June 28th, 2017

Obamacare replacement bill wildly unpopular…

…says article after article and poll after poll.

Well, why shouldn’t it be unpopular?

The drumbeat of the MSM that’s been denouncing it goes like this: It will kill millions and millions of people. It only favors the rich. It cuts many more millions off from health care. It is secret.

There’s probably more I haven’t listed, but you get the picture.

And then there’s the right, much of which only wanted “repeal.” Vast numbers think that this bill is merely craven establishment-Republican-style Obamacare-lite (and not all that “lite,” at that).

So who on earth would be supporting it?

I’d like to see another poll. This one would ask those same people questions about exactly what’s in the bill. Most of the respondents probably could answer nothing more than to parrot the thoughts in those headlines I listed, such as “it will kill millions of people.” In fact, if there actually was a quiz in these polls about the point-by-point provisions of the bill, I’m pretty certain that, if people were honest, at least 95% of respondents would have to choose the option of “have not heard enough about it to have an opinion.”

49 Responses to “Obamacare replacement bill wildly unpopular…”

  1. T Says:

    It may be unpopular with the masses, but Avik Roy, in his article for the Washington Post cites the Senate bill as historic.

  2. Cornhead Says:

    Warren Buffett of Omaha went on TV to complain about how the new bill would save him millions in taxes. This is coming from the same guy who has donated little, if anything, to healthcare in Omaha.

    The new University of Nebraska cancer center is the Fred and Pamela Buffett Cancer Center. It is always called the Fred and Pamela….. I think that’s his cousin or maybe an uncle. He only has sisters.

    $200-500m from Warren would have gone a long way at Creighton or Nebraska Medical Schools for research and tuition.

  3. Cornhead Says:

    I can certainly guarantee that for $50 or $100 million both Creighton and Nebraska would rename their medical schools as the Warren Buffett School of Medicine. But instead most of his money goes to the Gates Foundation.

  4. Big Maq Says:

    ” In fact, if there actually was a quiz in these polls about the point-by-point provisions of the bill, I’m pretty certain that, if people were honest, at least 95% of respondents would have to choose the option of “have not heard enough about it to have an opinion.”” – Neo

    Probably true about the vast majority of bills, EOs and other government policies / actions.

    If so, how DOES one go about getting support for anything in a democracy?

    Could selling the ideas have anything to do with it?

    Would credibility and trust be an important factor?

  5. neo-neocon Says:

    Big Maq:

    The MSM is the portal through which most of the information passes. That portal is dedicated to ruining all efforts by the GOP. Even many of the right-wing blogs are so against the Republicans in Congress that they are dedicated to the same thing, just coming from a different direction with different arguments.

    That said, the GOP members of Congress such as McConnell are poor, poor communicators. That’s a longstanding problem.

    And to top it all off, bills such as the Obamacare reform bill are inherently complex, lengthy, and difficult to understand, with effects that are very difficult to predict.

  6. J.J. Says:

    It’s unbelievable to me that more “investigative journalists” haven’t done some digging on this issue. The bill is not perfect. But it is what is possible given the political situation. Nothing is said about the small percentage of Americans who will actually be affected. Instead false hyperbolic claims are made about millions dying. A small reduction in the rate of increase in Medicaid spending is trumpeted as huge cuts in Medicaid. Meanwhile, no one even mentions the plight of the individual policy purchasers.

    The bill gets rid of the mandates, allows insurers to tailor coverage to purchaser’s needs, and gets rid of some taxes. Not a full repeal, but not chicken feed either.

    If this bill is so bad the Democrats should be stepping aside and encouraging its passage. If it is so bad, it could sink the Republican chances in the 2018 elections. Isn’t that what the Dems want?

    People should look at this as a first step. The next step is to pass legislation that will create more multi-state competition in health insurance, allow people to create buying co-ops/affinity groups for group health insurance purchases, and steps that actually reduce health care costs.

  7. Brian Swisher Says:

    Perhaps we just shouldn’t worry about it, given that we’ll all be dead soon because of the 93,000,000/day attrition rate due to handguns, per Gov. McAuliffe.

  8. arfldgr Says:

    if the republicans submitted a copy of the dems law, the dems woudl oppose them.

    you silly people…

    I’m against it (Horse Feathers) – YouTube
    https://www.youtube.com/watch?v=e7cry-4pyy8

  9. arfldgr Says:

    I don’t know what they have to say,
    It makes no difference anyway,
    Whatever it is, I’m against it.
    No matter what it is or who commenced it,
    I’m against it.

