Healthcare

BleedBlueGold

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Good luck with that.

The fact is that districts are very much rigged today, so even if you hold someone accountable, it won't change anything. The same stooges will keep coming in.

Senate elections are a different animal, but is similar. Given the perceived rise of single issue voters, I find it hard to believe that flip flopping on non-core issues, or issues where the single issues voters is low, will move the needle.

A big part of the problem is campaign money. It's hard to primary a sitting representative who's funded by big money. Factor in gerrymandering and voter suppression and it's even worse.
 
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Tulsi Gabbard (D-HI) just said the AHCA will literally pull the rug out from people. LITERALLY. In written, prepared remarks. We elect 535 members of Congress in a nation of 300 million citizens and we can't find Representatives with a fundamental understanding of the English language.

I'm not sure what's worse. Politicians being politicians or people not understanding that their words are just politicians being politicians.

I roll my eyes every time you say "omg this one is so stupid!" Dude, it's all an act. All of it.
 

Legacy

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This Dem argument that the AHCA is a "tax on the elderly" is asinine. No, being elderly is a tax on the elderly. Old people are sicker. Don't like it? Take it up with God, not Paul Ryan.
I just get fed up by the Catholic Church telling people how to think. I don't mind them reminding us of how Jesus lived, or what Jesus taught us, but they need to just stay out of politics, in my opinion.

You have had the means to do so for at least decades, so if your beliefs are so strong, then put up or shut up!"

A lot of what I post, I do so to highlight considerations, raise significant issues, and provide some facts for thought and discussion, when one chooses to. It can feel soulless, even when I post figures about medical debt among the elderly or lost coverage estimates, etc. I do not mean to highlight any poster with the above quotes, only that I would like to respond. But, especially in crafting healthcare legislation with some significant cost-shifting that impacts individuals, ethics should matter. The alternative is to risk losing a bit of our community, the ties we have to others and watching our society splintering based only on cost and risk.

So, I disagree that the Catholic Church should avoid letters to the Congress and salute the Congress for inviting the Pope to speak to them.

Transcript of the Pope's speech before Congress
A couple of initial paragraphs:
Each son or daughter of a given country has a mission, a personal and social responsibility. Your own responsibility as members of Congress is to enable this country, by your legislative activity, to grow as a nation. You are the face of its people, their representatives. You are called to defend and preserve the dignity of your fellow citizens in the tireless and demanding pursuit of the common good, for this is the chief aim of all politics. A political society endures when it seeks, as a vocation, to satisfy common needs by stimulating the growth of all its members, especially those in situations of greater vulnerability or risk. Legislative activity is always based on care for the people. To this you have been invited, called and convened by those who elected you.

Today I would like not only to address you, but through you the entire people of the United States. Here, together with their representatives, I would like to take this opportunity to dialogue with the many thousands of men and women who strive each day to do an honest day’s work, to bring home their daily bread, to save money and –one step at a time – to build a better life for their families. These are men and women who are not concerned simply with paying their taxes, but in their own quiet way sustain the life of society. They generate solidarity by their actions, and they create organizations which offer a helping hand to those most in need.

I found it worth reading.
 
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kmoose

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But, especially in crafting healthcare legislation with some significant cost-shifting that impacts individuals, ethics should matter.

So, I disagree that the Catholic Church should avoid letters to the Congress and salute the Congress for inviting the Pope to speak to them.

So you want the organization that moved pedophile priests around, instead of exposing them and getting rid of them, allowing them to molest even more little boys, to offer their advice on ethics to the United States Congress?

Wouldn't that be a little like CNN or Fox News having Donald Trump in to talk about accurately reporting the facts of a story?
 

Veritate Duce Progredi

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So you want the organization that moved pedophile priests around, instead of exposing them and getting rid of them, allowing them to molest even more little boys, to offer their advice on ethics to the United States Congress?

Wouldn't that be a little like CNN or Fox News having Donald Trump in to talk about accurately reporting the facts of a story?

You literally just apologized on the page before for taking a sh!t on the Catholic church then follow it up with this. Apparently you need the vitriol as a reminder that you're doing okay without the Catholic church.

I view the Catholic church as an organically developing institution that is always striving to unite people with an 'ultimate reality'. It attempts to define timeless principles in a constantly shifting world with Christ's words at the center. Whether you believe Jesus to be savior, morally neutral or repugnant hippy determines the value of those words.

