Look. I appreciate passion for the topic. I absolutely care about this too. I probably spend waaaay more time than a layperson should reading about healthcare problems and policy. Like a lot of other people here on an engineering forum like this, I know the power of approaching things as their own kind of system.
And it kinda looks like you don't yet. That's something I've no doubt you could fix, but you'd have to want it. Maybe even enough to google the term "socialized insurance." Or understand that when healthy people pay into risk pools... that's what insurance is.
> The Democrats are the party who put massive amounts of effort into derailing the only viable candidate to argue for public healthcare.
Presumably you're talking about Sanders. I encourage you to talk to his office while he's not running about other people who are supportive and enthusiastic about public healthcare efforts. There are plenty. Arguably not enough: if they'd had few more Senators to get past Joe Lieberman in 2010, Medicare-for-all-who choose would have been a reality then. As it was the ACA was a mixed but significant policy victory.
Health insurance is a commercial industry. There is absolutely nothing socialized about it. The CEOs of these companies are getting paid tens of millions of dollars. They are INCs. They are not socialized in any way shape or form.
They do have regulatory capture, mostly given to them by the Democratic Party.
I can't tell whether you're saying "Health insurance in the US is a commercial industry right now" or "there's no such thing as health insurance that is not commercial."
The latter statement is not true. Medicare for all would be socialized insurance, as would any single payer plan. There are other kinds of socialized insurance you can find in other countries.
The former statement is mostly true with notable exceptions, so we'll assume that's what you mean. You may not be aware there is socialized insurance in the US, though: Medicare and other state programs (and again, the vast majority of Democratic officeholders supported expanding access to that to everyone in 2010 via what was called the "public option" at the time, unfortunately they needed every last D Senator and Lieberman held out). There are also some non-profit private insurers.
> these companies are getting paid tens of millions of dollars. They are INCs.
The money flowing through these companies is not the problem. Getting paid to provide valuable services is not a problem. Even if you had a magic wand that you could wave that made Bernie king and M4A a reality, you would still need to employ people to source revenue for the general insurance fund, provide good financial stewardship over it, manage relationships with competent providers, provide service to people like you and I, etc etc. You'd have to pay all those people. Like Medicare already has to (and hires private parties to help).
It's likely that entirely socializing insurance would cut down on overhead (and certainly on any profit taking), but the thing is... that's already been limited. By who? Well... these Democrats you're suggesting are somehow primarily responsible for nurturing insurers. Where did this happen? The Affordable Care Act required insurance companies to reveal how they spend consumer premiums, and spend 80% of those premiums on care and efforts to improve quality of care. What companies can take in operating expenses and profits is limited by law to 20%.
Did you know that? If you didn't, why are you so confidently holding forth on this topic? If you did, why are you insisting on repeating the line that Democrats don't care and in fact are responsible for increasing expenses and capture of revenue?
> They do have regulatory capture
They have representation and influence in a democratic system. Arguably too much? Yeah. What's your plan for that?
> mostly given to them by the Democratic Party.
Again, you're welcome to lay out your model of how the democrats are responsible. If it's really limited to "other people in the party thought they'd make a better candidate/President than Bernie", though, you might want to see if you can come up with something stronger. And while you're at it, maybe start to admit at least to yourself that maybe you have some more to learn about this topic.
> Again, you're welcome to lay out your model of how the democrats are responsible.
Simple, prior to the ACA I was able to cover my health expenses out of pocket. I’m healthy and literally went to the doctor 3 times in a decade. After being forced by the ACA to buy unneeded and unwanted health insurance, I ended up paying >10k /year for literally nothing.
I’ve since paid so much in health insurance that I could have covered my own cancer treatments, out of pocket. I have received nothing for that $100,000+ dollars.
Add to that the “marketplace” with limited time windows, limited competition, the inability to get insurance from another location…
These were all Democrat initiatives that I lived through.
Then, twice the Democratic Party fought tooth and nail to kill M4A. Biden literally said he would never implement it. I’m no fan of the GOP, but when it comes to healthcare costs, no one is worse than the Dems.
Insurance is not something you have because you are ill, it's something you have as a hedge against the probability that you will be ill. Whether you're healthy now has limited bearing on that.
And if you want to be able to have it when you are ill, you need to be willing to contribute to premiums even when you're not. Whether that contribution comes in the form of an explicit premium paid into a risk pool administered by private insurers or in the form of a percentage of your tax dollars paid to a socialized insurance plan (like M4A), that's how insurance works.
