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Yeah, and they're dumbasses for doing that, which is my biggest disagreement with the Republican party. I was a single-issue on this for several years in the 2010s before I realized the Democratic party would never spend political capital on solving the problem -- which they do, largely, because of lobbying by the health insurance companies, for which reason I hate them.
May I ask why you think conservatives are stupid for denying public insurance options? As someone who has experience in both (consumer side) private and public insurance, the only reason why public insurance is affordable is because expenses are shifted to taxpayers instead of the individual insurer. The actual price per service is no different: collective bargaining does not give the government any particular advantage in negotiating prices for services. Almost all public health services have massive budget overages and increased costs which are expected to increase as time continues as well as having issues with patient backlogs.
In the US, Medicare (for elderly and for certain qualified disabilities) accounts for 17% of the national budget. Once again, the only reason for affordability is due to the taxpayer shouldering the costs whose base is dwindling. This isn't even accounting for standard government inefficiency as the US government is incoherently cost insensitive and unable to make sensible budgetary decisions.
So while I agree that private health insurance has many issues, it at least is self-maintaining and doesn't have the large macro issues that government health programs are currently facing.
Let me apologize for the tone of my recent posts on this topic, which were really dumb Twitter-tier reactions and don't reflect either my values or the standards of this place.
Yes, and I'm saying this is a good thing, and the percentage should be higher. It's a fair point that the public option is unlikely to increase efficiency, but increasing efficiency isn't really the goal for me. I like the idea of a public option because it means giving money to the government that is constrained by the Constitution, the courts, administrative procedure, etc... while giving money to a private insurer, while they absolutely are regulated to death, means giving money to a party whose entire purpose is to take as much of your money as it can legally get away with while giving you as little in return as they can legally get away with. It's the alignment of incentives I find disconcerting, not the level of efficiency.
I don't agree with the "healthcare is a human right" thing, but I do believe that it's right for society as a whole to shoulder the burden to take care of people who are vulnerable, struggling, chronically ill, etc. I put social welfare policies, particularly surrounding healthcare, in the same basket of public goods as roads, bridges, police officers, defense -- it's part of the fundamental social fabric that enables people to live at all, and shouldn't be subject to the whims of the market.
To be clear, my view on the Republican party on this issue is not that conservative voters examined the evidence closely and made a cost-benefit analysis, it's that conservative voters hate the idea of the public option because it's the government doing stuff, and there's an axiomatic belief among Republicans that the public sector is inherently inferior that is just as dogmatic as the belief among Democrats that the private sector is always exploitative.
Despite what my strong feelings on healthcare may suggest, I'm not actually particularly dogmatic on economic issues: except to say that I believe what should be done is the option that empowers ordinary people to live the best and most fulfilling lives as is possible. There are some areas where giving people more choices and the freedom to make decisions in a free market gives them the most power -- but likewise there are other areas where the amount of knowledge and wisdom a person would have to accumulate to make a judicious choice is so ludicrously high that people do need government officials to regulate away bad choices and build a system where people have the legal right to be treated fairly.
If that means trickle-down in one case, fine, if that means government monopoly in another, great, if that means single payer in one context, sure, if that means tax breaks at one point, I'm all for it. I'm apparently being an economic progressive today, so I'll throw some meat to the fiscal conservatives in the audience and say I think most concerns about corporate greed are silly, and price increases usually reflect underlying economic variables. Price fixing in particular is the worst possible solution to any economic problem.
I'm happy to agree with the more libertarian side of the fence that our current system is regulated to death and has the worst aspects of both private and government-run healthcare, but I don't see the solution being deregulation and turning healthcare into a McDonald's menu where people have to price-match and pay for add-ons in times of extreme time-pressure, information asymmetry, and profound emotional and physical stress. If there's any time whatsoever where we can be absolutely sure people aren't Homo economicus, it's when they have to make serious decisions that affect the life, death, and serious suffering of themselves or a loved one.
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30% of US health expenses are attributed to administration, which in the US context usually means the armies of secretaries hired by hospitals to not mess up billing and to argue with insurance providers, who have their own armies of secretaries hired to deny claims. If there were a public option in the US, it would (hopefully) make clear what is covered and what is not in an unambiguous way, which would make these armies of secretaries redundant.
But who am I kidding? Health care inefficiency is a jobs program for millions of white-collar PMC employees of extractive middlemen, and it will remain popular to kvech about high prices while doing nothing to bargain down prices as long as we rely on "employers" to pay for our medical expenses. Meanwhile kickbacks and bribes are legal as long as the people being bribed are responsible for buying health care equipment for us (hospital administrators) and buying drugs for us (group purchasing organizations). The corruption has been normalized.
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