[RD] Let's Repeal The Affordable Care Act

You're giving the answer I anticipated. Thanks, I was wondering just how far partisanship had dislodged rational political considerations in the US, I'm getting the idea that very much.

Well, that is a reasonable concern. President Obama and the Democrats adopted a healthcare plan developed by a right wing think tank and were condemned for it by the right wing...who made a decade long campaign against it the cornerstone of their politics.
 
Your solution, while elegant and simple, relies on "force the insurance companies." This leads to the immediate questions. What happens if they fold? Do we take responsibility for forcing them to take operational losses? Do we subsidize them to maintain their profitability? How much profitability? Do we allow them to give raises to their employees even if we are subsidizing them to keep them from failing outright?

Instead of subsidizing them, we could nationalize the industry and turn the insurance companies into government-owned corporations. You know, kinda like Amtrak.
 
Now, don't comment too hastily. I live in Denmark and is an avid supporter of publicly paid universal healthcare. I also see the ACA as a reasonable albeit flawed solution to the mess that is US healthcare, so out of pragmatism, I'm a supporter for that too.

The difference between Denmark and the US is scale, constitutional format, economic history, and cultural present. It's kind of a fad for leftists in the US to look in your direction, at Scandinavia as a whole, for conclusive proof that our health and educational systems should be nationally-run, even though our country bears not even a superficial resemblance to a Scandinavian country. The whole thing reminds me of back in the 80s and 90s when the US was making proclamations on how Asian countries should be managing their economies according to neoliberal principles, the so-called Washington Consensus, because these notions were working out so damn well for us at the time, and of course everyone on earth is the same so the policies would be just as awesome anywhere they are tried. Yeah, no.

With a population slightly less than the average State of the US, but high density in both population and wealth, the Danish system might be relevant when discussing how a state in the Northeast might want to devise a statewide health care system. Tiny regions might possess the wealth and ideological solidarity required to support a purely public system. Funds for hospitals would be provided by the state income tax, which would be like the federal tax in Denmark. Decision-making on how to spend the dough could take place at the local level, like it does in Denmark. A similarly small, wealthy US state could decide for itself how the balance of power within the state health care system would look, just like different Scandinavian countries do. Denmark is on the more "federalized" side; Sweden, in contrast, for instance funds its hospitals about three-quarters locally, when I last looked into this.

Denmark's nice way of doing things is not in effect in the US (on a nationwide scale) for the same reasons it's not in effect on a worldwide scale. Logistically, it's ludicrous on such a scale and in any environment with different tribes, and philosophically, our constitution was not designed to hold these different tribes in the grip of federal policies. Instead there are themes like freedom of religion/press/assembly, which all imply a right to disagree with others on any topic for any reason, and promulgate alternative views through legal channels. That is a form of diversity that bothers liberals in the US. It can preclude a national health care system and many other instruments of federal power.

It is with these ideas in mind, that I've thought of the single-payer crap as unfeasible in the US, whereas diverse state-level systems were already formidable before Obamacare. I like the mixed market approach and the empowerment of the states in this matter. Complexity in an inherently complex industry, and non-uniformity in an inherently non-uniform country, don't really bother me at all. Repeal Obamacare and replace it with nothing.
 
Instead of subsidizing them, we could nationalize the industry and turn the insurance companies into government-owned corporations. You know, kinda like Amtrak.

Nationalize and merge into one...and it would be just like Amtrak. Whether that is somehow better than having single payer through an actual government body or not I can't really guess, but if having a government owned corporation involved makes it more palatable to the Republicans that seems a reasonable compromise. Well done.
 
Question: If Trump came out with that proposal, and willing to try to pass it, how would each of you stand about it? I'm not even talking about "Medicare for all", I mean a National Health Service supported from general taxation. And I'm not wanting to argue whether Trump could do this, or pigs can fly. I'm just asking: if he proposed that, how would you stand, for or against?

I'd support him in doing it. I don't really WANT Trump to fail. Beyond this issue, if his harebrained agenda actually caused mass job creation and prosperity I'd grudgingly allow for it.

It's not going to happen, though.
 
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Trump parrots lines from the people he spoke to last, and so Ryan and Pence are going to kill any attempts at government spending that alleviates the healthcare of the working class. And reminder that Bannon detests poor people, so you're not seeing good healthcare policy from that cocaine-added whale.
 