    Your proposition may be good,
    But let’s have one thing understood,
    Whatever it is, I’m against it.

    And even when you’ve changed it or condensed it,
    I’m against it.

    I’m opposed to it,
    On general principle, I’m opposed to it.

  10. arfldgr Says:

    I protest your reaction to my post, regardless of what that reaction may be… i am against it, because i am your opposition, and will not give a inch, quarter, and will make you earn every millimeter.

    why?

    we, the left, are the only ones willing to do anything, say anything, be anything, hurt anything, and even confound heaven and hell if necessary to be over every human being and seal the future of my own.

    they will be traitors, they will break laws, they will murder people, they will deny that truth exists, they will bribe, cojole, trick… they will force, manipulate, adjudicate and prevaricate..

    in essence, they would destroy it all if they at any isntant thougth destroying it all would get what they want, or deny the other what they cant have.

    wake the heck up people
    your no where as serious as they are
    most of their opposition arent

    until its almost too late and the maximum price has to be paid by the innocents blood, and even then, there may not be enough blood.

  11. Tatterdemalian Says:

    Donald Trump wildly unpopular, says article after article and poll after poll.

    Meanwhile, outside the echo chamber, people are starting to realize that “free healthcare” actually means “you are not allowed to spend money to get better healthcare, not even for a baby.”

  12. Geoffrey Britain Says:

    JJ,

    What “investigative journalists”?

    I’m sure there’s a couple more but off the top of my head, I can only think of Sharyl Attkisson, Michael J. Totten and James O’Keefe.

    artflgdr,

    Horse Feathers indeed…

  13. Somebody Says:

    While plausible, this explanation for the bill’s unpopularity–people are too dumb to read it or think for themselves–is spiritually akin to the “what’s wrong with Kansas” mode of hand waving away a broad popular sentiment as the product of false conscience.

    Its equally possible that the bill’s sun setting of the Medicaid expansion and switch to block grants are unpopular because people genuinely like Medicaid, the leanest segment of our healthcare sector which covers a huge number of vulnerable people, like babies and the elderly, who might otherwise lack access to our employer-based insurance market. Or that the bill undermines its own ostensible goal of deficit reduction by pairing Medicaid cuts with a massive, unrelated tax cut for wealthy Americans. Which is to say, it’s possible the bill is massively unpopular with a rare supermajority of Americans because it’s simply and genuinely a terrible bill that runs contrary to the interests and principles of most Americans.

  14. Brian E Says:

    “Or that the bill undermines its own ostensible goal of deficit reduction by pairing Medicaid cuts with a massive, unrelated tax cut for wealthy Americans.” – Somebody

    What, exactly are those massive, unrelated tax cuts for wealthy Americans?

  15. Somebody Says:

    Brian, from the CBO:

    “The largest increases in deficits would come from repealing or modifying tax provisions in the ACA that are not directly related to health insurance coverage, including repealing a surtax on net investment income and repealing annual fees imposed on health insurers.”

    There’s no obvious connection to these tax cuts, which would amount to a $541 billion increase to the deficit, reducing the net savings of the bill to $321 billion over ten years. Which is to say, more than half the bill’s potential savings are eaten up by a tax cut that is unrelated to the other components–the Medicaid sunset/block grant shift and subsidy reductions.

  16. Brian E Says:

    That’s disingenuous Somebody. The capital gains tax increase of 3.8% was passed to fund the ACA.
    Repealing it with the reform of the ACA is hardly “unrelated”.

  17. Somebody Says:

    I guess it’s directly related if your primary objective of repealing the ACA is to reduce taxes on the wealthy that helped fund it, which the Senate bill appears designed to do. But there’s no obvious connection between the two in the senate bill–the cut is not required to make any of the other changes, as far as I could tell.

  18. Brian E Says:

    Somebody,
    Fair enough.

  19. Sean Says:

    The polls are b.s. How will we even know what’s in it unless we pass it?

  20. Richard Saunders Says:

    Bullshit, Somebody. The 3.8% net investment income tax was instituted specifically to fund Obamacare. If you eliminate Obamacare, you eliminate the tax, get it?

    Oh, wait — you undoubtedly are one of those people who believes the government owns everything, and any reduction of a no-longer necessary tax is a giveaway to the rich.