From a political standpoint, the individual mandate might have gone down more smoothly if people had been given a choice to opt out of it, in return for agreeing that they could be denied for pre-existing conditions. Democrats at the time made the calculation from a policy/values that too many people wouldn't understand what they were doing and end up shooting themselves in the foot. I used to think that was wrong.
> I ended up paying >10k /year for literally nothing.
> I could have covered my own cancer treatments, out of pocket. I have received nothing for that $100,000+ dollars.
Your numbers don't add up.
Out of pocket costs for a course of cancer treatment usually run well over $100k (and those stats might be for people who do have insurance).
There haven't been many years that the individual mandate was in effect. It went into effect in 2014. Tax for not buying insurance was lowered to zero by 2019. Your yearly premiums would have needed to be not ">$10k" but around $20k for you to have spent $100k in premiums.
And if you didn't want the insurance, it was always legal to simply pay that tax on not having it. How much? Well, for the median income household, that'd be about $700. Much less than You would need to be pulling something north of $500k a year in order for your tax to be $10k. Please, tell us where you worked, and why they were paying you that much while... not offering you insurance?
Or if you were making $500k a year as a business owner / contractor... why you didn't have any accountant or other financial professional giving you better advice? $10k a year in individual premiums is cadillac plan territory, even in expensive metro areas. Generally not what people who are healthy and go to the doctor three times in a decade buy. High-deductible plans with premiums below $300/mo are available to individuals in Los Angeles today. Your individual max required premium shouldn't be more than $3500 a year in 2021 (and in 2014, you could probably get away below $2400/year). Hell, you could cover a family of four in Los Angeles on less than $500/mo in premiums with ACA assistance, for a total cost topping out below $6000/year, so we know that's not what you're talking about (on top of the fact that you spoke in terms of your own health rather than mentioning any family).
Maybe there's some reasonable explanation for why all your numbers are so far outside of credibility here?
> the Democratic Party fought ... M4A
Please. M4A wouldn't even exist as a relevant concept in American political discourse without the Democratic Party. The only reason you know the label at all is because it was advocated in primary contests and by Democrats in congress. Yes, Democrats plural. For an example, read one piece of introduced legislation:
Notice the list of D Senators as co-sponsors. Notice that it is not short (nearly a third of the caucus at the time). It is profoundly wrong to characterize the Democratic Party as the primary obstacle to something like M4A when it is the only reason why M4A is a potential reality in the US. And saying "I'm no fan of the GOP" doesn't ameliorate that mistake: you can guarantee that the list of Senators sponsoring anything remotely like that bill in the GOP would have a length of 0 (and of course, given when the bill was introduced, only someone who was also ignorant of the composition of the senate at the time could think the primary reason it didn't go anywhere was D efforts).
Also, maybe check your misconceptions about Biden:
After I married a healthy partner: $2100 /month for the both of us.
After transitioning to full time employment: $2300 /month
These numbers align with my friends. In no way was paying $300 /month an option.
Health insurance is not health care. I don’t want it. I want public healthcare, barring that I want affordable healthcare. Pre-ACA was much more affordable.
I really wish neo-liberals could just admit when their policies fail. This one is not on the GOP. It’s 100% the result of DNC policy and actions.
I assume you want people to vote Democrat. To be effective there, step one would be to listen to people who have legitimate grievances and when your party is at fault, own it. Do not go on a tirade about how paying for insurance is actually a good thing. It’s not, it’s a failure of our social safety net.
I have no misconceptions about Biden. He was part of the admin that screwed me with the ACA, I watched every debate and heard him repeatedly state that he was going to continue to enrich the insurance industry on my back. Which is exactly what he’s done since taking office.
Sigh.
Look. I appreciate passion for the topic. I absolutely care about this too. I probably spend waaaay more time than a layperson should reading about healthcare problems and policy. Like a lot of other people here on an engineering forum like this, I know the power of approaching things as their own kind of system.
And it kinda looks like you don't yet. That's something I've no doubt you could fix, but you'd have to want it. Maybe even enough to google the term "socialized insurance." Or understand that when healthy people pay into risk pools... that's what insurance is.
> The Democrats are the party who put massive amounts of effort into derailing the only viable candidate to argue for public healthcare.
Presumably you're talking about Sanders. I encourage you to talk to his office while he's not running about other people who are supportive and enthusiastic about public healthcare efforts. There are plenty. Arguably not enough: if they'd had few more Senators to get past Joe Lieberman in 2010, Medicare-for-all-who choose would have been a reality then. As it was the ACA was a mixed but significant policy victory.