The difference between Denmark and the US is scale, constitutional format, economic history, and cultural present. It's kind of a fad for leftists in the US to look in your direction, at Scandinavia as a whole, for conclusive proof that our health and educational systems should be nationally-run, even though our country bears not even a superficial resemblance to a Scandinavian country. The whole thing reminds me of back in the 80s and 90s when the US was making proclamations on how Asian countries should be managing their economies according to neoliberal principles, the so-called Washington Consensus, because these notions were working out so damn well for us at the time, and of course everyone on earth is the same so the policies would be just as awesome anywhere they are tried. Yeah, no.

This is a mightily spurious argument given that the real rationale for neoliberal policies was to enrich the rich, which "works" in any county.

Denmark's nice way of doing things is not in effect in the US (on a nationwide scale) for the same reasons it's not in effect on a worldwide scale. Logistically, it's ludicrous on such a scale and in any environment with different tribes, and philosophically, our constitution was not designed to hold these different tribes in the grip of federal policies. Instead there are themes like freedom of religion/press/assembly, which all imply a right to disagree with others on any topic for any reason, and promulgate alternative views through legal channels. That is a form of diversity that bothers liberals in the US. It can preclude a national health care system and many other instruments of federal power.

Interesting, I must admit that's a new one - freedom of the press/religion/assembly means we have to let poor people die because they can't afford health care.

The real essence of your argument is of course utterly ridiculous - the US obviously has enough real wealth to provide the entire population with healthcare.
 
Besides, most of the wealth that is put into healthcare is inefficiently allocated: it goes into the bank accounts of private insurance companies and pharma CEOs. Not primary healthcare workers, or their support structures, or basic researchers, or translational researchers. It is a distorted set of incentives that misallocates resources.

Markets are good at somethings. It's garbage at other things, like emergency medicine, or preventative care, or rare genetic diseases.
 
The difference between Denmark and the US is scale, constitutional format, economic history, and cultural present. It's kind of a fad for leftists in the US to look in your direction, at Scandinavia as a whole, for conclusive proof that our health and educational systems should be nationally-run, even though our country bears not even a superficial resemblance to a Scandinavian country. The whole thing reminds me of back in the 80s and 90s when the US was making proclamations on how Asian countries should be managing their economies according to neoliberal principles, the so-called Washington Consensus, because these notions were working out so damn well for us at the time, and of course everyone on earth is the same so the policies would be just as awesome anywhere they are tried. Yeah, no.

With a population slightly less than the average State of the US, but high density in both population and wealth, the Danish system might be relevant when discussing how a state in the Northeast might want to devise a statewide health care system. Tiny regions might possess the wealth and ideological solidarity required to support a purely public system. Funds for hospitals would be provided by the state income tax, which would be like the federal tax in Denmark. Decision-making on how to spend the dough could take place at the local level, like it does in Denmark. A similarly small, wealthy US state could decide for itself how the balance of power within the state health care system would look, just like different Scandinavian countries do. Denmark is on the more "federalized" side; Sweden, in contrast, for instance funds its hospitals about three-quarters locally, when I last looked into this.

Denmark's nice way of doing things is not in effect in the US (on a nationwide scale) for the same reasons it's not in effect on a worldwide scale. Logistically, it's ludicrous on such a scale and in any environment with different tribes, and philosophically, our constitution was not designed to hold these different tribes in the grip of federal policies. Instead there are themes like freedom of religion/press/assembly, which all imply a right to disagree with others on any topic for any reason, and promulgate alternative views through legal channels. That is a form of diversity that bothers liberals in the US. It can preclude a national health care system and many other instruments of federal power.

It is with these ideas in mind, that I've thought of the single-payer crap as unfeasible in the US, whereas diverse state-level systems were already formidable before Obamacare. I like the mixed market approach and the empowerment of the states in this matter. Complexity in an inherently complex industry, and non-uniformity in an inherently non-uniform country, don't really bother me at all. Repeal Obamacare and replace it with nothing.

You're aware that this isn't the thread for this, aren't you?

