Is it difficult for you to reconcile the ideals of the Democratic Party with a "market" solution...?

[kentuck]

...to healthcare problem?

Do you have any problem with paying the insurance companies to insure everyone? Do you find it just a little uncomfortable to be working so close with the big insurance companies?

Does it feel out of character as a Democrat to support such a plan?

In my opinion, a lot of Democrats are have difficulty with this "market" solution. Does this mean we are now Republicans? And do Democrats now put their faith in the market over government solutions?

Is this a dangerous path we are going down? Are we compromising political ideology for political reality?

[PDJane]

1. Yeah, it's a compromise.

It's also a step that is likely to lead to a single payer solution in the end, strictly because a single payer system will cost less in the long run.

[zipplewrath]

2. It's a capitulation

A compromise is when I say 5 and you say 3 so we agree on 4. A capitulation is when I say 5 and you say A so we agree it is A.

And I fail to see how it "leads" to single payer any more than the previous situation did. We'll end up at single payer because this system will become too expensive. We were already on that path and then this came along creating an environment where no one will touch health care again for a generation.

But saying that this will lead to single payer is like saying that kicking the mob out of Vegas ended gambling there. It just changed who made the money, that's all.

[Puzzledtraveller]

3. It makes some people feel better to think that.

I have been doing medicaid for 5 years and just finished my HBE training. None of my co-workers, some with 30 years believe the ACA in anyway will lead to single payer.

[Wounded Bear]

9. I disagree....

I do think that the ACA changes the impetus a bit, but single payer is coming at the state level. Vermont is already on the way to it, Hawaii, IIRC, had something going that could be called UHC of a sort. WA and the other states that actually built workable exchanges have seen remarkable progress in insuring/covering people.

The red states, that opposed and dragged their feet on this will, I think, start feeling some heat on this.

[geek tragedy]

29. The most likely avenue is to convert the insurance companies into utilitiy companies

over time via regulation creep.

[FatBuddy]

5. it's an abdication

and a payoff.

[Agnosticsherbet]

4. Free Markets were a part of liberal political philosophy from its inception, so

no to your first questions.

(2)Personally, I don't think that a free market solution is the best way to deal with what should be a basic human right. (Germany does national health care that way, though their health care organizations are non-profits.) I have no problem paying insurance companies. I've done it much of my life.
(3) There is nothing inconsistent with the Democratic Party of the United States using a free market solution for Health Care. Liberalism, which is the original core of Democratic ideology, supported free markets as part of economic liberty. We are not Republicans for advocating a free market solution.
(4) I can't speak for all Democrats. I'm retired military and enjoyed the most efficient socialist medial care system in America while on active duty. Tricare has been mostly quite good. I also used health insurance from employers, and as a child health care paid for by my mother. We are not comprimising political ideology because free markets are an essential piece of liberal ideology.

(4) Dangerous, no. It is not the most efficient way to deliver health care to all citizens, in my opinion, bit it isn't inconsistent.

[Fumesucker]

10. It's not a free market if you are mandated to participate

[Agnosticsherbet]

26. You appear to be confused about how a free market relates to insurance.

You can buy insurance from any provider operating within your state. The solution uses these organizations to provide insurance. You are not mandated to buy from only one insurance company, say Blue Cross. That would be a government created monopoly. You are mandated to buy insurance or play a penalty.

A non free market system would be the military hospital system, the VA, or Medicare, though medicare utilizes free market HMOs, hospitals, and doctors to provide the actual care. There are not Medicare owned and managed Hospitals to treat the aged. Medicare is a single payer system.

[upaloopa]

6. Insurance cos are middle men who get a profit

that we don't need to add to the cost of health care.
A single payer cuts out the middleman.

[markpkessinger]

25. Exactly . . .

. . . a middle man who adds zero value and merely adds to cost.

[Phlem]

30. yep!

[polichick]

7. Enabling corporate profits is the new(ish) calling of the Dem party...

Yes, it's dangerous - but we went down the path quite a while ago.

[JoePhilly]

8. The President should have used an executive order to dissolve the insurance

companies.

Problem solved.

[Fumesucker]

11. A few well placed drone strikes would achieve the same result

Enemy combatants and all.

[JoePhilly]

12. Na, you'd need boots on the ground to kill all of the

insurance agents in the field too.

[Fumesucker]

21. Take out a few dozen #2 men in the insurance companies and we could really crimp their style

Sure it wouldn't be total victory but what the hell, the MIC needs to make a buck or three.

Maybe we could offer a free vaccination program in the places we think they might be hiding out and use that to get DNA samples for positive identification.

[Indykatie]

13. Would You Rather Have Nothing and Hold Onto Purist Beliefs

How would Dems get to a non "market" solution given the current make up of our government? Despite my personal preference for single payer solution I realize that was never going to happen and I applaud the ACA as a start to improve the current situation for the millions without access to insurance. The ACA won't cover everyone but we can now work on that as a needed improvement especially if like minded folks show up at the polls and vote.

[kentuck]

15. Wouldn't it be ironic...?

...if the Democrats that did not want the public option or the single payer but were OK with the Republican "market" solution were to lose their seats, when they could have voted for the single payer and would not have received any more criticism than now?

