Biden never will, and it's going to be awesome to see Buttigieg on The View explaining how employer-sponsored health insurance simply needs a stimulus directly to insurance companies to be able to keep covering furloughed and temporarily laid-off employees. Same as it ever was.
Hi Paul, Ryan here. We're friends through music, definitely been on the same email list before, have 26 mutual Facebook friends, etc, haha. I'm about 85% sure we've met at Fest and such before, want to say at like Timeshares or Signals Midwest or something, but I would never rely on my Fest memory (it was indoors, and it was hot). Never actually read your writing before or visited Splinter, but thought I'd toss some money towards this blog after reading the about page. Good luck with the endeavor!
Healthcare is so bizarre in this country. I've had probably 5-7 different private plans over the past 15 years, mostly through employers, but have also purchased in the market place before, which was a generally awful experience of paying more for less coverage. Nothing has consumed more of my disposable income over the years than healthcare, no doubt, even on what you'd consider a good plan. I do have a couple chronic health issues and I think this year will be the first year I don't hit my out of pocket max in the past 4-5 years, which even on my best plan would be at least $6500 out of pocket per year. In practical terms, including medications, copays, and premiums the number is probably closer to $10k.
Really, I feel fortunate though. I work in IT and can generally land the types of jobs where I can afford those bills. It's definitely not lost on me that $10k/year in medical expenses is more than most people can probably afford, and I know that even being able to afford those costs still serves as a significant stressor in life.
I had some contract work supporting Center for Medicare and Medicaid (CMS), particularly the innovation center that was created as part of the ACA. I didn't stay long. I've worked at a variety of organizations: big investment firm, humanitarian aid/international development nonprofit, environmental advocacy nonprofit, workforce development nonprofit, and with campuses for senior living communities. Nothing was as daunting to me as the CMS stuff. Gimme a natural disaster any day. The level of complexity in this health care system is a fucking nightmare. I hope I never have to sit in a meeting and listen to people try and describe health care models ever again. Not because they aren't highly intelligent people, but because you can't just innovate your way out of a system where the incentives, leverage, and basic understanding of human behavior are so out of whack. The smartest minds in the room can't fix this.
Anyway, the point of this comment is actually that I think a good place to advocate for single payer is with the people that actually administer Medicare and Medicaid. There was a lot of skepticism around that type of solution. Why wouldn't there be though really? If you are having trouble administering something to start and the proposal is an enormous expansion of what you're doing, it seems a pretty rational thought to me. If single payer is ever implemented it will be first through overwhelming public acceptance, not political acceptance. Be well!
I think you're spot on that this is something that needs buy-in from the bureaucracy. I think a lot of people in the bureaucracy are frustrated by the system as is, though -- especially since the implementation of Obamacare and the shift of more Medicaid and Medicare services to private insurers, I'm sure they're fielding calls from people that they can't help because of Aetna or whoever is fucking them over.
Where I disagree is that I think that, like with gun control or any other issue, the political willpower is way behind public support. Most polls show that Medicare for All has majority approval among all voters and I think that number would be growing exponentially right now if the Democratic nominee was pitching it even as a temporary solution to get these 5.4 million (likely more than that) back on healthcare coverage. It's not overwhelming support, of course, but over the past five years it's gone from a fringe position to something that most Democrats and independents are interested in moving towards.
The bigger problem is that there is nothing more insular than a congressional Democrat, and in many cases, it's not just a matter of ideological disagreement but one where they're breaking with an entire industry that's very active in the political process. Republicans are a lost cause, but if you have Obama 2009-2010-style majorities and broad consensus within the party on Medicare for All, it becomes a reality overnight.
I think it's a three-pronged process: getting support for it from someone like Biden, a mainstream centrist who's a party leader, convincing swing seat Democrats that it won't kill their re-election chances (or that it's worth killing their re-election chances for), and most importantly, successfully replacing safe seat Democrats who oppose it (or support it only nominally) with people who will actively fight for it. More AOCs and Jamaal Bowmans, basically.
