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View Diary: Republicans rethinking one of their few ideas for health reform (49 comments)

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  •  Why is it only a good thing with single payer? (2+ / 0-)
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    scott jones, HeyMikey

    Obviously, having single payer is a good thing all by itself, and it would make this proposal better.

    But even absent single payer, wouldn't moving people from employer-based insurance purchased from a private insurer, to individual insurance purchased from a private insurer, be a good thing in and of itself?

    Art is the handmaid of human good.

    by joe from Lowell on Wed Dec 11, 2013 at 10:21:43 AM PST

    •  A public option would result in a pool (0+ / 0-)

      big enough to offset the loss of an employer's paying 50% or more of an employees' health insurance cost.  That's why there would need to be a public option, but I'm not sure why single payer would be necessary.  Single payer wouldn't make it necessary for anyone to have a tax credit for purchasing health insurance, but it would necessitate a rise in income or Medicare taxes in order to pay for it.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Dec 11, 2013 at 10:42:31 AM PST

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      •  D'oh, I meant public option! (2+ / 0-)
        Recommended by:
        HeyMikey, SueDe

        I get your point about the size of the risk pool, but isn't that what the exchanges are for?

        Art is the handmaid of human good.

        by joe from Lowell on Wed Dec 11, 2013 at 10:54:29 AM PST

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        •  A federal public option would result (0+ / 0-)

          in an enormous risk pool, much larger than one state (the state exchanges include only that one state's population), and give the federal government enormous leverage to limit health care costs - including pharmaceutical prices, if they'll do it.

          "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

          by SueDe on Thu Dec 12, 2013 at 04:31:50 AM PST

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    •  Exactly (2+ / 0-)
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      untorqued, HeyMikey

      If I can't get single payer, at least let me pick my own insurance.  That way I can take it with me from job to job or change it if I don't like it.  I'm not just stuck at the whim of my employer.  I once had an employer that would change plans every. single. year.  It was annoying.

      Ron Wyden had a plan in 2008 to do this.  He would have required eliminated the group deduction and required all employers to "cash out" their group coverage: provide employees with raises equal to the amount formerly spent on the group plan.  Employees would then buy their own insurance on an "exchange"--all private, but at least playing by fair rules and be subsidized. Employers would also be required to pay a additional tax (about 6%) to cover the cost of the exchange subsidies.  

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

        And I caution my fellow Democrats not to make the same mistake that has painted Republicans into a corner: dismissing the validity of an idea based on the fact that the other side is proposing it. Remember, the health insurance reform outlined by the conservative Heritage Foundation only became toxic on the right when a Democratic president pushed to make it law.

      •  But in order to do that (0+ / 0-)

        you will need the individuals to be able to pool risk so they aren't cherry picked by insurers. You would then need to have consumer protections to prevent the sick from being screwed, and community rating to prevent them from being over-priced. But doing that would require standardization among plans and increasing the cost for the healthy. What about the healthy individuals who can't afford that increase?? Well, to offset that you would need to offer them subsidies based on income, and a mechanism to make sure the pool isn't prone to adverse selection. Something like say...a mandate.

        And then you have the affordable care act.

    •  I have had the same thought, but (0+ / 0-)

      the disruption is what worries me. The disruption of this change would be an order of magnitude greater than anything seen with Obamacare.  And major disruption in the healthcare system costs lives and suffering.

      Now maybe the pros outweigh the cons of getting off the employer-based system. I mean, more and more companies are reducing coverage and there is a tipping point where it's simply causing more of a divide between the better off and the less well off.

      Tens of millions of people without employer coverage get no deduction now because the floor is pretty high. In order to keep it revenue neutral (and there's little chance the deficit-fearing R's will propose something that grants net tax relief overall), a person with the median employer plan will no longer be able to deduct the full amount. This will be felt immediately in the paycheck for tens of millions of Americans with employer coverage. The fact that additional millions will now be able to deduct more, and that people have more choice will not be what the media covers.

      So politically, I'd FAR rather the republicans propose this. It'll make the current storm over Obamacare loss of coverage.look like a summer breeze.

      Want a progressive global warming novel, not a right wing rant? Go to and check out New World Orders

      by eparrot on Wed Dec 11, 2013 at 02:31:10 PM PST

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