  21. AesopFan Says:

    ” In fact, if there actually was a quiz in these polls about the point-by-point provisions of the bill, I’m pretty certain that, if people were honest, at least 95% of respondents would have to choose the option of “have not heard enough about it to have an opinion.”” – Neo

    And that’s just the Congresscritters….

  22. Somebody Says:

    Richard,

    On the contrary! I simply believe that the bill appears to have been designed almost exclusively to cut those taxes, without reference to actually reforming the health care sector. There’s virtually nothing in the bill that would really affect the way Americans consume or buy healthcare, other than reductions in Medicaid (which would cause people who mostly lack access to the benefits of the employer-based insurance market) and cut subsidies for people to buy into that market. That is, cutting that tax has nothing to do with reforming the market.

    And cutting the tax doesn’t really pay for anything in the bill; it’s not a necessary component to achieve anything else in the bill. You could keep it or cut it and the rest of the bill would look the same. Senate Republicand made a point of touting the savings of the bill, but if the goal were simply savings–which would be a separate but equally legitimate goal of this bill–then why add in measures that will add to the deficit that are unnecessary to achieve the other savings per the Medicaid and subsidy cuts?

    So it looks like the bill is not really about saving money (could have easily saved more) or about healthcare reform itself (no major changes to the market place). Which makes it seem a lot like the tax cuts themselves are the purpose, and the bill is being called a healthcare reform bill for expediency’s sake.

  23. Somebody Says:

    But to that point about the government “owning that”:

    I remember when Obama proposed raising the top marginal tax rate a percentage point or two and the right responded with cries of “tyranny!” And I remember being confused by that, because it was a measure that would have affected a small percentage of dollars earned at the top margin–a marginal rate only taxes dollars earned within a specific income range, so any dollars earned over x amount are taxed at x rate, any dollars over y amount at y rate, etc–and only at a level far below top marginal tax rates under previous Republican presidents. It doesn’t seem like tyranny!

    And that comes back to my point about minimum wage: if you don’t think there should be ANY taxes, then ok, that’s a tough but principled stance. But if you agree that there should be SOME taxes, then we’re just quibbling over the appropriate rate to achieve the greatest public good at the lowest public cost. We can disagree over that, that’s fine, but then we’re basically just accountants arguing over charts. You’re not in a mora position to argue that your rate is freedom and my rate is tyranny, if we both agree there should be a rate.

    And yes, I believe that burdensome regimes of rules and regulations can increase aggregate freedom. Think about the absurd number of rules we’re required to follow. The state tells us what we can drive, when we can drive it, how old we have to be to drive it, how fast and slow we can drive it, which side of the road to drive it, what condition it has to be to drive it, and so on and so on forever, with constant pervasive surveillance and enforcement. But that regime of rules also enables such a dramatically greater freedom, relatively safe and orderly travel, that we don’t even think about how burdensome the rule regime is.

    Similarly, I think single payer could be a burdensome regime that produces so much aggregate freedom that we’ll forget about the regime. We can dive into that, but it’s disingenuous to argue that liberalism is anti-freedoms for disagreeing with you in degrees, not kind.

    But that’s a fairly post-ideological version of liberalism, the bland post-politics that Clinton ran on, and it didn’t serve her very well, so I can’t claim to be representative of all liberals here.

  24. Brian E Says:

    Somebody,

    I think you’re going to find most conservatives will object to your distortion of the word “freedom”.

    Your using it to mean safety or security, which isn’t the general definition of the word, which is almost the antithesis of the word freedom.

  25. Brian E Says:

    Arbeit macht frei

  26. Somebody Says:

    Actually no! I literally mean “freedom” in exactly the same way you do! It’s funny how that works. We’re not that different!

    By that I mean: we all generally accept that driving regulations are acceptable and don’t represent impositions on our freedom in the same way that we might view, say, extrajudicial killings by police officers. We accept an enormously burdensome regime of rule and regulations, ultimately enforced at gunpoint (which is the ultimate enforcement mechanism of every law), almost without a single conscious thought to it. We’ve internalized it so completely that it’s never addressed, but it represents one of the biggest areas of government regulations in our lives that we’ll encounter almost every single day. And the only explanation I can offer is that it affords us the greater freedom to travel virtually anywhere in our country at our whim. That is a great freedom! I gladly make that trade, and I suspect you do too, to the extent that anyone even thinks about it. Restrictions on our freedom, even incredibly burdensome, can actually generate even greater freedoms.

