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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsHealth Care: We Are Nowhere Near A Single-Payer System
http://hcao.org/home/2016/4/20/health-care-we-are-nowhere-near-a-single-payer-systemLetters to the Editor The Seattle Times, April 5, 2016
by Marcia Stedman, Bothell
I greatly respect Paul Krugman. However, when it comes to health care, his understanding of a single-payer system is deeply flawed [Learning from Obama, Opinion, April 4].
He offers his opinion that Obamacare is looking much more like a single-payer system than anyone seems to realize. The Affordable Care Act bolstered the health insurance industry by requiring all Americans to purchase health insurance or else get it from their employers. Many of the laws provisions did benefit Americans who otherwise were not able to afford medical care.
However, the system we have now under the ACA is not in any way a single-payer system. As long as multiple insurance companies and health plans are involved, it is a multi-payer system. As such, it does not provide anywhere near the truly universal access, administrative savings or negotiating power that a true single-payer system would. We already have one of those its called Medicare, and it does bring down health-care costs and make care more affordable for its targeted population. Its time to roll that system out to all Americans.
http://static1.squarespace.com/static/5037dc7ac4aa52a2f9107b23/t/57185896f699bb3a1e3a990f/1461213693690/?format=750w
http://hcao.org/home/2016/4/20/health-care-we-are-nowhere-near-a-single-payer-system
malokvale77
(4,879 posts)SHRED
(28,136 posts)...$14,000 in 2014.
$12,000 last year in the individual market.
This is with about half of our premium covered under a Covered California Silver plan.
That's a good chunk of change I pay.
Baobab
(4,667 posts)"For the purposes of this Agreement
(b) 'services' includes any service in any sector except services supplied in the exercise of governmental authority;
(c) 'a service supplied in the exercise of governmental authority' means any service which is supplied neither on a commercial basis, nor in competition with one or more service suppliers."
SHRED
(28,136 posts)Baobab
(4,667 posts)nt
ScreamingMeemie
(68,918 posts)Asking someone else to find what you are talking about is a lazy way to post.
Baobab
(4,667 posts)in the real world do?
Do you want to know why our health care is screwed up, or don't you?
People learn more if they learn things by a process involving some action.
ScreamingMeemie
(68,918 posts)As for me... ACA got me in the door to a doctor, which is more than I can say for the years before. The damage was done, but I got in the door and they had to treat me.
My comment was in regard to your response to SHRED. That was undeserved.
Baobab
(4,667 posts)Broadly speaking, there are three tiers of GATS rules affecting health care. The first tier of rules, General Obligations and Disciplines, apply equally to all service sectors of all WTO member countries, regardless of whether those sectors are committed in a countrys schedule or not. The second tier, Specific Commitments, apply only to those sectors that a country commits to its schedule. These rules are more far-reaching, and members were given the opportunity to write any exceptions or limitations to them into their schedules. Finally, under GATS Part III, Article XVII, WTO member countries are allowed to negotiate a third tier of rules to govern their commitments above and beyond the underlying Specific Commitments rules that normally apply. Citing this provision, the United States has inscribed its Financial Commitments schedule with the supplemental rules of the Understanding on Commitments in Financial Services. These rules apply in addition to the underlying GATS Specific Commitments rules on Market Access and National Treatment (described below). Table 1 Selected rules included in the General Agreement on Trade in Services Rule tier Binding upon Rule content General Obligations (Tier 1) All member states of the World Trade Organization 1. Most-favored nation treatment. 2. Prohibition on new monopolies 3. Disciplines on domestic regulation Specific Commitments (Tier 2) Only those service sectors that members choose to bind in their schedules of commitments 1. Open market access obligations 2. National treatment of all foreign service provider Supplementary Voluntary Commitments (Tier 3) Service sectors already scheduled that members choose to make additional liberalization commitments in (financial services in the U.S.) 1. Subjection of public entities to GATS rules 2. Standstill of existing exceptions to liberalization 3. Requirement to allow any new financial service 4. Requirement to endeavor to remove or limit any significant adverse effects of domestic regulationInternational Trade Law and U.S. Health Reform
/ 367 General Obligations and Disciplines. These rules apply to all service sectors of all WTO member countries, regardless of whether or not the sectors have been committed to a nations schedule. While these are generally the least controversial provisions, several may have serious implications for reform or regulation of the health sector (4). Most-Favored-Nation Treatment: This provision requires a member to give service suppliers of any other WTO member no less favorable treatment than it gives service suppliers of any other country (4, Art. II). Prohibition on New Monopolies: This provision requires that if a country grants new monopoly rights regarding the supply of a service covered in its schedule, the country granting the monopoly must enter into negotiations to provide compensation to any other member adversely affected by it. If an agreement is not reached, the affected member may refer the matter to arbitration, and the monopoly may not go into force until the compensation required by the arbitration has been made. The term monopoly rights is not defined anywhere in the agreement (4, Art. VIII). Disciplines on Domestic Regulation: In sectors where no commitments have been undertaken, the GATS states that a special Council for Trade in Services shall develop disciplines that assure that qualification requirements and procedures, technical standards, and licensing requirements for the provision of services are not more burdensome than necessary to ensure the quality of the service. Regarding sectors in which commitments have been undertaken, however, it is unclear whether such a necessity test is already in force (4, Art. VI). Specific Commitments. These rules apply only to service sectors that members have volunteered to submit to the rules by inscribing them in their schedules. Members were also given an opportunity to reserve specific exceptions to the rules during the negotiations of their schedules. Rules in this section fall into two broad categories, Market Access and National Treatment. Market Access: The rules in this section are aimed at preventing governments from limiting the number, type, form, or size of foreign service suppliers in their markets or intervening to affect or regulate the way the firms provide the service. Examples of prohibited measures include (4, Art. XVI):