At this point, with Bernie out of the race, I think it's a 10-20 year project, and maybe something to be rolled into the Green New Deal. But I think the more healthcare and economic crises we go through, the more people get moved away from traditional jobs towards gig work, and so on, the more people are going to wake up to the reality that employer-based health insurance is only fundamentally not fair, but not feasible either.
Hope all of that fleshes out my view on what it'd take to get to Medicare for All a bit more. Thanks for subscribing!
Thanks for the reply Paul! The main concern I'd have though is I don't think Biden is a single payer believer and this is a thorny enough issue that I don't know I really want someone who isn't full hearted into it talking about it from that platform. I think there's a solid chance for backfire there. I'm a big Warren fan, have been for a long time, but she sounded terrible on this topic and it made the whole idea look poor. If someone's going to advocate single payer I think they need to be able to do it honestly. Just my opinion though. I'm also somewhat skeptical of the public opinion part. I'm glad it's trending that way, but I cannot help but remember to that whole year I read the news about Obamacare debate every day and saw how effectively Republicans sidelined it. I actually feel like that was the turning point when they realized they didn't really need to tell any kind of truth, they just had to look strong in what they were saying. Who knows though, I hope you're right.
My experience with the marketplace has been such a nightmare. Before I got hired at Splinter, my premium was jacked up $175 year over year for a plan that actually covered less than the previous one did. Aside from small business owners, I'm not sure how they expect anyone who's coming to the marketplace in the first place to pay for this shit.
My employer has already announced another round of layoffs are coming so I checked the ACA plans to see what I can expect to pay. The absolute cheapest plans are starting at $300/month and offer no coverage till the deductible which is over $8,000.
I sincerely hope Buttigieg is crushed to death by a giant whiteboard in the near future.
Biden never will, and it's going to be awesome to see Buttigieg on The View explaining how employer-sponsored health insurance simply needs a stimulus directly to insurance companies to be able to keep covering furloughed and temporarily laid-off employees. Same as it ever was.
If it ain't a handover of public money to private companies, then it ain't Neoliberalism. That's the Pete promise.
Hi Paul, Ryan here. We're friends through music, definitely been on the same email list before, have 26 mutual Facebook friends, etc, haha. I'm about 85% sure we've met at Fest and such before, want to say at like Timeshares or Signals Midwest or something, but I would never rely on my Fest memory (it was indoors, and it was hot). Never actually read your writing before or visited Splinter, but thought I'd toss some money towards this blog after reading the about page. Good luck with the endeavor!
Healthcare is so bizarre in this country. I've had probably 5-7 different private plans over the past 15 years, mostly through employers, but have also purchased in the market place before, which was a generally awful experience of paying more for less coverage. Nothing has consumed more of my disposable income over the years than healthcare, no doubt, even on what you'd consider a good plan. I do have a couple chronic health issues and I think this year will be the first year I don't hit my out of pocket max in the past 4-5 years, which even on my best plan would be at least $6500 out of pocket per year. In practical terms, including medications, copays, and premiums the number is probably closer to $10k.
Really, I feel fortunate though. I work in IT and can generally land the types of jobs where I can afford those bills. It's definitely not lost on me that $10k/year in medical expenses is more than most people can probably afford, and I know that even being able to afford those costs still serves as a significant stressor in life.
I had some contract work supporting Center for Medicare and Medicaid (CMS), particularly the innovation center that was created as part of the ACA. I didn't stay long. I've worked at a variety of organizations: big investment firm, humanitarian aid/international development nonprofit, environmental advocacy nonprofit, workforce development nonprofit, and with campuses for senior living communities. Nothing was as daunting to me as the CMS stuff. Gimme a natural disaster any day. The level of complexity in this health care system is a fucking nightmare. I hope I never have to sit in a meeting and listen to people try and describe health care models ever again. Not because they aren't highly intelligent people, but because you can't just innovate your way out of a system where the incentives, leverage, and basic understanding of human behavior are so out of whack. The smartest minds in the room can't fix this.