    Now, this is obviously not true of all rules regimes. Business licensing is a great example; requiring barbers to receive licenses has more to do with established businesses recruiting government authority to restrict market access to customers.

    I don’t think any of this is controversial, yes? We (probably) agree that SOME taxation, an intrusion into our freedom to choose how to spend our dollars as we see fit, can produce more freedom than it costs. For example, taxation to fund defense spending represents a burdensome intrusion into our freedom, which we exchange for the greater freedom of being free from the boot of the Tyrant King George III. Right? We can agree on that? Some taxes spent on some things generate more freedom than they cost us, yes? We can agree on that? Is that controversial?

    So I posit that we literally disagree only at the margins, but you’re alluding to me being a Nazi. And that, my friends, is the root, I suspect, of our poisonous political culture.

  27. Somebody Says:

    Here’s how I think universal health care would increase our actual freedom in literally the same way that you mean the word:

    (This is really a rough sketch, I’m only offering a broad outline.)

    – We were already taxed to pay for our healthcare system. We’re taxed to pay for Medicare and Medicaid. We’re indirectly taxed to pay for each other’s employer-based health insurance policies through tax breaks on the companies providing the policies. We’re indirectly taxed on each other’s health savings accounts, which represents untaxed income. (Tax breaks simply shift the revenue burden on someone else, they don’t actually save the system money.) We’re taxed on federal aid to emergency rooms. And etc. We’re taxed a lot.

    – Further, under the ACA, we’re effectively taxed through penalties on not carrying insurance, so we’re required by our government to either pay a new tax OR pay our money to a private company, an awful choice.

    – So: we’re already taxed extensively. A universal healthcare system that rolled Medicare, Medicaid, and employer-based insurance subsidies into a single tax might not represent a major change from what we’re already spending. (I don’t know if this is true or not, but I’m including to emphasize that we’re already extensively taxed, so that no one can argue that universal healthcare would require the imposition of new taxes where none existed before, since they absolutely do.)

    – Universal access to healthcare would general drive healthcare interventions earlier, so that the number of chronically ill (who, if they’re poor, have historically relied on emergency care that does nothing to alleviate chronic conditions) would go down. I realize that you have already rejected arguments that “freedom from” don’t actually represent greater freedom (though I suspect you’re comfortable with defense, which absolutely represents taxing us to provide a “freedom from”), but it’s a really important component for me.

    – Separating insurance from employment would provide an enormous boon to entrepreneurship. As long as insurance is linked to employment, then our actual health and lives are linked to our employers, which almost certainly has a major dampening effect on innovation, risk taking, and labor market liquidity.

    So yeah! I’m looking for a system that is fairly revenue neutral (or at least represents a change in degrees and not kind in terms of taxation) that would increase entrepreneurship. I generally prefer systems like that of France, where a basic level of care is guaranteed alongside a relatively free market in private care.

    Sure sounds like a Nazi! You caught me!

  28. Brian E Says:

    “So I posit that we literally disagree only at the margins, but you’re alluding to me being a Nazi. And that, my friends, is the root, I suspect, of our poisonous political culture.” – Somebody

    Good grief. It was not my intention to project any Nazi-like motives to you.

    “And the only explanation I can offer is that it affords us the greater freedom to travel virtually anywhere in our country at our whim.”

    There you go again, to not misuse the great Ronald Reagan.

    The fact that I can travel across the country with a degree of surety that other people on the road are following the same rules as I am doesn’t in any way expand my freedom. I’m just as free to travel with the rules as I am without– it’s just I perceive my safety to be enhanced.

  29. Somebody Says:

    I mean, I guess you could argue that, in the absence of any rules regime for driving, you would be absolutely free in the Sartre, existentialist sense that if life is a priori meaningless then we are absolutely free to act as we see fit. But there’s a major difference between “I am abstractly free to exit my house and walk from one end of the country to the other,” and “it is a practical possibility for me to actually travel.”

    And I’d then ask: why DO we accept an incredibly burdensome set of regulations and rules for managing traffic, if we didn’t get something better for it? Are we all just…sheeple? I guess I just think more highly of my fellow Americans.

