Why are people treating health care reform like it's a first step?

[ContinentalOp]

What other major social program has ever been improved? Has social security ever been improved? Welfare? Public Education? As far as I can see these things have only ever been slowly but systematically defunded and dismantled.

What is the cause of the idealistic fantasy that we can get some kind of halfway step toward health care reform now and improve it later? Where is the precedent in U.S. history for something like that ever happening?

[lindisfarne]

1. What have the Romans ever done for us? (... And the wine ...)

http://www.youtube.com/watch?v=hSELOCMmw4A

[ContinentalOp]

7. Alright but...

apart from the sanitation, the medicine, education, wine, public order, irrigation, roads, fresh water system, and public health....

[Howzit]

2. What happens when idealism meets realism?

I fully expect you to be accused of being a closet conservative...

[ContinentalOp]

11. I don't know, I consider myself a realist.

I supported Obama, not because I thought he would be a progressive hero but for the simple reason that I knew he could WIN.

But by extension I was hoping he could use that political capital to get shit done. And now that we have clear majorities in Congress I was hoping we could get a lot more done.

I know single payer is probably unrealistic but FFS, I thought at least my health insurance costs would go down. I guess that was a pipe dream.

[madville]

3. Appear to be doing something while making the corporations richer?

Mandate we all buy health insurance, keep tying it to employment hindering small business, the tax on the rich won't make it through the Senate, underfund whatever happens, it all sounds like business as usual to me.

[Echo In Light]

38. That's the point, and America will passively accept it as they do every other atrocity.

That's the defining aspect of America.

[sandnsea]

4. All of them

They added disability and survivors to social security.

They added food stamps to the food warehouse, and then added WIC to that. Added school breakfasts to school lunches.

They added SCHIP to Medicaid, and many states have added subsidized insurance for adults.

Everything has been improved over the years. It's the way it's done in this country.

[ContinentalOp]

8. OK, I stand corrected. -nt-

[dflprincess]

13. Reagan rolled back survivor benefits so kids are cut off when they're 17 or 18

When I was collecting Survivor's Benefits we could get them until we were 22 as long as we were in school. A lot of people wouldn't have gotten through college without them.

Disability has become very hard to qualify for unless you can afford a lawyer. As an example, the local news recently had a story about a man who has renal failure and has to have dialysis done several times a week. Social Security no longer considers renal failure grounds for disablility.

Food programs have been cut and eligibility tightened. Keep in mind that food subsidies were not started for entirely altruistic reasons. During WWII military doctors were shocked by the number of recruits they had to turn away because they had problems that were the result of early childhood nutrition problems (these were the Depression kids). It was decided that something had to be done to keep potential cannon fodder healthy.

States that are strapped for cash are cutting their medical programs. In Minnesota Gov. Pawlenty completely did away with General Assistance Medical - the program that aided the poorest.

If this plan that's being put forward were truly a step toward single payer, single payer would have been a serious part of the discussion this time around; instead it has been largely ignored except for a few members of Congress actually care about the "general welfare". If "reform" in it's current form is passed, it will be years before the issue is ever revisted.

[ContinentalOp]

15. I agree. What truly bothers me is that if the current plan is going to act as a first step...

toward single payer, it has to be cheaper than most people's private insurance. As well it should be, absent any profit motive. And yet there is much anecdotal evidence here on DU that the plan currently under discussion would be more expensive for many people.

[sandnsea]

20. We could go back to 1920

Then you'd at least have something worthy of bitching about.

SSD eligibility
http://www.thedisabilityexpert.com/Disability%20Benefits%20for%20Kidney%20Disease,%20Other%20Disorders%20of%20the%20Urinary%20Tract,%20and%20Reproductive%20Organs.html

Food programs have not been cut or tightened in Oregon. It's easier to get on them now than I can ever remember. Even though the programs started as a military endeavor, which I have posted on several occasions, that hasn't been their purpose in a long time. WIC has been expanded to provide fresh fruit and veggie vouchers. There are summer free lunch programs in the parks. Day cares get federal lunch program money. The food banks all get food deliveries and money from the feds. Improvement.

Many states did do away with adult assistance programs and transferred those funds to work assistance programs. The state pays the worker minimum wage and employers provide internship training.

This may or may not be a first step towards single payer. Single payer was never on the table because there wasn't a snowball's chance in hell it would pass. IF we ever get to single payer, it will be because a public plan works better than private insurance. Pragmatic progress. It's the way we do things in this country.

[ContinentalOp]

21. There's a problem with your logic.

What if the public plan doesn't work better (cheaper) than private insurance? All of the evidence points to that being the case. It helps the uninsured but does nothing for the middle class who are already insured. Won't that just prove the opponents' arguments that public health care won't work, therefore undermining the very idea of public healthcare in the public's eye?

