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by tptacek 2719 days ago
Why would I be excited about a proposal to totally restructure an industry that every American comes into contact with and that represents something approaching 20% of our economy just for the prospect of a ten percent savings? Take any family complaining today about the cost of a Silver plan on an ACA exchange, offer them a 10% savings, and see if they're OK with what they're paying.
2 comments
bshoemaker 2719 days ago
Because it covers millions more, while spending less. Is this difficult to understand?
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tptacek 2718 days ago
It leaves us overspending on health care by a huge amount, raises everyone's insurance, and ultimately takes away everyone's employer-provided care, which the majority of Americans who have it like. If it was cutting our expenses in half, the cost savings might sell it. But 10%?
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pjc50 2718 days ago
> ultimately takes away everyone's employer-provided care

Really? Even the NHS system allows a parallel employer provided system to run alongside it, it's just only common for higher-paying jobs and those with US parent companies.

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tptacek 2718 days ago
Right, the rich will retain private care no matter what. The challenge is what happens to the middle class, the majority of whom have employer-provided care that they actually like (this is a major challenge with any health reform in the US: the status quo has powerful support). There's a near-consensus that the impact to the market for these insurance products will, within a few years, be eliminated by M4A.
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selestify 2718 days ago
> It leaves us overspending on health care by a huge amount

How is that the case when it reduces costs by 10%? Doesn't sound like we'll be spending any more than we already are.

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grecy 2718 days ago
You literally just said "It's not perfect, so I don't want it".

Don't let perfect be the enemy of improvement.

Constant improvement is what the system needs, and anything that improves it is good and should be done.

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tptacek 2718 days ago
It's not that it's imperfect, it's that it's insignificant.

If the proposal had no costs, it would obviously be worth pursuing.

But it's a historically disruptive proposal. For changes on that scale, we should be targeting significant fixes. 10% is just nibbling at the edge of the problem --- to put it another way, if the cost savings is 10%, then a few years after the change was enacted, we'd be right back where we are now.

You can't iterate on restructuring the economy; it's not a PHP program. You can iterate on incremental fixes, but that's not what M4A is.

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