  30. Brian E Says:

    “A universal healthcare system that rolled Medicare, Medicaid, and employer-based insurance subsidies into a single tax might not represent a major change from what we’re already spending.” – Somebody

    might

    I might win the lottery tonight.

    What’s the chance of that?

    When Medicare was enacted in 1967, it was projected that by 1990 it would cost $12 billion. We were already spending $98 billion by then. We’re now spending $570 billion.

    Excuse me for being skeptical about any government projections on costs.

    But more importantly government regulations have already interfered with the doctor-patient relationship under the ACA. It would be interference on steroids with a true Medicaid for all scheme.

  31. Brian E Says:

    “why DO we accept an incredibly burdensome set of regulations and rules for managing traffic, if we didn’t get something better for it? Are we all just…sheeple? I guess I just think more highly of my fellow Americans.” – Somebody

    Those burdensome set of regulations don’t make me more free! I give up my freedom to make life more orderly.
    And yes we are sheeple, in some instances. Fighting the administrative state is not cost effective in most instances.

    Our little town started using roundabouts to direct traffic. It dawned on me after so many people were running red lights and the city actually put up signs reminding people that a red light meant you had to stop that roundabouts are used in parts of the world where there may not be common agreement about rules of the road. 🙂

    And this doesn’t make me think more or less of my fellow Americans.

  32. Somebody Says:

    I think this is really, really important: your relationship with your doctor is already shaped in myriad ways by government regulations and taxes, and not just in terms of doctor credentialing. I mean that if you have employer-based insurance, your “choice” of doctor has already been shaped by bureaucratic decisions. Everything from how many plans you can choose from to what those plans cover to how much coverage they provide to which plans are attractive enough to doctors to accept are products of government interference in the marketplace.

    As with driving, we’re so deeply embedded in the regulatory and tax regime surrounding healthcare that we don’t even think about how burdensome it is or how it affects our decisionmaking. And so I suspect that a lot of the debate over universal health care is predicated on the false notion that it’s a debate between “unfree” universal healthcare and our current “free market” system, and that if we acknowledged how incredibly unfree our system is, the debate would sound different.

    Now, if you wanted to make a case for a completely free market in health care, then that’s a principled stance I can disagree with but respect. It would almost certainly entail the exclusion of a huge number of people from any access to health insurance, and probably a big chunk of people from any health care whatsoever. But if that’s the position you want to advocate, ok! Let’s do that. But don’t pretend that the ACA represents a change in kind; it might represent a change, but the government already interferes in your relationship with your doctor. If we’re going to have interference, I’d rather have a more efficient interference that produced better outcomes, which is what I expect we could get.

  33. Somebody Says:

    Oh this is a really fascinating area of using rules to affect behavior!

    “…that roundabouts are used in parts of the world where there may not be common agreement about rules of the road.”

    On the contrary, roundabouts are generally used as a way to affect traffic patterns without introducing rules signage. Because the design of the road itself demands drivers to pay more attention to their surroundings, they slow traffic and produce fewer collisions than signed intersections (in general).

    There are jurisdictions in Europe that have experimented with removing all signage from streets in dense urban environments where drivers are more likely to interact with both drivers and non-drivers sharing the road (bikes, pedestrians, etc). The theory is: drivers rely on signage (and regimes of rules) to govern their driving, which reduces their attention to the actual conditions on the road and puts them on something of an auto-pilot. Removing signage forces them to slow down and pay more attention, with a resulting decrease in collisions.

    I love this kind of stuff! I am a traffic design nerd.

  34. Brian E Says:

    “I think this is really, really important: your relationship with your doctor is already shaped in myriad ways by government regulations and taxes, and not just in terms of doctor credentialing.” – Somebody

    Great. If I understand your logic.

    Capitulate! You’re already pawns, beholden to the system. Stop resisting. Government is here to help. They know what medicines you should take, what procedures you should have, when it’s time to take the blue pill.

    Well, I’m convinced. Bring on Medicaid for All. It will make me so Free I may not be able to stand it.

    The notion that because the Government already has had it’s bureaucratic hand in healthcare for some time, and just doubled down with the ACA, the only rational extension is more Government Run Healthcare is silly and not a convincing argument.

    And the notion that the Government will get it right this time, with more efficient outcomes– that I’ll be healthier just because the government is writing the rules isn’t born out by their track record.