It appears anyone opposed to the right is anathema and anytime someone gets in the way of your god, you denigrate them to undercut their authority.

Even non-believers are expressing gratitude to the Pope for standing up for the infirm and elderly and you continue to sh!t on the Church because you disagree.

We get it. The Church has no authority over you and you will not bend the knee. In fact, you'll spit in the face of those who find value in the Catholic church.

It's noted KMoose. We all understand. Now, do you have something else to contribute? Do you want to see the ACHA passed? If so, why? What does their plan solve from your view?
 

wizards8507

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I just thought of a fantastic analogy for removing the essential benefits provisions of the Affordable Care Act. It's exactly the same thing as cable packages.

You say: I want a package that includes ESPN, ESPN2, HGTV, CNN, AMC, and HBO.

Comcast says: No, you have to buy a package that includes ESPNU, SEC Network, VH1, MTV, USA, TNT, MSNBC, Fox News, The Disney Channel, and 100 other channels you don't want or need. And you have to pay for them.

Sling TV says: We have this skinny bundle that just has a few channels and it's half the price of the Comcast bundle.

The Affordable Cable Act says: The Sling TV package is illegal because it doesn't include essential channels.

Republicans say: We're not going to make you buy the Comcast package if you don't want those channels.

Democrats say: REPUBLICANS ARE TRYING TO TAKE AWAY YOUR ESPNU, SEC NETWORK, DISNEY CHANNEL, FOX NEWS, AND MSNBC!
 

IrishLax

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I just thought of a fantastic analogy for removing the essential benefits provisions of the Affordable Care Act. It's exactly the same thing as cable packages.

You say: I want a package that includes ESPN, ESPN2, HGTV, CNN, AMC, and HBO.

Comcast says: No, you have to buy a package that includes ESPNU, SEC Network, VH1, MTV, USA, TNT, MSNBC, Fox News, The Disney Channel, and 100 other channels you don't want or need. And you have to pay for them.

Sling TV says: We have this skinny bundle that just has a few channels and it's half the price of the Comcast bundle.

The Affordable Cable Act says: The Sling TV package is illegal because it doesn't include essential channels.

Republicans say: We're not going to make you buy the Comcast package if you don't want those channels.

Democrats say: REPUBLICANS ARE TRYING TO TAKE AWAY YOUR ESPNU, SEC NETWORK, DISNEY CHANNEL, FOX NEWS, AND MSNBC!

This really is an excellent analogy.
 

kmoose

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You literally just apologized on the page before for taking a sh!t on the Catholic church then follow it up with this. Apparently you need the vitriol as a reminder that you're doing okay without the Catholic church.

No. I didn't. I apologized if it offended anyone, especially OMM since I do respect him and his postings here. But I never apologized for pointing out that the Church has failings. If you don't believe they do, then that's your view.

I view the Catholic church as an organically developing institution that is always striving to unite people with an 'ultimate reality'. It attempts to define timeless principles in a constantly shifting world with Christ's words at the center. Whether you believe Jesus to be savior, morally neutral or repugnant hippy determines the value of those words.

I view the Catholic Church as a bunch of men(and women, but run by men almost exclusively) who are fallible. I think that the teachings of the Catholic Church are mostly noble and respectable. If I had them, I would raise my children as Catholics. But I also think that the Church, and people's faith in it, have been used as a tool for controlling people, for millennia. I believe Jesus to be a great man, a holy man, a peaceful man. A man who honestly and genuinely put his flock first. I honestly don't know if he was the Son of God, sent to be a savior. I would like to believe it, but my mind tells me that there is no science to back that up, and that my faith is not strong enough to overcome that lack of evidence.

It appears anyone opposed to the right is anathema and anytime someone gets in the way of your god, you denigrate them to undercut their authority.

Even non-believers are expressing gratitude to the Pope for standing up for the infirm and elderly and you continue to sh!t on the Church because you disagree.

We get it. The Church has no authority over you and you will not bend the knee. In fact, you'll spit in the face of those who find value in the Catholic church.



You apparently don't get anything, but that's for you to figure out. You wouldn't listen to me if I tried. You have figured me out, and that's all there is to it. You couldn't POSSIBLY be wrong, now could you?