[sandnsea]

22. Then people will have subsidies for insurance

And who the hell gives a shit as long as everybody has health care that isn't bankrupting them?

[ContinentalOp]

23. As a fairly well off middle class person...

I was hoping to get out from under the evils of the private insurance industry as well. But if this is just about helping the neediest I can accept that. I just kind of thought that's what Medicare and Medicaid were already about. I don't really know anything about those programs though.

A lot of people have made the point that Sicko for example was not about the uninsured but about people who thought they had good health coverage and ended up getting screwed by the system. I had assumed that the problem was much bigger but of course taking care of the uninsured is an important first step.

I just know that under the proposed house plan, if I suddenly get dropped from my private insurance for some reason my insurance costs will double. I had bought into the idea that a public plan would amount to huge savings but it looks like that's not really going to be the case for many people. But on the other hand it's nice to know that I at least have the public option.

[sandnsea]

25. Why did you think that would happen?

Seriously, talk me through the thinking process over the last couple of years that caused you to believe we were going to get rid of private insurance with any electable Democrat's health reform plan?

After that, why would your insurance cost double if you were dropped from your private insurance? And why would you not get assistance with your insurance, unless you consider everyone making less than $100,000 per household, "needy".

[ContinentalOp]

33. I didn't think we would get rid of private insurance but I thought the public plan would be cheaper

not more expensive. Lack of a profit motive and other efficiencies were supposed to make the public option competitive with private insurance right? If the plan under discussion is $10,000 a year for families then that's over double what our private insurance is now.

[dflprincess]

41. There wasn't a chance single payer would pass because it was never given a fair hearing

Polls are showing at least half the public favoring single payer and a big majority favor a strong public option. The problem is, 100% of those who own Congress are against it.

[Juche]

5. medicare

It used to have a cap on taxes like SS, but it was eliminated in 1993. As a result medicare will be solvent for far longer than it would've been and had Clinton not removed the cap it likely would be bankrupt already. No republicans voted for the 1993 budget bill, and the GOP took over congress in 1994.

Medicare also had a prescription drug benefit added.

Plus SS has had it's tax rate raised several times. So social programs can and do become bigger.

[ContinentalOp]

9. Good to know, thanks. I thought the prescription stuff was controversial though.

I'll admit to knowing absolutely nothing about it.

[scheming daemons]

6. Social Security was improved in the 50s, 60s, and 70s

It wasn't until Reagan and the 80s that it started being dismantled.

[ContinentalOp]

10. OK, having been born in '77...

my life's impression is an ever advancing push toward privatizing and dismantling every useful function of government. So I'm a bit skeptical about "first steps" toward single payer.

[scheming daemons]

12. Because, 29 of your 32 years came after Reagan

...and your perspective is that of a life lived mostly under Republican rule.


Republicans whose stated goal was to dismantle the entitlement programs of this country.



Prior to Reagan, our government often improved on programs from their initial "first steps"


...the GI bill

...Social Security

...The Interstate Highway System

...Medicare

...the FHA

...and many many more.



We've just purged our government of the Reaganites for the time being. Maybe it will hold.

[ContinentalOp]

14. Exactly. I think things have changed permanently for the worse.

Particularly if you look at other countries who used to have great social programs far beyond ours that are also getting dismantled by right wing elements. This is some kind of global trend.

I'm not as optimistic as you that we've "purged our government of the Reaganites."

[scheming daemons]

16. There's no such thing as "permanently" in politics, or in life

In 1933, many people thought things had changed "permanently" for the worse.

25% unemployment
No safety nets at all (no Social Security, Welfare, Medicare... NOTHING)


But FDR *DID* change it.

Obama's presidency is at a similar crossroads for this nation as FDR's was.



Every time in this nation's history that things looked darkest, we managed to pull ourselves out of it. Your limited perspective, growing up in the age of Reaganism, doesn't permit you to believe it.


But you need to try.

[ContinentalOp]

17. No, I agree, but that's why I see this as a window of opportunity...

and I'm worried that it will be squandered.

Based on my limited understanding of history, my impression is that FDR did change things for the better and after that there were a few decades of minor tweaks at best, followed by a several decade downward slide.

[Laelth]

18. Very good question. k&r n/t

:dem:

-Laelth

[leftstreet]

19. Because our wealthy overlords have no intention of giving us single payer

This for-profit bs bill is it.

It will fail.

Then the talking heads can tell us that Americans just weren't ready for healthcare reform.

:puke:

[billyoc]

24. Because nobody wants to admit that the Democratic Party was never going to do it anyway.

It's easier to say, "We can build on it from here", and "It's a good first step", than to admit and/or realize that the Democratic lawmakers they worked *SOOOOO* hard to elect are in the employ of the insurance/hedge fund industry.