  35. Big Maq Says:

    “The MSM is the portal through which most of the information passes. That portal is dedicated to ruining all efforts by the GOP. Even many of the right-wing blogs are so against the Republicans in Congress that they are dedicated to the same thing, just coming from a different direction with different arguments.” – Neo

    The msm bias is not a new problem, even if we were to agree that they are “the” portal (while may have been true years ago, it is quite debatable today, and is probably highly dependent on the demographic).

    The real problem is back to the people, after all, THEY are the ones who are choosing who they consume their news from.

    If they didn’t like what the msm was telling them, then they’d swipe the page, click a different link, turn the dial, switch the station, pick up a different paper / magazine at the news stand. It is not like there isn’t a plethora of choice for news and information sources today.
    .

    The role of a politician and party is not just to represent, but to also sell their ideas to a wider audience and build support.

    We as citizens also have a critical role in selling the ideas.

    But, if we sit back and say it is someone else’s job, or, worse, give up altogether because we think it hopeless and that those left of us will never listen, can never be persuaded, they ONLY listen to the msm and the msm is perpetually against anything the GOP does, then it becomes self fulfilling.
    .

    Right now, where we stand, we have a POTUS who isn’t leading on the issue (heck, nobody knows where he truly stands on the issue, and is there any doubt he is far from versant on even a minimum of details? then on what basis can he effectively “negotiate”?), and a GOP majority Congress whose leadership don’t want to cross trump (entitlements are “untouchable”, the House proposal is “mean”), and who’ve never coalesced / built support around a set of proposals to start with, let alone set the stage for change by selling those ideas earlier, while vehemently opposing obamacare.

    So now, they are in d*mned if they do, d*mned if they don’t pass something.
    .

    What is on the table is likely to be a significant improvement over obamacare, but then we don’t really know, not having much time to understand it all, given its complexities, and given that we hardly have anywhere to go for trusted sources of analysis (see our discussion on the CBO report http://neoneocon.com/2017/06/27/the-cbo-scoring-on-the-senate-health-insurance-reform-bill/#comment-2226551 )

    Add to the mix the hard pounding the GOP did for what, six years, on repealing obamacare. If the major underpinnings remain in place, the same underlying principle is kept, what does that say about all that past bluster?

    There is a very REAL credibility problem for the GOP.

    Oh, there’s those words again… credibility… and trust.

  36. Somebody Says:

    Again, not trying to convince.

    And while I admire your spirit, I think it’s silly to imply that you’re, in some way, rejecting tyranny while I capitulate.

    Because the system I think you’re trying to defend, our current system (or maybe pre-ACA? Not clear) already entails significant government intervention. If that system doesn’t entail tyranny, then neither does universal.

    Or maybe you do think that a completely free market is ideal, which, as I said, is admirable if odious. But, as far as I can tell, you’re not advocating deregulation, you’re advocating one regulated system over another.

    When you fear that Medicaid would entail a bureaucrat determining what medication you’d receive, I think you’re conflating something like the UK’s NHS, where all doctors are government employees, with Medicaid, which functions as an insurance.

    Health insurance sort of conflates two different things: catastrophic insurance, the way we understand something car insurance, and pooling buying power. It’s the latter that allows the insured access to healthcare that otherwise bankrupts the uninsured poor. Insurance companies negotiate lower prices for their members by negotiating in bulk. Medicaid does the same thing but on a much larger scale, which is why it’s one of the cheaper components of our heath care sector per capita. No bureaucrat is any more or less involved in a Medicaid patient’s healthcare than a company actuary is in yours (plus the government bureaucrats who figure out things like tax incentives to your employer).

    So universal could do it like the NHS–I’m not a fan–or a mixed system where the government guarantees a basic level of care and then people are free to buy insurance on the market (like France’s system), basically Medicaid for all plus a marketplace.

    But if you want to pride yourself on resisting tyranny by rejecting a system that differs from your preferred system only by a matter of degree, not kind, then you do you.

  37. Brian E Says:

    So you like the French system?

    Then read this:

    1.1. A System Under Pressure

    The system of health care in France is known as l’assurance maladie, or the Sécu, an abbreviation of sécurité-sociale, although the latter term is often also used to refer more generally to the system of social security in France.

    It is often rightly praised for the quality of the treatment and the level accessibility it offers to patients.

    France certainly spends a lot of money on health, around 10% of gross national income, one of the highest rates in the world.

    Perhaps as a result of this expenditure the French enjoy a life expectancy only exceeded by that of the Japanese!