I won't apologize for my lack of strength when it comes to faith. That's between me and God, and fuck you if you think you have anything to say about it.

It's noted KMoose. We all understand. Now, do you have something else to contribute? Do you want to see the ACHA passed? If so, why? What does their plan solve from your view?

No. I don't want the AHCA passed. Not as is, anyway. It's completely idiotic to think that tax relief is an answer, when people can't afford the monthly payments in the first place. And all because some professional politician thinks that, if people get to pay for their insurance pre-tax by participating in an employer provided group plan, then individuals should be able to as well. I believe that; but you can't then say that you are helping them to buy insurance through that mechanism. That's pretty Wimpy-esque: "I'd gladly pay you Tuesday, for a hamburger today."
 

Rogue219

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I want the Comcast package that allows me to opt out of paying Paul Ryan and Mitch McConnell's salaries.
 

Veritate Duce Progredi

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No. I didn't. I apologized if it offended anyone, especially OMM since I do respect him and his postings here. But I never apologized for pointing out that the Church has failings. If you don't believe they do, then that's your view.

I view the Catholic Church as a bunch of men(and women, but run by men almost exclusively) who are fallible. I think that the teachings of the Catholic Church are mostly noble and respectable. If I had them, I would raise my children as Catholics. But I also think that the Church, and people's faith in it, have been used as a tool for controlling people, for millennia. I believe Jesus to be a great man, a holy man, a peaceful man. A man who honestly and genuinely put his flock first. I honestly don't know if he was the Son of God, sent to be a savior. I would like to believe it, but my mind tells me that there is no science to back that up, and that my faith is not strong enough to overcome that lack of evidence.

You apparently don't get anything, but that's for you to figure out. You wouldn't listen to me if I tried. You have figured me out, and that's all there is to it. You couldn't POSSIBLY be wrong, now could you?

I won't apologize for my lack of strength when it comes to faith. That's between me and God, and fuck you if you think you have anything to say about it.


No. I don't want the AHCA passed. Not as is, anyway. It's completely idiotic to think that tax relief is an answer, when people can't afford the monthly payments in the first place. And all because some professional politician thinks that, if people get to pay for their insurance pre-tax by participating in an employer provided group plan, then individuals should be able to as well. I believe that; but you can't then say that you are helping them to buy insurance through that mechanism. That's pretty Wimpy-esque: "I'd gladly pay you Tuesday, for a hamburger today."

Your faith is not my concern here. Your message to IE is the Pope has no business telling us about healthcare because sexual abuse, right? That was your point and you also believe the Church could do more good by selling their possessions and paying for American's healthcare now than 'hoarding' their money and continuing to fund their works around the world.

If that's incorrect please tell me? I'm not trying to "figure you out", I'm trying to make sure I understand the intent of your message(s).
 
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phgreek

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So Koch Bros publicly throwing money around to get a no vote because it doesn't go far enough to support their money interests. Vote no, we'll give you money for your campaign. Vote yes, no soup for you. But Trump wants this to pass so he can look good. This is a prime time HBO Fight Night throwdown.

People who vote yes, help Trump, but lose Koch support dollars and also (most likely in certain states) lose their seat at mid-terms.

People who vote no, turn their back on Trump, gain Koch dollars and most likely keep their seat.

giphy.gif

Probably more truth to this than we'd like...

I do think there are some people who care about the affordable part...unless thats one of those deals where the word "Affordable" has been coopted, and now means, "costs less to the winners we pick".

I don't think the bill was doable...it would have made more sense to me to phase it in over a reasonable period. Once you allowed people to build health savings so they could afford to pay the premiums, and make it to the end of the year to get the tax benefit. Shrug.

Anyway, my issue is with the folks who have ideas but never formalized them...How can you be Mike Lee and Co., and not have everything from an entire plan to well-formed bolt-ons to existing plans so that you'd be able to negotiate and solve issues.

Republicans sucked ass all the way across the board on this.
 

IrishinSyria

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<iframe width="560" height="315" src="https://www.youtube.com/embed/nCQGQ5qBQTA" frameborder="0" allowfullscreen></iframe>
 

IrishinSyria

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Vote postponed. House in recess.

