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5/15/2017 1:11:15 PM |
Conservatives should love single payer healthcare |
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nole_89
Loganville, GA
54, joined May. 2010
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Conservatives should love single-payer health insurance
10/7/14 9:00am by Jon Green
What if I told you that the theoretical underpinnings of single-payer health insurance are supported by conservative economics?
In 1982, leading political economist Mancur Olson published The Rise and Decline of Nations, a book that merged theories of collective action and macroeconomics to explain economic growth patterns across geographic regions and time periods. The argument goes like this.
The freedom afforded by democratic societies entails the freedom to organize into interest groups, each of which lobbies to secure an increasing share of the economic pie. The efficacy of these groups will be affected by their size (larger coalitions are harder to manage), wealth (money is power) and geographic concentration. The longer a democracy remains stable, the more interest groups form and, therefore, the greater share of the economic pie is set aside for group-specific, as opposed to general, interests. In the long run, this slows economic growth as small, wealthy, well-organized interest groups are able to out-regulate and out-litigate the national interest.
The tradeoff implied by Olson is that democracy, in the long and uninterrupted term, does not allow for maximized economic growth. This doesn’t make him anti-democratic, and he also isn’t wrong.
His theory explains the post-WWII economic booms of Japan and Germany, where the countries were given an effectively clean slate with respect to interest group organization (along with monetary and institutional support from the West). It also explains the stagflation seen in Great Britain at the time of his writing, where labor unions had made the British economy unnecessarily rigid. Olson’s work has received a great deal of critical and academic acclaim: a quick Google Scholar search shows that his work has received over eight thousand academic citations.
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But while conservatives love Olson because he takes academic digs at organized labor, they gloss over one of his bigger implications: A market’s efficiency is very much dependent on its ability to discourage the organization of specialized interest groups. Nowhere is this more true than in the market for health insurance.
Liberals join in some of the conservative critiques of Obamacare, even if the reasons for the bill taking the form it did are in many ways conservatives’ fault. As Theda Skocpol and Lawrence Jacobs outline in their book on the passage of Obamacare, putting together comprehensive legislation in America goes about as well as Olson would predict: When conservatives complain that the bill is a messy cobbling-together of interest group carve-outs designed to keep everyone just happy enough to not make a fuss, they’re right. The law is a series of regulations and mandates crafted with industry and consumer groups in mind — not the general national interest.
For pragmatic reasons, that may have been the best we could do. And don’t get me wrong, the law is an unarguable improvement over the system we had previously. But the corollary to the conservatives’ criticism — one they would rather not talk about — is that the even better alternative, in line with Olson’s theory, is a health insurance system that bypasses interest groups altogether and establishes an insurance system with an encompassing interest in mind. Namely, and perhaps ironically, a national one.
When the Affordable Care Act was being pieced together, proposed changes to health insurance regulation had to pass muster with AHIP. And the AMA. And the AFL-CIO. And PhRMA. And the MDMA. And the AMTA. And the AARP. Et cetera, et cetera. Some interest groups’ support had to be won; others’ had to be appeased in order to blunt their opposition. In line with Olson’s theory, the Skocpol and Jacobs show that as more groups were given a seat at the table, the bill became increasingly complex, ad-hoc and opaque.
The bill’s best and worst components are all directed at slices of the American public instead of the whole. From the Medicaid expansion to the medical device tax (which trade groups are vigorously pushing to repeal); from the extension of dependent coverage to the age of 26 to the tax on Cadillac plans; and from closing the Medicare Part D donut hole to the employer mandate (if it’s ever implemented), the bill isn’t a comprehensive overhaul so much as it is a series of narrowly-aimed tweaks to the existing market. This makes implementation messy and, as we liberals have to admit, somewhat inefficient.
For a conservative, the obvious solution to this inefficiency is to simply not bother to regulate the insurance market at all. After all, the free market is able to correct for things like this, right?
Wrong.
Demand for health care, and by extension health insurance, is inelastic. If your leg is broken, you won’t choose to not get it treated. You will go to the hospital and figure out the (high) costs later. Since practically everyone is guaranteed to use health care, but there’s a great deal of uncertainty regarding when the care will be accessed, it makes sense to spread medical risk across as wide of a pool of consumers as possible. The more people paying into the system, the less each person has to pay in order to ensure that everyone’s expenses are taken care of.
That’s why Medicare has far lower operational costs than individual or otherwise-private health insurance plans. In addition to the fact that a private company needs to take a cut in order to turn a profit, they’re also insuring a smaller pool of people than if there were only one provider — this means that competition in the health insurance market drives costs up, not down. In other words, the fragmentation of the health insurance industry contributes to its inefficiency as much as if not more than the private-ness of it.
So what we’re left with is an inefficient market that is susceptible to capture by special interest groups and isn’t able to self-regulate without failing. The solution, then, is to eliminate the market. A single-payer system for financing health insurance — not the care itself, just the mechanism by which we pay for it — would address liberals’ concerns about access and conservatives’ concerns about efficiency.
