Opponents of single payer are moral monsters on par with AHCA proponents
Count me in as a moral monster. There are better systems out there than single-payer.
Its major provisions include changing the refundable tax credits of Obamacare so that they are more generous to younger people and less generous to older people and so that they are more generous to higher income people and less generous to lower income people.
Right. This 3:1 ratio is one of the key problems with the ACA, making it unsustainable. So, you have a dilemma; charge older people more, or watch the entire mess fail. Here’s why:
Suppose you have two customers, and you need to bill $1000 from them in order to make a profit. One of the customers wants a lot more stuff than the first one, but you can only charge that customer 3X the first one even though he wants to buy 5 times as much stuff.
So, your equation is X + 3X = $1000. A little math shows you that you bill the first guy $250 and the second guy $750.
All’s well and good until the first guy says “Uh….I only want to buy $175 worth of stuff. So screw you, I’m not buying anything.” Now you have to write off the $250, because you can’t charge the second guy more.
So, the business says “Well, tell you what. I’m not doing business under these regulations anymore” and they go do business elsewhere where they can charge what they need to charge to stay in business. But, you were the only supplier for the second guy, who still needs to buy stuff. He’s screwed.
Now, let’s suppose the ratio you can charge is 5:1. The equation is now X+5X = $1000. The second guy now has to pay $833, but that’s a lot closer to the value of the goods he’s getting; he was getting something for nothing before. And the first guy? His bill drops to $166. He’s happy, buys, and the business stays too, because they’re now making a profit.
That’s why 3:1 is a recipe for disaster, and 5:1 works. If anyone has a way to make the math come out differently, please advise.
As a result of these changes, the CBO estimates that by 2026, 24 million more people would be uninsured relative to current law. The liberal reaction to this proposal has been rightly horrified.
Well, yes. But they should also have been horrified at how far the CBO was off the last time they tried to estimate anything regarding health care.
Yep. That’s the CBO estimate from 2010 up at the top. That’s what really happened down at the bottom. This is largely why the CBO quit scoring the ACA after 2014. Sheer embarrassment. :-)
There’s no argument that the GOP was hamhanded in their handling of the matter. However, they have a legitimate point that the CBO doesn’t know how to score these sorts of plans.
The difference between Obamacare and AHCA is 24 million uninsured people while the difference between single-payer and Obamacare is 28 million uninsured people. If you favor Obamacare over single-payer or dismiss single-payer as relatively unimportant, then you are a moral monster at least on par with the AHCA proponents you condemn.
There are several questionable assertions and assumptions in that paragraph that are assumed to be fact. They include:
- The AHCA is in its final form. Had it passed the House, it would have been marked up in the Senate heavily in order to pass. Then reconcilation would have taken place. Not final.
- Single payer depends (if you look at how the model works in other nations) heavy cost controls on providers. Doctors in Sweden (my nephew is one) earn an upper middle class wage. Here, they’re wealthy. The same dynamic applies to other providers like nurses (which in many countries is almost like working for charity) and the hospitals. One of the reasons why we have the best critical care outcomes in the world is that our best and brightest go into medicine; take away the monetary incentive, you’re going to get a lower class of provider. Further, single payer systems DO DEPEND to varying degrees on limiting end-of-life coverage; most systems will ration expensive care if the individual does not have a statistically reasonable chance of survival.
So, there are MULTIPLE moral choices involved. One moral choice is “should we have a universal care system?” Another is “is it moral to substantially chop what we pay our providers, and accept a lower standard of care?” A third is “do we accept the notion that end of life care must go though a cost-benefit analysis”.
It’s not easy. But just saying “single payer solves everything” is not correct, in the least.