Wednesday, September 13, 2017

Ryan Grim — The Obamacare Fight Is Over — Now It’s On To Universal Medicare


The train is pulling out of the station.

13 comments:

Noah Way said...

Reforming the financial-health-industrial complex is on par with reforming the financial-military-industrial complex.

Matt Franko said...

"enough is enough" = "we're too stupid to figure it out"

Tom Hickey said...

This has been figured out and amply tested outside the US.

The major difficulties in the US are reversing course on the vested interest in the sectors involved, principally insurance, health care provision including admin, and pharma.

These sectors stand to lose big in reform since the problem is their obscene rent extraction.

Matt Franko said...

Then just make the providers come up with a number on offer like everybody else does...

Tom Hickey said...

Reduce the amount of rent extacted by increasing efficiency.

Markets only work through competition to increase efficiency and effectiveness.

Natural monpolies/monopsonies and oligopolies/oligopsonies, and well a highly regulared fields that create artificala scarcity thtough licensing, are not competitive environments.

Health care is not a competitive marketplace in either insurance or provision, and there is no way to make it a competitive market place. The attempt to do is a boondoggle that is driven by ideology on one hand and vested interests on the other.

The only way to correct his other than socializing it is to tax away the rents.

Matt Franko said...

Tom that's not the way it just worked in the oil...

North America increased production and lowered their price on offer and gained share...

Now we are down to $50 from $150 when the OPEC had full control...

Just make sure every market (major) has more than 1 provider network and they can compete with each other...

What does "single payer" mean anyway? There are no details in this slogan...

Trump is proposing an annual federal tax credit for healthcare, that would make the govt the "payer" and the govt is a singular entity so it could also be considered "single payer"...

What are the details? And who is developing them and are these people qualified?

Bernie is NOT qualified I can tell you that he is a moron political science major who knows how to run his mouth to the other moron SJWs but he probably could not even check the oil in his car...





Tom Hickey said...

ust make sure every market (major) has more than 1 provider network and they can compete with each other...

Matt, there is no competition in rural America in healthcare and there won't be for lack of resources in the first place, and secondly owing to entry costs. It's just not profitable or it would have been done.

"Increase compettion" is the classical liberal/neoliberal solution. In the neoclassical/ Austrian models, all economic problems arise from a lack of competition to set the correct price that balances supply and demand at the optimum level of investment of loanable funds that result from saving.

The (impossible) ideal is perfect competition, that is, no asymmetries affecting markets. The solution is to fit reality to the model of an ideal world by privatization and deregulation.

The reality is social Darwinism — let those that can't afford a good or service go without and die off if it is a vital good or service.

Matt Franko said...

Darwin is as Darwin does....

Matt Franko said...

Then establish rural zones and increase the subsidy if you live in those counties....

GSEs already do this they have identified high cost areas where the conforming limit is higher than most other areas...

This is not hard...

What IS hard is all the STEM work you have to do to get qualified as a provider...

Tom Hickey said...

Not enough volume to make competition profitable. Subsidies cancel the advantage of competition in bringing greater efficiency.

The classical liberal paradigm doens't work in this environment.

Matt Franko said...

Tom, Trump's entire tax credit is an individual subsidy... it's not a subsidy to a provider it's a subsidy to the US person...

Healthcare has gotten so complex that ALL US persons need an individual subsidy to purchase coverage..

Matt Franko said...

I just got a quote from my broker the other day: Maryland small group, female, age 64; $6500 deductible $905/mo....

fuhgetaboudit....

Tom Hickey said...

Medicare for All is the no brainer. Medicare works great for beneficiaries. The government can afford and as monopolist, it calls the shots on pricing.

The economic liberals ahve their chance and couldn't make it work.

Medicare just needs to be expanded to cover things like dental care and provision of prescription glasses.

There would still be a market for private "Cadillac care" and private insurance policies covering it, for those able to afford it.