<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">President Trump just called me. Still on phone.<br>"We just pulled it," he tells me.</p>— Robert Costa (@costareports) <a href="https://twitter.com/costareports/status/845357678390104066">March 24, 2017</a></blockquote>
<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>
 

Whiskeyjack

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The Week's Michael Brendan Dougherty just published an article titled "Republicans just faceplanted on the biggest stage there is":

Republican lawmakers have voted to repeal ObamaCare on dozens of occasions — by some counts, more than 60 times — since the Affordable Care Act was signed into law almost exactly seven years ago. It was the longest table-reading and dress rehearsal in modern political history. And yet, at the moment when the stage lights snapped on with a great buzz, and Republicans were finally about to debut their act before a paying audience, they froze up with stage fright. Now they are nervously rewriting the script in the wings, while the audience laughs at the farce of it all.

Yes, after all their talk, and after all these years, Republicans finally achieved real power in Washington — and promptly failed to repeal and replace ObamaCare. They couldn't even vote on it. Congressional leaders abruptly canceled their planned vote on the American Health Care Act at the last minute on Friday afternoon, when it became embarrassingly clear that Speaker Paul Ryan had failed to corral conservative members of the House Freedom Caucus, plus no small number of moderate congressmen who refused to go along.

You can tell how much of a political loser Republicans think the American Health Care Act is in the way everyone is trying to spread the credit. Hence the Trump administration has all but expressly forbidden people to call the bill "TrumpCare." And Speaker Paul Ryan insists that it isn't his bill but "our bill," roping in the reluctant White House.

Looking beyond the Republican backrooms in which it was being furiously revised, the only support for this bill seems to come from talk-radio studios (Sean Hannity is a fan) and anti-tax groups. Of course. The biggest feature of the bill as it was originally drafted is that it was not so much a health-care reform as a series of tax cuts aimed at reversing all the increases the previous administration had tacked onto its own health-care bill to make the numbers work at the bean counters' office. Would the Republican plan improve health-care coverage by making it cheaper or simpler to obtain? No. It was a fiscal bill.

But late in the week it became clear that the House Freedom Caucus — the hardcore conservative group known for making principled stands, even when they seem quixotic — wasn't on board with merely repealing the taxes while leaving in place "Obamacare Lite." And those freedom-lovers began stripping all the popular elements of ObamaCare that the House leadership had tried to preserve, such as the regulations that allow 26-year-olds to stay on mom and dad's insurance plan, or that bar insurers from discriminating against the already ill. If the conservatives get their way in the end, the Republican bill would actually look something like the "repeal" promised. But the politics of that solution are awful. Such a repeal would be DOA in the Senate, and would have given every Democratic House challenger in 2018 a small armory of attack ads.

What's so amazing is the way that Republicans managed to score so many own goals in this process. Eight years ago, conservatives made Nancy Pelosi's quote about the Affordable Care Act into a kind of legend of high-handedness and anti-democratic maneuvering. "We have to pass the bill," she said, "so that you can find out what's in it." And now Republicans are saying the exact same thing: You'll find out what's so great after we vote. Rep. Chris Collins (R-N.Y.) said that there was a "lot of misunderstanding about what it is we're doing and once we get it done, and then we can have the chance to really explain it."

While President Trump did try to whip up support for this bill, he has also kept a certain amount of distance, and leaked to the press that if the House can't get themselves together, he'd like to move on. Why wouldn't he? The plan to repeal ObamaCare was one he borrowed from Republicans, a tie that he put on to fit in before he bought the whole club and changed the dress code to something more suitable for him. Trump ran on infrastructure spending, immigration control, and revisions of American trade and foreign policy. Does anyone really think he cares about replacing ObamCare with something that makes the House Freedom Caucus and Paul Ryan happy? Before the dust began to settle on Friday, Trump called The Washington Post and let it drop that he'd be willing to cut a deal with Democrats on health care.

Republicans need to figure out who they must prioritize while they have a working majority: talk-radio hosts and big donors, or the swing voters who made Trump president.

Which group do you think is more likely to bail on the party if Republicans let them down?
 

phgreek

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TheOneWhoKnocks

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Hannity has never been a fan of the bill or how it's been handled, dunno what that guy is talking about.
 