Limitations on the number of service suppliers Limitations on the total quantity of service output Requiring a specific type of legal entity (e.g., nonprofit) Limitations on the total value of service transactions or assets National Treatment: This set of rules requires that foreign service suppliers receive, in respect of all measures affecting the supply of services, the same treatment that a nation gives to its own service suppliers. It is easy to think of situations in which a country may want to shape policy to favor domestic industry368
/ Skala over foreign operations, but the GATS rules go even farther than these requirements. Under the National Treatment rules, any measure that modifies the conditions of competition in favor of a domestic supplier is a GATS violation. In other words, even if a policy has no intent to discriminate against foreign service suppliersindeed, it can be totally unrelated to service provision at allif it has the effect of disadvantaging them, it is potentially a violation of the GATS (4, Art. XVII). Special Rules for Health Insurance. The United States committed health insurance to its schedule under the Financial Services section. Two special sets of rules apply to commitments made under this section. The first is the Annex on Financial Services, a unique set of constraints that apply to all commitments in financial services, no matter what nation makes them. The second is an even more expansive Understanding on Commitments in Financial Services, a set of extreme liberalization rules that are an optional attachment to commitments in financial services that the United States has chosen to take. These rules go so far in constraining governments that only developed countries have signed on to them. The Annex on Financial Services: Most financial services are related to banking and investment, hence the Annex provisions pertain mostly to them. One provision in particular is significant in assessing the impact of the GATS on health care:
Subjection of Public Entities to GATS Rules: Normal GATS rules make an exception for government services and procurement (with significant limitations). The Annex specifically states that if a nation allows domestic service suppliers to compete with public entities, those entities are subject to GATS rules. This will have significant implications for Medicare, as we will see (4, Annex on Financial Services, §1(b)(iii)). The Understanding on Commitments in Financial Services: The most farreaching document in the GATS, the Understanding binds signatory nations to an extreme level of financial services liberalization. The commitments undertaken by signatories to the Understanding include (interpretation of the Understanding [5] aided by Kevin C. Kennedy, Professor of Law, Michigan State University College of Law):
The Standstill Provision: The signatories pledge that any exceptions to the commitments they have made are limited to existing measures. The implications of this vaguely worded provision are not entirely clear. Some commentators believe that the signatories bind themselves to never enact a limitation on their commitments in the future that was not in effect when the Understanding was inscribed in their schedule. In effect, the level of privatization at the time of the implementation of the Understanding is locked in (5).International Trade Law and U.S. Health Reform
/ 369
New Financial Service: Signatories pledge to allow foreign firms to offer any new financial product in their territory, as long as another WTO member offers it (5, Art. B(7)).
Domestic Regulation: Signatories pledge to endeavor to remove or limit any significant adverse effects on foreign investors of any laws that affect adversely the ability of foreign firms to operate, compete, or enter the domestic market (5, Art. B(10)).
Baobab
(4,667 posts)they are experts at dumping people when they get serious illnesses.
Is a huge huge gift to the insurance industry and did not do one damn thing to reign in health care costs...
Baobab
(4,667 posts)preventing a reduction in prices.
SammyWinstonJack
(44,130 posts)Hydra
(14,459 posts)And they still complain about it!
Single payer is inevitable, the only question is how much suffering all of us are going to have to endure before we get there.
SHRED
(28,136 posts)Arguing, judging, and keep the masses fighting.
Yes, the question truly is how much suffering will be tolerated before the inevitable occurs...public health care.
Baobab
(4,667 posts)At least 100,000 people a year die earlier than they would in the civilized countries.
That has to be worth something, in terms of savings to the health insurance companies. Also drug companies get to increase prices still more. Also it helps keep poor people with minor illnesses out of the job market.
And keeps US wages down.
Also its a RFOA which allows employers to lay off older workers legally when they need to.
Also, it prevents class mixing. (When some poor person self pays or goes overseas and accidentally gets good health care, which can cause liability problems)
Baobab
(4,667 posts)Hydra
(14,459 posts)The people profiting will not let go easily.
Insurer Achmea paid Bill Clinton $600,000 to make a speech
Lifestyle
June 30, 2014
Dutch insurance company Achmea paid former US president Bill Clinton $600,000 to make a speech in Friesland in 2011, according to research by the Washington Post.
The fee the equivalent of 440,000 is one of the highest ever paid to Clinton who is much in demand as a public speaker. The highest fee was $750,000, paid by mobile phone giant Ericsson in 2011, the Washington Post figures show.
The Dutch speech, in the Frisian village of Achlum where the company was founded, was to celebrate Achmeas 200th anniversary at a conference on the future of the Netherlands.
According to the Volkskrant, in his speech Clinton called for a unique Dutch answer to modern solidarity.
Achmea, the biggest player on the Dutch health insurance market, declined to comment on the report, the Volkskrant says.
ReRe
(10,597 posts)... when I hung on every word of Paul Krugman. Back when PO first came into office. So, now that he has confessed his leanings, I have one less column to read every day. Good.
SmittynMo
(3,544 posts)Ummm yeah......
Here's the problem:
Hillary - No way
Bernie - Hell yes
So who are you going to vote for?
KG
(28,751 posts)Baobab
(4,667 posts)Last edited Sun Apr 24, 2016, 09:34 PM - Edit history (1)
which is in my .sig