[bgoggin]

This is not correct. There was no prohibition on private insurance. Rather, all would have been required to participate in the public plan to spread the risk. That's the only way it could work. If someone wanted to also pay for a private plan, that was allowed.

[ameister14]

So that's not true.

They had to prohibit overlapping coverage in order to make sure that all private practice physicians accepted the medicare system, which has lower reimbursement rates than private insurance. You can pay for more coverage, because that doesn't compete with the public system, but you cannot pay for private insurance that may lead to lower access for publicly insured persons.

[bgoggin]

Yes, I did not read closely enough. You referred to new medicare for all plans, while I responded recalling similar false accusations against Obamacare. Some of these new proposals do not allow duplicate plans. Nevertheless, I don't think this particular objection makes them DOA. I believe this is an objection that could be overcome with discussion.

[Aurornis]

No, this is incorrect. Here is the actual section from the bill:

> SEC. 107. PROHIBITION AGAINST DUPLICATING COVERAGE. (a) IN GENERAL.—Beginning on the effective date described in section 106(a), it shall be unlawful for— (1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or (2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.

You could technically also buy extra insurance for… something extra, but your existing insurance plan would have become illegal.

This was a huge sticking point, despite how many people try to deny it or downplay it.

[jrajav]

I'm honestly curious what the real meat of the objections to this were (I never heard much about this sticking point). Why would you want duplicating coverage anyway? Is it not strictly better for any consumer to only be paying for the extra coverage you want on top of the public coverage?

[Aurornis]

I didn't say I had objections to it. I said it was unpopular with the general public when you told them the details.

This is an example of a situation where people dislike the system but when you ask them about it they like their part of the system.

For example, people generally have an extremely low opinion of Congress, but on average they like their own Congress person.

You get similar results when you poll people about healthcare and health insurance: People generally hate the health insurance system, but if you start talking about taking away their health insurance or their doctor and replacing it with an unknown system, they get upset.

> Why would you want duplicating coverage anyway? Is it not strictly better for any consumer to only be paying for the extra coverage you want on top of the public coverage?

Duplicating coverage is superfluous if you assume the new plan would be better in every way and you give up nothing in the process, obviously.

However, the fear is that upending the entire system would require people to give things up and replace it with unknowns. There's a good chance that some people would be forced to be reassigned to different doctors under a centrally-planned system, or that access to things would be reset and need to be re-determined under new guidelines.

If this doesn't make sense, consider a situation where someone got special approval for off-label coverage of a drug (happens all the time) but the new government insurance had stricter guidelines about which conditions could be treated with which drugs (to keep cost down). Those people could lose access to medications or treatments that were covered privately.

We tend to think of "Medicare for All" type plans as being without downsides, but when you get into the details of changing the entire health care system out and banning the old ways, it's inevitable that some people would start losing things they liked. And that's where people get upset.

[redserk]

To be fair, there was a log of disingenuous fear mongering around the notion of "the government is getting rid of your insurance".

It would be extremely difficult to get an accurate idea of what the general public thinks about a measure before certain interests get involved with publicizing FUD.

[Aurornis]

> fear mongering around the notion of "the government is getting rid of your insurance

But that’s literally what the bill said.

Why is it “fear mongering” to state the effects of a bill? People truly didn’t like this idea.

[themoonisachees]

Because it's being disingenuous. The insurance isn't getting removed, just like "the HVAC tech is removing heating" is not a coherent statement if the tech is just replacing your furnace. You might have opinions about the performance of the new furnace, but saying that the heating is going to be removed is simply untrue beyond discussing the logistics of that change.

[s1artibartfast]

Lots of people want to be able to pay to get faster treatment, or pay for better doctors if they can.

[JumpCrisscross]

> Why would you want duplicating coverage anyway?

What I have works. It doesn’t for everyone. But it does for me.

If I’m too busy to read a thousand-page bill, it’s rational to default to the status quo. (Also, Americans like competition. Banning duplicate coverage sounds like ruling out the competition.)