Whiskeyjack

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...If the deal trump cut opened up competition, rolled back the mandate, allowed for catastrophic plans, and got out of compelling 80 year old widowers to buy child birth and rubbers, killed any notion of a Cadillac tax...I'm good for a bit to see what would happen.

You think the congressional Dems would agree to any of that?
 

kmoose

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Your faith is not my concern here. Your message to IE is the Pope has no business telling us about healthcare because sexual abuse, right? That was your point and you also believe the Church could do more good by selling their possessions and paying for American's healthcare now than 'hoarding' their money and continuing to fund their works around the world.

If that's incorrect please tell me? I'm not trying to "figure you out", I'm trying to make sure I understand the intent of your message(s).

My message is that the Council of Bishops has no right to try to push their agenda on the sitting Congress. And that they have no moral high ground to lecture from, because of their decidedly lacking response to the sexual abuse scandal.
 

phgreek

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You think the congressional Dems would agree to any of that?

You mean to infer Trump couldn't get that deal done?

He is a deal maker...the sultan of sway...the king of craft...it'll be a Tremendous, Uge, Beautiful Deal to fix that Disaster.
 

NOLAIrish

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You think the congressional Dems would agree to any of that?

If you turned the Cadillac repeal into a fix for the inflation problem rather than a repeal, it's possible some of the moderates would trade the individual mandate (which is pretty ineffective) and maybe even soften the employer mandate. Without the individual mandate, "catastrophic plans" are effectively permitted. Narrowing EHBs (the contraceptive problem) can be done through regulation -- you don't need the Dems to fix that, just the will to "fix" Obamacare. I'm assuming "opening up competition" means "permitting interstate sale of insurance"? That's more or less an empty promise -- there's no federal law restricting interstate sale of insurance; and even the states aren't that much of an issue. The problem is twofold: 1) state regulations are variable and compliance and licensure in multiple states is a real cost; and 2) insurers don't have interstate provider networks and don't have a lot of interest in supporting them.
 
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Goldedommer44

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This really is an excellent analogy.

This is another reason I don't think Health care and health insurance should not be a for profit business. We should be able to buy the channels we want and not pay for what we don't want, but the Networks package there channels together so if you buy ABC you have to pay for all other ABC owned Channels reguardless if you want them or not.

I also don't think you should have to pay a penalty if you say I don't want maternity coverage but then accidentally get pregnant. Males should have to pay for maternity coverage because last I checked they have to be part of the process in making a baby. By mandating Maturnity coverage reguardless if you can have a baby or make a bay it keeps the cost down. Just like getting mandating younger people to buy insurance to help pay for the sickest Americans .

I am a 36 year old man who had a Vasectomy 8 years ago. I can not have any more children but if me paying an extra $50 a year helps to make maturnity coverage affordable for people who can so there children are safe and healthy I am alll for it.
 

phgreek

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If you turned the Cadillac repeal into a fix for the inflation problem rather than a repeal, it's possible some of the moderates would trade the individual mandate (which is pretty ineffective) and maybe even soften the employer mandate. Without the individual mandate, "catastrophic plans" are effectively permitted. Narrowing EHBs (the contraceptive problem) can be done through regulation -- you don't need the Dems to fix that, just the will to "fix" Obamacare. I'm assuming "opening up competition" means "permitting interstate sale of insurance"? That's more or less an empty promise -- there's no federal law restricting interstate sale of insurance; and even the states aren't that much of an issue. The problem is twofold: 1) state regulations are variable and compliance and licensure in multiple states is a real cost; and 2) insurers don't have interstate provider networks and don't have a lot of interest in supporting them.

OK...serious question...

If we have basically federalized "insurance" why would we not 1) define universal regulations; 2) incentivize the buildout of interstate provider networks. At this point that is almost an infrastructure investment.
 

wizards8507

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This is another reason I don't think Health care and health insurance should not be a for profit business. We should be able to buy the channels we want and not pay for what we don't want, but the Networks package there channels together so if you buy ABC you have to pay for all other ABC owned Channels reguardless if you want them or not.

I also don't think you should have to pay a penalty if you say I don't want maternity coverage but then accidentally get pregnant. Males should have to pay for maternity coverage because last I checked they have to be part of the process in making a baby. By mandating Maturnity coverage reguardless if you can have a baby or make a bay it keeps the cost down. Just like getting mandating younger people to buy insurance to help pay for the sickest Americans .

