"We're constituted differently than European countries and Canada. We're younger than other countries."

We are actually one of the oldest countries in the world. We have probably the oldest written Constitution. Some of the oldest continuous institutions of state. We have one of, if not the, oldest political parties in the world (give it up for the Democrats). So I hate listening to that shit.

"We're a young country." Yes, a spritely 232 years old. That's hardly enough time to figure out single-payer when creaking dinosaurs like 141-year-old Canada were able to do it over forty years ago.

Better talking points, please.

Questions for Ezra and commenters:

Assume that a middle-of-the-road reform bill is passed, including some sort of mandate and limit on ability of private insurers to deny coverage, with or without a public option. Also, EMRs, comparative effectiveness, yadda yadda. To what extent would this change alone spur improvements in quality of care and cost control?

Ie, if an insurer now knows that it has to take you and can't save money by denying care down the road, doesn't it now have a strong incentive to bargain down provider payments, identify unnecessary treatments, improve chronic disease management and preventive care, etc.

Am I missing something?

This is just someone in power, representing empowered interests, scrabbling together a few pseudo-reasons because he doesn't want to tell the truth:

We don't have universal healthcare in this country because the wealthy and powerful know full well that they can deny it to us without risking massive unrest. But Baucus isn't going to say that any more than a boss is going to say, "We didn't give the workers a raise because they're not in a union and won't go on strike."

It'll "be time" for Medicare-for-All when a crowd of 2,000,000 shows up on the Mall not to cheer our politicians but to tar and feather them.

"We need a uniquely American result."

we already have that and it sucks. wanker.

Is there anyone on this forum who is able to envision the time and circumstances that would make a single-payer system right for the US? Of course not because there will always be powerful senators with powerful interests behind them who are unwilling to do the right and selfless thing. Not long ago it wasn't the right time for blacks to integrate, or blacks to marry whites, or gay marriage. Do you get this point, now? So, Ezra, stop trying to tell me how great Baucus is or Daschle for that matter. They blow!

I have to call bullsh*t on anyone who blames the fact that we can't get single payer on the wealthy and powerful. We can't get single payer right now because the middle class won't stand for it because most of them are relatively satisfied with the health care they're getting and afraid that they will be worse off under the new system.

sean, if you're referring to my comment, I think you misunderstood what I was getting at. I don't blame the wealthy and powerful for wanting to keep their wealth and power at our expense. That's what they do.

The difference between the US and France, for instance, on this issue has to do with the difference between the working class and middle class of the US and their equivalents in France. In France, workers, including professional workers, are more than willing to shut most of the country down in a general strike. Here, it's a pipe dream.

Americans, for whatever combination of reasons, just aren't in the habit of engaging in that kind of solidarity and troublemaking. So we live with the consequences -- or, in the case of too many of us, don't live.

Baucus' answer is honest, but it's also negotiating with yourself, by defining the "left" position on health care as an individual mandate, which was actually always the right-wing plan for universality (i.e., force poor and middle class consumers to pay off their campaign contributors and get next to no health insurance in return) and the "right" position as no universality at all. Liberals can't win in that environment.

The correct approach is for the Democrats to INITIALLY support, as a bloc, single payer. Make it a non-negotiable issue and enforce a party line on it. If you don't support it, you lose your committee assignments, etc. Then, when it comes to NEGOTIATING the actual plan, you can bargain down. But the only thing that is going to pull any resulting plan in a decent direction is the threat of single payer.

Ie, if an insurer now knows that it has to take you and can't save money by denying care down the road, doesn't it now have a strong incentive to bargain down provider payments, identify unnecessary treatments, improve chronic disease management and preventive care, etc.

Am I missing something?

Yes you're missing something. Insurance companies exist to maximize profits. Sure, they'll cut down provider payments and put that extra money into their own pockets. They certainly wont be lowering overall healthcare costs.

Why pay for an expensive middle man who siphons 40% of the money off the pile while providing NO ADDED VALUE to the system?

We need single payer. Get rid of the middle man.

jackray, cut the crap. That 40% figure is ridiculous. It's more like 15% in admin/profit. Public systems have 3-6% admin.

By the way, profit margin for private insurers is around 5%. This is not like the margins in pharma, which are often as high as 20% or even more. You are confusing your industries.

As for providing no added value, please. If they provided no value, no one would purchase their services. Does car insurance provide no added value? Home insurance? The value is in financial security.

There is a lot that can be criticized in the way private insurance works, but you haven't touched on those things.

As for providing no added value, please. If they provided no value, no one would purchase their services. Does car insurance provide no added value? Home insurance? The value is in financial security.

There's a difference. Other types of insurance pay for rare, unplanned, high cost events (accidents, fires, etc.). Insurance is good for those things because it aggregates risk. (It isn't the only way to do it-- the government can aggregate risk too, as it does with FEMA. But insurance can work in that environment.) Health insurance does do that, but it also covers routine, planned, moderate cost events. And there's no aggregation of risk in that second function, so all insurance companies are doing is acting as middleman and siphoning off some surplus that would otherwise be shared between you and the medical provider.

Assume that a middle-of-the-road reform bill is passed, including some sort of mandate and limit on ability of private insurers to deny coverage, with or without a public option.

Sen BAUCUS is full of bull, he was paid to take it off the table. The insurance industry gave him millions. Hell, if I was given millions and it was my decision I would have thought about taken single payer out of the equation. Frankly, it's up to us, to press our reps into it. I call constantly, will it help I don't know. I hope if enough of us do it, it will but when its money in their pockets, I mean in the Champaign coffers it's hard to tell. When we work we are paying for it, we add it to the kitty, why cant we just open medicare for all. I still have not gotten an answer from any of my senators or rep. Maybe one of you, guys can get an answer because I never do.

Actually, jd, the admin/overhead for medicare is a whopping 3%. On the other hand, the private sector skims 25%-27% off the top for employer insurance and a whopping 40% for private insurance (the main type of insurance that a government plan would be replacing.)

http://institute.ourfuture.org/files/Jacob_Hacker_Public_Plan_Choice.pdf

But no... go invent a bunch of bullcrap answers. The $2k you are flushing down the toilet this year is nothing compared to your principles.