| > I think public support of the health insurance status quo will collapse and Medicare for All will become an actual Thing. I'm almost certain about the first part (collapse) but much less certain about the second. The fundamental issue is affordability: we can't afford the health system we have. No matter who pays, the burden is going to be substantial. It's just a question of whether it's foisted onto shareholders (capital), households, or taxpayers. I'm honestly 50/50 on whether we'll head toward more widespread government insurance or whether coverage will become harder to get, thereby forcing more people into the private markets, with healthcare orgs working more like auto repair shops -- mostly private with a lot of price competition, and broad affordability. Either outcome has its pros and cons. I think a lot of the next 15-20 years is going to depend on what happens during the next 5. It's basically two outcomes. Scenario A: Interest rates continue to climb, urban housing affordability improves through some level of deregulation/less aggressive zoning, tech fans out a bit. The sense that prosperity is too concentrated starts to dissipate. Ocasio-Cortez and co. lose steam and the US turns back toward a more moderate politics. Scenario B: Things continue as they are now. More young people embrace socialism because growing student debt, unaffordability of housing, and rising/unavailable healthcare lead to a greater desire for government control of the economy. US takes a hard left turn, we get Bernie or someone of the far left for president. US is in the grip of populism (both left-populist Antifa and right-"blood and soil" nativism), things go backward. If we get scenario B, we're going to get some form of national single-payer. If we get A, I'm less certain. |
The bubble I live in is that I've actually got enough money to pay the out-of-pocket costs if the insurance company screws me. It won't bankrupt me, at least not in the near term. But looking outside my reality, there are a huge number of Americans without anything even approaching that luxury. Especially younger generations. When I look at the numbers, I think your scenario B looks a bunch more realistic. Right now I just have political ideology, but I see a lot of people who have real skin in the game and I wonder how long we can maintain the status quo before those folks collectively realize just how numerous they are and how much change they can effect if they try.