I am a 36 year old man who had a Vasectomy 8 years ago. I can not have any more children but if me paying an extra $50 a year helps to make maturnity coverage affordable for people who can so there children are safe and healthy I am alll for it.
Do you believe in ANY personal responsibility whatsoever? Why do you believe adults shouldn't have to live with the consequences of their actions? I'm not talking about the poor and handicapped, I'm talking about able bodied people who CHOOSE not to insure themselves.

Also, it's not $50 extra per year. It's hundreds of dollars per month.
 

wizards8507

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If you turned the Cadillac repeal into a fix for the inflation problem rather than a repeal, it's possible some of the moderates would trade the individual mandate (which is pretty ineffective) and maybe even soften the employer mandate. Without the individual mandate, "catastrophic plans" are effectively permitted. Narrowing EHBs (the contraceptive problem) can be done through regulation -- you don't need the Dems to fix that, just the will to "fix" Obamacare. I'm assuming "opening up competition" means "permitting interstate sale of insurance"? That's more or less an empty promise -- there's no federal law restricting interstate sale of insurance; and even the states aren't that much of an issue. The problem is twofold: 1) state regulations are variable and compliance and licensure in multiple states is a real cost; and 2) insurers don't have interstate provider networks and don't have a lot of interest in supporting them.
It's all disingenuous. The system collapses without preexisting conditions coming out, and there's no political will for that. The day the ACA was passed is the day we guaranteed we're going to end up with single payer.
 

NOLAIrish

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OK...serious question...

If we have basically federalized "insurance" why would we not 1) define universal regulations; 2) incentivize the buildout of interstate provider networks. At this point that is almost an infrastructure investment.

They're fair questions, and it's one of the main arguments used in favor of nationalizing -- there are efficiencies to going that way.

The reasons we don't do it within the current structure are varied, and not all of them are good reasons:
1) Status as "insurance" -- regulation of all forms of insurance has historically fallen within state police power;
2) Some of the insurance variations reflect actual differences among the states -- the cost of insuring a resident varies wildly by state which means that an insurer needs a different level of capitalization to support the same population in different states;
3) This feeds into the one above, but providers vary wildly among the states -- a state like Florida or Louisiana is going to have more rural providers and a better per-capita capacity to handle tropical diseases than a state like Minnesota. There's also a significant difference in both surge capacity and the need for such capacity in a coastal state than in an inland state. There are also wide variations in provider sophistication and capacity to operate as insurers or ACOs, which is typically regulated by insurance commissioners. These variations have a dramatic impact on the state insurance code (legal, not regulatory) governing the insurer-provider relationship;
4) The insurer-pharmacy relationship is highly variable and depends on the level of fragmentation of that market within a state -- where the state has high levels of independents it tends to be more heavy-handed with PBM regulation than in a state where chains predominate;
5) Incentivizing national provider networks will require busting state oligopolies. In Louisiana, for example, the Blues and Medicaid are nearly the entire market. Same for a state like Alabama (I think Alabama may actually be the most monopolistic, but that's purely from memory). They will actively work to prohibit providers from contracting with foreign insurers. Nationalizing will also create intense pressure on state legislatures to pass price controls -- this happens in the pharmacy market already, where health insurers' use of national wholesale price lists as the basis for reimbursement creates pressure to implement state-level price adjustments.
6) The provider network structure scales very poorly. It would really be better to do away with it entirely if you're going to nationalize. It's not a good or a bad option (okay, gun to my head, it's probably a good thing on balance to do away with it), just a reality

I'm sure I can come up with more thinking through it further
 

Veritate Duce Progredi

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My message is that the Council of Bishops has no right to try to push their agenda on the sitting Congress. And that they have no moral high ground to lecture from, because of their decidedly lacking response to the sexual abuse scandal.


The council of Bishops has no right to attempt getting their message through to sitting congress? Why? You don't believe faith informs every other part of life? You don't believe faith is the foundation from which many form their life's philosophy.

You believe faith should be compartmentalized? ie - not lived out in the public square?

And just so I'm understanding correctly: anyone with past transgressions, or transgressions by association can never attempt to make moral arguments for or against something?
 
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