[sandnsea]

26. No Democratic Party leader ever promised single payer

I have said it for years, there will not be single payer. This country won't pass it. Don't say nobody wants to admit it. Democrats have done nothing but scream it from the rooftops but the left won't accept it.

[Laelth]

28. That may be true.

But why can't we have a public option like the U.K., then, funded by taxes (solely) that does not require any premium payments. The NHS was never single-payer. It's just a taxpayer-funded public option. What's wrong with that? Why can't we have that?

:dem:

-Laelth

[sandnsea]

31. Subsidies are funded by taxes

The subsidies will go to both the public option and the private insurance. What difference does it make if the affordable part is called a tax or a premium?

[ContinentalOp]

34. Well for starters not one dime of public subsidies should go to the private insurance industry.

I don't care what it's called but there's a clear difference between a tax and a premium. An income based tax would be progressive and could fall most heavily on the very wealthy and, by definition, add no burden at all to the unemployed. Premiums are a roundabout way where we still offer a subsidy to the poor, but then there's a broad middle class segment where everyone is paying the same flat rate right? Which is not progressive. Or do I misunderstand the plan?

[sandnsea]

35. Well there will be subsidies

They will be on a sliding scale, up to 400% of poverty. As I said earlier, just about everybody will get help unless you consider households earning less than $100,000 poor.

[Laelth]

43. And the non-subsidized part?

The non-subsidized contribution represents a whopping, 12%-of-gross income tax on uninsured Americans. And the uninsured are the people who can't afford insurance already.

Let's be clear. Only a small portion of the cost of this plan will be paid by tax increases on the rich. The majority of the cost will be paid through a massive, new tax on the uninsured.

That's insane. It's unconscionable, and it will drive people away from the Democratic party. Frankly, I don't care what we call it. It's a bad idea.

:dem:

-Laelth

[Sebastian Doyle]

29. And as long as you keep making excuses for this corporatist bullshit

They'll keep right on doing it.

[billyoc]

40. It's all part of the dream. Of Democratic boosterism and triangulation.

[Laelth]

42. I learned my lesson with Clinton.

It's not enough just to pass "something" so that a Democrat can say they got something done. Using that strategy Clinton dismantled AFDC, gave us NAFTA, gave us the Telecom Act of 1996, and repealed Glass-Steagal. On those fronts, Clinton was a disaster for working Americans, but he remained popular. No. Not this time. "Just any new law" will not do.

And this one is a disaster in the making.

:dem:

-Laelth

[FunkyLeprechaun]

27. I think Health Care in the US is already at crisis point

Over 40 million people cannot afford health care. I think health care reform should be one of the first steps in improving the American health system.

[mp9200]

30. Agreed

We need to drastically change the way we approach such areas.

[Maru Kitteh]

32. and just let people die in the process. That's so honerable and so "freedomy"

It's totally patriotic to let uninsured people die. GO FREEDOM!

[ipaint]

36. We have for decades.

The for profit insurance companies bought this bill. The same ones that have killed hundreds of thousands of americans because they make profit by NOT providing care. How anyone not delusional can believe this bill or anything watered down that will be final does not cater to the insurance industries need for more and more profit is beyond me.

It has failed in every state that attempted it. Massachussetts is in the process of cutting off all legal immigrants who were subsidized because there is no money. I guarantee just like in welfare reform the subsidies will be whittled away. People who receive subsidies will be ostracized and accused of being lazy parasites living off of hardworking unsubsidized folks dime.

We are nationalizing a failed model for health care because the insurance companies have us by the balls.




BILL MOYERS: Sid, you've been watching this and involved in this since 1971. What happens if they pass comprehensive health reform that is really just more of the same in disguise? What happens to health care after that?

DR. SIDNEY WOLFE: Well, the country, whether it's the employers who have to pay for it, or the patients who are paying for it, is going to go bankrupt much more quickly. It is not economically feasible to pass anything other than a single-payer, government collecting the money and paying the bills, and provide health care. It's never been done in any country. Taiwan, of all places, said, we don't like the fact that 40 percent of our people are uninsured. They passed, essentially, single-payer plan and within a few years 90-95 percent of the people were covered.

So, we have lots of models to draw on. Learn something from Canada, learn something from Taiwan, from a number of other places. It's inexcusable that we do anything but that. Anything that passes is not going to work. I guarantee that, 100 percent. And David will agree with me.

http://www.pbs.org/moyers/journal/05222009/transcript2.html

[BlooInBloo]

37. This appears to be a thread about you knowing nothing.

[JVS]

39. All those things you mention were either started or improved by the new deal, and then again...

with the great society.


I'm not sure the healthcare plan is a first step or a terminal one, but your examples really suck for the argument you're making.