In other words, they could have voted for the public option just as easy as they voted for Heritage Plan.

[markpkessinger]

20. Great point! . . .

. . . Those blue dog Democrats are getting hammered just as hard for voting for the Free Market Faerie's Magic Healthcare Bullet as they would have for voting for single-payer or the public option. So, what was really gained here?

[jwirr]

14. For me this idea is not new. Here in MN I have had Medicaid for my daughter for many years. It was

administered through Blue Cross/Blue Shield. The laws were from the government but the implementation was the work of this insurance company. While I do not trust them I cannot say that my daughter lacked for any type of care that she needed and it was a great deal of care.

Having said that I think the government could do the same thing a lot cheaper because it is non-profit.

[LadyHawkAZ]

16. Yes, but I also think it was the best we were going to get

at this time, and hopefully will lead somewhere better in the future.

[kentuck]

17. I try to envision where this will lead in the future?

As long as the crooked insurance companies are involved, I don't ever see a single payer system.

[LadyHawkAZ]

24. My take: given time, it will help in one very important area

and that is the court of public opinion- particularly if Vermont is successful with their single payer plan. What sank health care reform under Clinton was the fact that the insurers were able to turn public opinion against the idea with the "big, scary gov't in your healthcare" campaign, and it's cost us 20 years. Now, though, we have a real law really in place, insurers trying to get greedy with the new rules, and a single payer system ready to roll in one state- all VT has to do is not screw it up, and we will have a functioning alternative to the greedy insurers that we can push.

Of course there will always be some that would rather believe Faux News than their lyin' eyes, but most people can understand concepts like "this will cost you less money and work just as well", and that's the biggest hurdle. I think we're going to win this one, it's just going to take some time.

Meanwhile, let's throw some support to VT, keep our fingers crossed, and do some major GOTV in 2014.

[markpkessinger]

18. I find it very disappointing . . .

. . . And yes, when we have come to the place where Democrats are touting the free-market fairy as a solution to what is fundamentally a social problem, it does rather underscore the point that the two parties are but two sides of the same coin.

[kentuck]

19. You are not alone.

I'm sure many Democrats feel similarly.

[TheKentuckian]

22. What fucks me up is how weak the "market reform" ended up.

No re importation of drugs, state pools and regulatory regimes, pass poor ramping to the exchanges, they can still do rescission for the same lame reasons, even left the antitrust exemption in place.

Okay, all we could do is a market based approach but for it to be so weak just in that context is sad sack shit.

[socialist_n_TN]

23. As a couple of other posters have rightly pointed out,....

"Market solutions" ARE the Democratic Party, at least in one of it's manifestations. Dems have ALWAYS been supporters of the "market", i.e., capitalism. Any support for workers is coincidental when supporting capitalism.

The only time it's possible to be a Party that is all things to all people, IOW workers AND owners, is during the boom times. And even then the owners get the lion's share and workers get a few more and bigger crumbs. Inevitably that Party winds up having to make a choice between the two at some point during times of heightened class struggle and economic down time. That's the reality of capitalism and the dictatorship of capital. It's also inevitable that when those times come a bourgeois political party will side with the bourgeoisie and NOT with the workers.

[arcane1]

27. The ultimate purpose of government is to protect its citizens from the "market"

Does our government, at the federal, state, and local levels, accomplish this protection?

No.

[geek tragedy]

28. I view it as an improvement on the current market based system.

Even our public programs--Medicare and Medicaid, are administered by private insurance companies.

The federal government doesn't have the logistical capability of implementing single payer. Heck, it barely has the capability of putting a website together.

Even the modest amount of upheaval the ACA is causing has been extremely problematic. Single payer would have been this times 100.

I don't view "buy insurance or die/face bankruptcy" as being terribly different from "buy insurance or pay a penalty."

[Hoyt]

31. Let's scrap Medicare too. 28% of beneficiaries choose Advantage Plans run by insurance companies.

Every provider claim is paid by, yep an insurance company. Prescription drug plans are through insurance companies, as are supplemental policies. Just in case, sarcasm thingy.

The truth is, you couldn't get rid of them immediately even if there were a will among Congress to do it. So you let them administer programs under government oversight, pay for systems, carry the risk, ratchet down what the get over time, make them offer similar plans so they all look pretty much the same, etc. Maybe someday we can get rid of them, banks, weapons manufacturers, and the like. Don't think it will be soon, no matter how right we think it is.

[jazzimov]

32. It's Progress. It's not ideal, but it is Progress. nt

[Spider Jerusalem]

33. What are the ideals of the Democratic Party?

"Market-based solutions" don't seem too out of step with the general direction of the party since...Clinton, at least; "third way", "business-friendly", centre-right economically. Is it what LBJ or Truman or FDR would have done? No. Am I really thrilled by it? No.

[kentuck]

34. I have always assumed that the Democratic Party stood up for the interests of the people...

...over corporations, insurance companies, etc.

My confusion is over whether this is for the interests of the people or the interests of the insurance companies?

It seems so......Republican.