    Nevertheless, the system is under severe financial pressure, there is a growing shortage of suitable staff in many regions, and a higher proportion of the running costs are having to be picked up by patients.

    At an institutional level the organisation and financing of the system is complex and is often characterised by high levels of tension between the various parts of the system.

    Most health professionals who work outside of hospitals are self-employed and depend for their income on fee paying patients whose costs are reimbursed by the social security and voluntary health insurance systems.

    Patients, in turn, have been allowed to have unrestricted access to doctors and specialists with the result that no-one in the health system has had any particular incentive to keep down costs.

    Over the past few years the government has introduced a series of reforms, the whole purpose of which is to increase efficiency and drive down costs. These reforms are on-going.

    Social security health contributions have been increased, as have fees for medical consultations, whilst reimbursement levels have been reduced.

    At an administrative level everyone is now required to register with a doctor to obtain the full level of reimbursement, medical records for patients are to be introduced, and there have been some reforms to the institutional structure.

    Continuing concern about rising costs has resulted in stronger controls by government limiting the freedom of professionals and patients and controls on the prices of drugs.

    To anyone from outside of France some of these reforms may appear logical and long overdue, but there is widespread concern in France about their impact.

    Many health professionals consider the changes are too bureaucratic, and there are many commentators who consider that the costs of health care are going to increasingly fall upon poorer members of the community and those who are ill.

    In short, like most other developed nations, France can no longer afford its health service.

    https://www.french-property.com/guides/france/public-services/health/system-overview/

  38. Somebody Says:

    I mean, that’s not actually what this one single article actually says; it says the system isn’t perfect and they’re trying to figure out ways of fixing its problems.

    I’m guessing you googled around and pasted in the first link you found detailing problems with the French system? Ah, yes. An undated and unsourced article from a website about buying French real estate! Tres bien! But I strongly suspect that you engaged in finding something that fit what you already wanted to find, and that you’re not going to seriously engage in this. And that’s fine! You’re not really going to convince me and I’m not really going to convince you (blog comments!).

    My point in all of this was just to engage with the idea that liberals can have non-terrible reasons for believing what they believe. Maybe even reasons you recognize as similar to yours! So if you want to engage on universal health care at the level of “the French system has problems and they’re trying to fix them, that’s way preferable to “the French system is basically a gulag and You’re Stalin for thinking it.”

  39. Somebody Says:

    PS–senate republicans are now considering keeping the tax in order to pay for larger refundable tax credits for middle class. Socialist tyranny or just regular tyranny?

  40. Brian E Says:

    Somebody,

    Yes I googled around, read several articles trying to find something that didn’t reek of confirmation bias.

    You would think that a website representing French property would put a positive spin on their own healthcare system. Actually, if you delve deeper into the website, you’ll find information on how to navigate the various elements of the system.

    I read an expat’s experiences with the French system (mostly positive) but very anecdotal. There were comments from others that were also positive, which you would expect. If it’s the only system you know, it’s hard to gauge it’s relative merits.

    But if you want more stories about the looming difficulties other European models are facing with the aging population, I’ll can find more.

    Look, what I’m looking for in all this are unbiased facts. I would think you want the same.

  41. Richard Saunders Says:

    So, if we’ve already given up some freedom, we should give up more because it’s a lost cause? Hmmm… You know, I just don’t see it that way.

    Yes, national health would be great – get rid of all those fat people —

    http://www.telegraph.co.uk/news/2016/09/02/obese-patients-and-smokers-banned-from-all-routine-operations-by/

    And who cares about prostate cancer, breast cancer, or cervical cancer in young women? Why, it just wouldn’t be economically justified to spend more than £30,000 on drugs for a patient —

    https://www.theguardian.com/society/2009/aug/11/nhs-sick-hea

    Let me give you an example: You go skiing in Mt. Tremblant, Quebec. You hit your head on a tree. Everybody says, no worries. And there are no MRIs there, anyway. It turns out you have suffered a severe brain injury. You die.

    You go skiing in Vail, Colorado. You hit your head on a tree. The hotel you are staying at insists you go to one of the five MRIs in Vail. They discover you have a severe brain injury. They helicopter ambulance you to a major surgery center, where they operate on you. You live.

    Guess which kind of health care I want?