Regardless, you're making a bunch of wrong assumptions. I'll allow you to take it to the actual Obamacare thread, you can post there answering my following points, if you're interested. Please send me a PM with a link to the post if you do, I'm unsure whether cross thread quotation alerts users on CFC. I'll put it in spoiler due to this not being the threat for it.
Spoiler :

High population density in Denmark - Yes, Denmark has more population density than in the US. Yet universal healthcare works in Iceland, Greenland, Canada and Australia.
US average pop density: 35/km^2
Iceland: 3.2/km^2
Greenland: 0.028/km^2
Canada: 3.92/km^2
Australia: 2.8/km^2

I'm aware that I'm going by the population density of all of USA instead of state level. However, the lowest state pop densities are South Dakota (4.4), North Dakota (4.2), Montana (2.7), Wyoming (2.3) and Alaska (0.5). This means we're counting five states that are just in the ballpark of what has been proven possible in Canada and Australia if you want to talk about size. And just to remind you, Canada is the world's second largest country, Australia is the world's 6th largest country and Greenland is the world's 12th largest country, if you consider them independent from Denmark.

You can argue that Greenland's abysmal population density should make universal healthcare possible, and that Greenland's healthcare is only possible through Danish subsidies. But if you want that argument, your point about Danish population density making it possible would be incredibly problematic, since following that Denmark actually has a much larger area to cover. So, you know, Denmark's healthcare actually covers a much smaller population density in that regard. Denmark would be the world's 12th largest country with an abysmal population density if you want to make that argument - Denmark prior would be just 2% of its total size.

EDIT: This is how they do it btw. http://mastermind-project.eu/partners/agency-for-health-and-prevention-greenland/

Diversity. Of these examples, Iceland isn't very diverse. Denmark could also be argued to not have much diversity. But regardless of what you hear in the news, Denmark does have 10% of its population stemming from immigration. This is not an insignificant number, even though the US have "just" 73% of people being white and a 17,6% Latin minority, depending on what you care about when measuring diversity. There are a bunch of other statistic that demonstrate, yes, it is true that the US has more diversity than Denmark.

But if you lived here, you would understand it's not that simple. To get the obvious out of the way, we've always have had issues with a significant German minority. But there's something in regards to our demographics that foreigners don't realize. Thing is, due to our island make up, Denmark has a lot of incredibly diffuse dialects. The difference between West Jute, North Jute, South Jute and "rigsdansk", the dominant dialect, is so large that these Jute accents are completely incomprehensible to Danes from other areas. This doesn't include the dialects that are just difficult to understand rather than impossible. Anecdotically I can refer to my ex girlfriend who couldn't even understand her own grandfather, even though they saw each other all the time. This ties in with real political tensions between the capital and the provinces. This doesn't show up on Wikipedia because people simply identify as Danish due to a moderately succesful nationalist nationbuilding in the 1800s. But it does not mean that there aren't real differences between rural and urban Denmark, if anything regards to values. In fact the question about rural Denmark could easily be argued as ethnic problems. But they aren't normally because Danes just so happen to identify as Danes. The cosmopolitan, Atheist, socially democratic Denmark that tourists meet does not tell the whole picture of the nation; in fact, your point about tribalism very much applies here. Another point is that we're incredibly racist, yet neither native Danes or brown migrants believe the other shouldn't be allowed universal healthcare. To answer your prompt, we don't universally do things "nicely", infact, I'm not sure we deserve the reputation of being a "nice" country.

Also if you really want to ignore Denmark, the point about diverging ethnicities making universal healthcare impossible is just a fallacy seeing how many countries succesfully do this with diverging ethnicities.

Freedom of religion/press/assembly and its relation to culture. This baffles me. So the US can't have universal healthcare because you have these... Danish citizens don't have these rights? European citizens don't have these rights? Is it because diversity feeds into this, as if European countries aren't diverse and don't have ethnic issues? Have you ever picked up a history book, or heck, just a book about contemporary demographics?

USA is not the exception. The Mongols are.

OTOH I can understand the difficulties in funding depending on state/federal level, I don't have an answer prepared for that at this point. There is a real difference in regards to parliamentalism and constitutional function - Denmark's constitution is laughably ignored at this point. I'm not sure how it is a dealbreaker however. The countries granting universal healthcare are incredibly diverse and I have seen nothing innate about US administration that makes this innately impossible. Now, what's difficult is trying to get such a fundamental overhaul through the US political machine, but there's a large difference between that and managing the policy once it's already in place. You're free to try to explain this to me - in the other thread.
 