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5/15/2017 1:21:01 PM |
Conservatives should love single payer healthcare |
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condor_0000
Tampa, FL
60, joined Feb. 2013
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Trump’s forbidden love: Single-payer health care
By Aaron Blake
May 5, 2017
https://www.washingtonpost.com/news/the-fix/wp/2017/05/05/trumps-forbidden-love-singe-payer-health-care/
Excerpt:
President Trump claimed a victory Thursday after the House approved a more free-market approach to health care.
Then he capped it off by praising a country with government-run, universal health care.
Alongside Australian Prime Minister Malcolm Turnbull at an event in New York, Trump reflected on what the House had just done. He took the occasion to bash Obamacare as being terrible, and then he turned to Turnbull.
"We have a failing health care — I shouldn't say this to our great gentleman and my friend from Australia," Trump said, as The Post's Abby Phillip reports, "because you have better health care than we do."
Australia's health-care system is run by the government. It's essentially a single-payer, Medicare-for-all system that is available to everyone, with private insurance also available. (They even call it "Medicare.")
Consider this merely the latest evidence that Trump, in his heart of hearts, wants single-payer health care. Indeed, it seems to be his forbidden fruit.
Back in 2000, he advocated for it as both a potential Reform Party presidential candidate and in his book, "The America We Deserve."
"We must have universal health care. Just imagine the improved quality of life for our society as a whole," he wrote, adding: "The Canadian-style, single-payer system in which all payments for medical care are made to a single agency (as opposed to the large number of HMOs and insurance companies with their diverse rules, claim forms and deductibles) … helps Canadians live longer and healthier than Americans."
Just before the 2016 campaign, Trump appeared on David Letterman's show and held up Scotland's socialized system as the ideal.
"A friend of mine was in Scotland recently. He got very, very sick. They took him by ambulance and he was there for four days. He was really in trouble, and they released him and he said, ‘Where do I pay?’ And they said, ‘There’s no charge,’" Trump said. "Not only that, he said it was like great doctors, great care. I mean, we could have a great system in this country.”
Then, early in the 2016 campaign, he again praised the single-payer systems in Scotland and Canada — while also arguing that the United States needed to have a private system.
Asked on "Morning Joe" whether he supported single-payer, he said: "No, but it’s certainly something that in certain countries works. It actually works incredibly well in Scotland. Some people think it really works in Canada. But not here, I don’t think it would work as well here."
He said two days later at a GOP debate: "As far as single-payer, it works in Canada. It works incredibly well in Scotland. It could have worked in a different age, which is the age you’re talking about here."
Later on, Trump would repeatedly push for universal health care without specifically subscribing to the words "single-payer."
"Everybody’s got to be covered. This is an un-Republican thing for me to say," Trump said in a September 2015 "60 Minutes" interview. "I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now."
He added when asked who is going to pay for it: "The government’s gonna pay for it." That was enough for Breitbart, which would become vehemently pro-Trump during the 2016 campaign, to declare Trump had embraced single-payer.
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5/15/2017 1:21:51 PM |
Conservatives should love single payer healthcare |
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longbobby
Lufkin, TX
56, joined Aug. 2010
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Link?
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5/15/2017 1:26:34 PM |
Conservatives should love single payer healthcare |
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61falcon
New Hope, PA
76, joined Feb. 2008
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Not if his House of Representatives have anything to do with it,Lyin Ryan has shown repeatedly that he could care less if average working Americans have adequate affordable health insurance.
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5/15/2017 1:32:29 PM |
Conservatives should love single payer healthcare |
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condor_0000
Tampa, FL
60, joined Feb. 2013
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Not if his House of Representatives have anything to do with it,Lyin Ryan has shown repeatedly that he could care less if average working Americans have adequate affordable health insurance.
Trump doesn't believe in single-payer either. But he said he did because he knows that 95% of America wants it, including most right-wingers. Trump wants one thing and one thing only: more money for billionaires.
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5/15/2017 1:36:48 PM |
Conservatives should love single payer healthcare |
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nole_89
Loganville, GA
54, joined May. 2010
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Not if his House of Representatives have anything to do with it,Lyin Ryan has shown repeatedly that he could care less if average working Americans have adequate affordable health insurance.
One day I would like to take a trip up to Ryans district in Wisconsin and see exactly what kinds of people these are that would vote for an a** clown like that. It's hard to imagine an entire district of Archie Bunkers.
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5/15/2017 1:40:06 PM |
Conservatives should love single payer healthcare |
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nole_89
Loganville, GA
54, joined May. 2010
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Trump doesn't believe in single-payer either. But he said he did because he knows that 95% of America wants it, including most right-wingers. Trump wants one thing and one thing only: more money for billionaires.
What Trump wants is anything that satisfies his ego. If he thought that passing single payer would make him extremely popular and adored he would do it. The problem right now with Trump is who he has surrounded himself with. Mostly bad apples. Replacing Bannon with Kushner is actually a BAD thing.
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