the most cost-effective way to provide healthcare for every person in the United States.

    As a former advocate for single payer I knew this, but put aside the empirical evidence. Instead, I allowed those with the most money to decide what kind of healthcare we should have.  Even though single payer had the support of more than 60 percent of Americans, two-thirds of doctors as well as nurses, I ignored the desires of the people and instead worked with the insurance industry, pharmaceutical industry and for-profit hospitals.  This was a terrible mistake and a missed opportunity that would have resulted in the United States getting on the path to becoming the most efficient and effective healthcare system in the world; instead we remain the most expensive system that produces mediocre results.

    Today, I am announcing the drop two words campaign.  Rather than producing a law of more than one thousand pages and thousands of pages of regulations, I am going to work to drop “over 65” from the Medicare law so that Medicare will serve everyone.  After we pass this law, future administrations can work to make the law better as even the best health systems in the world constantly work to improve themselves.  My hope is that Medicare covers more health services and ends out-of-pocket costs for healthcare, but for now we are merely seeking to drop two words and provide healthcare to all.

    There's more to it, too -- goes on to "apologize" for the whole set of rights-and-sovereignty-destroying "free trade" secret arrangements now underway.  Interesting that there's such resistance to a Constitutional Convention to "renegotiate" the social contract (probably wisely, given the impotence of the progressive parts of the political economy), but that "Constitutional Convention" is running and will eventually result in pretty much total privatization of just about everything -- the Libertarian's pet dream:

    "Journey Into A Libertarian Future"

    "Is that all there is?" Peggy Lee.

    by jm214 on Wed Nov 20, 2013 at 08:12:26 AM PST

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