  42. Somebody Says:

    I think you might misunderstand “confirmation bias.” Confirmation bias “is the tendency to search for, interpret, favor, and recall information in a way that confirms one’s preexisting beliefs or hypotheses. It is a type of cognitive bias and a systematic error of inductive reasoning.”

    Rejecting sources of information that contradict your a priori assumption that the French system is bad, and then only treating a source that agrees the French system is bad, will only produce information that confirms your assumption the French system is bad. It won’t actually tell you anything you didn’t already assume, a priori.

  43. Somebody Says:

    That is, the sources might be unbiased, but you have no way of judging their biases because your search sounds explicitly biased to cherry pick specific results.

  44. Somebody Says:

    So google lets you do this fun thing when you search for something like “comparison of healthcare outcomes by country” — search through scholarly journals. Maybe slightly more rigor then, ahem, a real estate website. From just one, published in 2009:

    Results. American adults reported worse health than did English or European adults. Eighteen percent of Americans reported heart disease, compared with 12% of English and 11% of Europeans. At all wealth levels, Americans were less healthy than were Europeans, but differences were more marked among the poor. Health disparities by wealth were significantly smaller in Europe than in the United States and England. Odds ratios of heart disease in a comparison of the top and bottom wealth tertiles were 1.94 (95% confidence interval [CI] = 1.69, 2.24) in the United States, 2.13 (95% CI = 1.73, 2.62) in England, and 1.38 (95% CI = 1.23, 1.56) in Europe. Smoking, obesity, physical activity levels, and alcohol consumption explained a fraction of health variations.

    Conclusions. American adults are less healthy than Europeans at all wealth levels. The poorest Americans experience the greatest disadvantage relative to Europeans.

  45. Ymar Sakar Says:

    Google is pretty much the definition of confirmation bias.

  46. Ymar Sakar Says:

    And the notion that the Government will get it right this time, with more efficient outcomes– that I’ll be healthier just because the government is writing the rules isn’t born out by their track record.

    You lack faith. You know what the Leftist alliance does to those that lack sufficient faith, Brian.

  47. Somebody Says:

    So I realized that a better way of characterizing my point above is: many of the features of a universal system–taxes, rationing, bureaucrats, etc–are all banal, every day features of our current system that we take utterly for granted. I think that most people who are angry at the thought of universal health care are able to be as angry are because they’ve mentally categorized banal aspects as something different. It allows you to treat features of virtually any modern health care system as unique and uniquely bad. So instead of rationing, which absolutely occurs in our system, we talk about “death panels.” And this is why we have so much difficulty talking about this, because I say “banal features we should tweak” and you hear “capitulation to tyranny.”

  48. Bilwick Says:

    As I’m sure I’ve mentioned before (I’m an old guy now, so I have a right to repeat myself), I have a radical healthcare program I wish the ruling class (whether Republican or Democrat) would give some consideration to. The program is: if you need medical attention of some kind, you pay for it yourself. Or, if you can’t afford it, you get rich “liberals” to pay for it. We know they’ve got the compassion to do this, because they’re always telling us how compassionate they are.

    We also know they’ve got the bucks: look at the millions they recently poured into Dishonest Jon Ossoff’s campaign, and the billions they poured into Queen Cacklepants’ presidential campaign in November. “Liberals” could actually use that money to help poor people! What a concept, right? Darth Soros alone could probably buy every poor person in the US good, basic health insurance.

    I call this radical program “liberty.” It’s a word modern statist pseudo-liberals should look up in a dictionary. The beauty part of my plan is that if “liberals” balk at spending their own money to help the people they allegedly care so much about, they can SHUT THE HELL UP, take their hands THE HELL OUT OF OUR POCKETS, and leave the rest of us THE HELL ALONE! Or is that too subtle?

    “I remember when ‘liberal’ meant being generous with your own money.”–Will Rogers.

  49. Ymar Sakar Says:

    My dear American patriots, the Leftists here and out there are laughing at your suffering, while crying “we feel for you, it’s so bad you suffered under capitalist healthcare”. That’s banal for your healthcare life.

    The Left decides when and how you will die, and the privilege of how much you will pay for it. That is how you are “allowed” to complain. You are able to be as angry as you are because the Left allows it. That is their Faith and their Religion. They Feel Your Pain, you know.

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Previously a lifelong Democrat, born in New York and living in New England, surrounded by liberals on all sides, I've found myself slowly but surely leaving the fold and becoming that dread thing: a neocon.
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