Anyway, the point of this comment is actually that I think a good place to advocate for single payer is with the people that actually administer Medicare and Medicaid. There was a lot of skepticism around that type of solution. Why wouldn't there be though really? If you are having trouble administering something to start and the proposal is an enormous expansion of what you're doing, it seems a pretty rational thought to me. If single payer is ever implemented it will be first through overwhelming public acceptance, not political acceptance. Be well!
Hey Ryan! Good to hear from you.
I think you're spot on that this is something that needs buy-in from the bureaucracy. I think a lot of people in the bureaucracy are frustrated by the system as is, though -- especially since the implementation of Obamacare and the shift of more Medicaid and Medicare services to private insurers, I'm sure they're fielding calls from people that they can't help because of Aetna or whoever is fucking them over.
Where I disagree is that I think that, like with gun control or any other issue, the political willpower is way behind public support. Most polls show that Medicare for All has majority approval among all voters and I think that number would be growing exponentially right now if the Democratic nominee was pitching it even as a temporary solution to get these 5.4 million (likely more than that) back on healthcare coverage. It's not overwhelming support, of course, but over the past five years it's gone from a fringe position to something that most Democrats and independents are interested in moving towards.
The bigger problem is that there is nothing more insular than a congressional Democrat, and in many cases, it's not just a matter of ideological disagreement but one where they're breaking with an entire industry that's very active in the political process. Republicans are a lost cause, but if you have Obama 2009-2010-style majorities and broad consensus within the party on Medicare for All, it becomes a reality overnight.
I think it's a three-pronged process: getting support for it from someone like Biden, a mainstream centrist who's a party leader, convincing swing seat Democrats that it won't kill their re-election chances (or that it's worth killing their re-election chances for), and most importantly, successfully replacing safe seat Democrats who oppose it (or support it only nominally) with people who will actively fight for it. More AOCs and Jamaal Bowmans, basically.
At this point, with Bernie out of the race, I think it's a 10-20 year project, and maybe something to be rolled into the Green New Deal. But I think the more healthcare and economic crises we go through, the more people get moved away from traditional jobs towards gig work, and so on, the more people are going to wake up to the reality that employer-based health insurance is only fundamentally not fair, but not feasible either.
Hope all of that fleshes out my view on what it'd take to get to Medicare for All a bit more. Thanks for subscribing!
Thanks for the reply Paul! The main concern I'd have though is I don't think Biden is a single payer believer and this is a thorny enough issue that I don't know I really want someone who isn't full hearted into it talking about it from that platform. I think there's a solid chance for backfire there. I'm a big Warren fan, have been for a long time, but she sounded terrible on this topic and it made the whole idea look poor. If someone's going to advocate single payer I think they need to be able to do it honestly. Just my opinion though. I'm also somewhat skeptical of the public opinion part. I'm glad it's trending that way, but I cannot help but remember to that whole year I read the news about Obamacare debate every day and saw how effectively Republicans sidelined it. I actually feel like that was the turning point when they realized they didn't really need to tell any kind of truth, they just had to look strong in what they were saying. Who knows though, I hope you're right.
My experience with the marketplace has been such a nightmare. Before I got hired at Splinter, my premium was jacked up $175 year over year for a plan that actually covered less than the previous one did. Aside from small business owners, I'm not sure how they expect anyone who's coming to the marketplace in the first place to pay for this shit.
"This punk motherfu...Oh. I see."
My employer has already announced another round of layoffs are coming so I checked the ACA plans to see what I can expect to pay. The absolute cheapest plans are starting at $300/month and offer no coverage till the deductible which is over $8,000.
I sincerely hope Buttigieg is crushed to death by a giant whiteboard in the near future.