Sun, 09/14/2008 - 2:59pm — hipparchia
Update: the discussion took place here.
If you're interested --
In addition to house parties around the country [for viewing the documentary Diagnosis:NOW!], Firedoglake will be hosting a virtual house party on September 14th at 7pm EST, with special guests Jim Gilliam, who's moving story is featured in the documentary, Roger Hickey, co-director of the Campaign for America's Future, and California Representative and health care champion Pete Stark!
I'll check it out, but probably not enough to report back on it, since the HCAN people bug me.
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Catch me up, Hipparchia
Why does HCAN, or their people, bug you?
short answer
i think they're actually NOT in favor of single payer.
the long answer would take several posts on the hacker plan [or obama's modification of it]: what it is, why i think it ultimately won't work, and how we came to be stuck with the democratic party and hcan pushing it.
also, the longer answer would include a bunch of *$^^ &%#* (#$^ #%$ *@($ from me in response to the non-information that hcan is spending $40 million on giving us.
but if it all ends up bringing us real single payer in short order, then i'll go ahead and eat a short order of crow. ;)
Crow would be fine
under those circumstances, I agree.
I'm of course 110 percent in favor of single-payer, but I wonder how it could be implemented in the medium-term, never mind quickly, even if all the political objections were swept away, simply because of the question of what happens to the vast insurance company infrastructure and its employees.
I've not seen single-payer advocates address the practicalities of that. What happens if single payer were decreed tomorrow? Would the fed government -- ie, we taxpayers -- have to buy out the insurance companies and their shareholders? Is there even enough money in the federal treasury to do that? And what happens to the hundreds of thousands, maybe more, direct insurance co. employees suddenly jobless, not to mention the many more employed by physicians and hospitals and other health care institutions solely to deal with insurance company claims paperwork?
Seems to me the transition simply couldn't be accomplished quickly but would have to involve some many-years-long gradual process of some kind, although I can't even imagine what that would be.
What struck me about Hillary's hc plan, to the extent I understood it, was that by opening up government hc as an option, there would be a sort of organic withering away of private health insurance as people migrated away from it.
insurance employees
hr676 provides funding for retraining and for up to 2 years unemployment benefits [i'd have to check that number, but i think it's correct]
withering away of private insurance companies
i used to think it would work that way too, but now i'm convinced they're too good at gaming the system. we'd be funneling even more taxpayer $$ to the insurance industry, until the rising costs finally break the public system too. this is what they're well on the way to doing with the medicare advantage plan [medicare pays for private insurance for some folks] -- costs have risen remarkably fast compared to back when medicare was all-public..
quick transition
actually, it's not impossible. canada took a few years, but the original province that started it all just... jumped right in.
That's encouraging, but
what's the difference in population between Canada and the U.S.? Seems to me the problem is orders of magnitude greater here.
i think this is a red herring
canada's population is ~33 million, and we have ~38 million people over 65 [most of whom are in medicare already] not to mention that we have ~50 million disabled people [many of whom are in medicare], and i don't know how many poor people in medicaid, schip, etc, so we're already taking care of more people than all of canada is.
the complexities of making the shift are lessened because we already have a proven nationwide taxpayer funded program in place, and it's been doing a good job [and is well-liked] for 40+ years now. the only big jump left to make is enrolling everybody else who isn't already in the system. it's not like we're proposing to set up a whole system, which, incidentally, the obama plan is proposing to do, simply based on a few focus groups where the phrase "uniquely american plan" was deemed more popular that the word "medicare".
buying out the insurance companies
that's one of the areas i'm still fuzzy on. from the text of the bill --
so, i'm not sure if "providers" includes insurance companies [it does include hmos], or just hospitals and the like. the point to keep in the forefront is that, even with buyouts, retraining, and other one-time expenses associated with the conversion process, it will cost the taxpayers the same amount as we're paying right now.
Providers here
looks to me like actual health care providers, not insurance cos. I hadn't even though of those grotesqueries, for-profit hospitals, which this provision largely addresses.
It's also not clear to me that a two-year period of retraining and unemployment will do more than put a very small band-aid on the displaced employee problem. There simply aren't the jobs available in our economy to absorb these people, and certainly not at the same economic level.
Not meaning this as an excuse to avoid single-payer, but just worried that the overall economic effect could be huge, never mind the effect on vast numbers of entirely innocent employees.
innocent employees, dying insurance companies
yep, looks like that to me too.
according to the bureau of labor statistics, there are about 2.3 million people employed in the insurance industry. i couldn't find numbers for which ones are only health-insurance-related, but in a quick tour of the fortune 500 list i dug up a few numbers.
the property and casualty sectors shouldn't be affected [well... don't get me started on property insurance and living in hurricane alley].
of the life and health companies listed, i recognize several that sell both life insurance and health insurance. they'll make some cutbacks, but the companies themselves won't necessarily go under, and to make up for the loss of health insurance business, they can, to some extent, push their other lines more, thus keeping on some of their employees that might want to make the switch.
the health insurance / managed care sector [the top companies employ ~240,000] will be problematic, but if they've got hmos, they'll be given a chance to convert those to non-profit.
we'll still need several thousand employees [i'll guesstimate 30,000-70,000 based on canada's numbers and adding a bit more to be generous] to administer the expanded medicare program, these will just be working for the government rather than industry.
there will be shakeups, but it's not quite as dire as hcan's jason rosenbaum's comment suggests.
what hipparchia said
all I would add is that if HCAN't is trying to co-opt the health care movement, I advocate single payer advocates co-opt HCAN't.
we could be moles!
i'f you can't beat 'em, infiltrate 'em!
dcblogger
you rock!
argh!
"The good thing about where we are is that we don’t have a plan yet." [from hcan]
not reassuring.
Oh, it's even worse than that
It's the old idea that whenever you're at a meeting, and you don't know what the agenda is, there is an agenda, and the agenda is to fuck you.
[ ] Very tepidly voting for Obama [ ] ?????. [ ] Any mullah-sucking billionaire-teabagging torture-loving pus-encrusted spawn of Cthulhu, bless his (R) heart.
"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi
alas, too true
that whole discussion was just... fluffy.
people recounted their horror stories with the system and basically got told but the insurance companeez! think about the poor insurance companeeeeez!!! in that thread.
Damn, who left the tag open? N/T
We can admit that we're killers ... but we're not going to kill today. That's all it takes! Knowing that we're not going to kill today! ~ Captain James T. Kirk, Stardate 3193.0
We can admit that we’re killers … but we’re not going to kill today. That’s all it takes! ~ Captain James T. Kirk, Stardate 3193.0
1 John 4:18
it's usually my fault
but darned if i can figure out which tag you're talking about.
never mind
.