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So Dingbat Don repeats his "promises" about pie in the sky with ice cream, even his detractors have to say it was a good speech, and today he will no doubt go right back to the same train wreck of governing that we have watched in horror for forty days.
 
Oh and @innonimatu yes I would accept the proposition if Donald suggested it. I would accept it so hard. IDC how it happens. I want people to be happy.
 
The difference between Denmark and the US is scale, constitutional format, economic history, and cultural present. It's kind of a fad for leftists in the US to look in your direction, at Scandinavia as a whole, for conclusive proof that our health and educational systems should be nationally-run, even though our country bears not even a superficial resemblance to a Scandinavian country. The whole thing reminds me of back in the 80s and 90s when the US was making proclamations on how Asian countries should be managing their economies according to neoliberal principles, the so-called Washington Consensus, because these notions were working out so damn well for us at the time, and of course everyone on earth is the same so the policies would be just as awesome anywhere they are tried. Yeah, no.

This is a significant misunderstanding of the Washington Consensus. It was pushed not as an authentic reform package or advice, except by naive exponents, but rather as an instrument of insuring the entanglements of the International Monetary Fund, World Bank, and others. Places where this package were challenged based these challenges off of judicious study of the actual reform and industrialization policies exercised in the countries where the IMF and World Bank were based. Before the Consensus, Japan was the poster-child of its inverse; and after, those who repudiated it (South Korea and Taiwan) survived the Asian financial crisis whereas those who dutifully adhered to it (Philippines, Indonesia, Malaysia) suffered accordingly. So it really had nothing to do with applying the same set of principles everywhere and much more to do with imperialistic capitalist bullying, as usual.
 
Question: If Trump came out with that proposal, and willing to try to pass it, how would each of you stand about it? I'm not even talking about "Medicare for all", I mean a National Health Service supported from general taxation. And I'm not wanting to argue whether Trump could do this, or pigs can fly. I'm just asking: if he proposed that, how would you stand, for or against?

It depends on the details. Same for his ACA "replacement." I'm not even opposed to the general ideas put forth in some of Congress' ACA replacement proposals, until you drill down into the details and realize that they aren't intending to fund high-risk pools for pre-existing conditions with even 1/100th of the amount of money it would take to make care affordable and accessible to all with pre-existing conditions who wanted it. And that's just one problem of many.
 
You're giving the answer I anticipated. Thanks, I was wondering just how far partisanship had dislodged rational political considerations in the US, I'm getting the idea that very much.


With the Republicans, it's entirely party over country. Sadly, many of them probably don't even realize that.
 
You're giving the answer I anticipated. Thanks, I was wondering just how far partisanship had dislodged rational political considerations in the US, I'm getting the idea that very much.

"Stonewall everything so the other guy can't get credit" unfortunately is a rational political consideration in the US these days. And I have to say it's pretty close to my attitude toward Trump.
 
Isn't this RD thread redundant with the RD Affordable Care Act thread J started?
Initially it was meant for the specific purpose of providing alternatives for the ACA whoch is sufficiently different imo. Seeing how it's developing into regular discussion, I agree mostly, and will probably totally agree if it continues down the current path.

Not because the given points are bad.
 
Initially it was meant for the specific purpose of providing alternatives for the ACA whoch is sufficiently different imo. Seeing how it's developing into regular discussion, I agree mostly, and will probably totally agree if it continues down the current path.

Not because the given points are bad.

I was going to point this out as the difference.

This thread arrived quickly at the recognition that the only useful replacement for the ACA is single payer. The thread J started so he could whine about the ACA may or may not ever reach that conclusion, because it is focused on the Republican "repeal it and replace it at all costs, even if we replace it with chaos" principle.
 
I was going to point this out as the difference.

This thread arrived quickly at the recognition that the only useful replacement for the ACA is single payer. The thread J started so he could whine about the ACA may or may not ever reach that conclusion, because it is focused on the Republican "repeal it and replace it at all costs, even if we replace it with chaos" principle.

Well I don't disagree this is the best solution. I'm just baffled at what the Republicans expect to do about this exactly. They're going to lose millions of votes if they repeal the ACA without any replacement.
 
Well I don't disagree this is the best solution. I'm just baffled at what the Republicans expect to do about this exactly. They're going to lose millions of votes if they repeal the ACA without any replacement.

They are going to replace the ACA with the RACA, which will be exactly the same.
 
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