Comments by "Xyz Same" (@xyzsame4081) on "Andrew Yang Lies In *New* Campaign Ad" video.

  1. People transition to Medicare at the age of 65 - and most seem to cope fine, just fine ! In the first year of the rollout of the Sanders plan the 55 year olds would have to deal with the trauma. Of course they too might find out that they do not miss "private insurance" one bit. In the following year the 45 year olds would have to rise to the challenge .... (if the rollout goes on without major hiccups it could be sped up - or the Sanders campaign would put pressure on Congress to pass EFFECTIVE regulation on insurers so they cannot play games with the insured anymore. * right now Medicare is not sufficiently funded to offer compehensive ! coverage (which is a sign of a well implemented single payer system) so people have to pay extra for private insurance ! packages on top if they want really good coverage (as it would be standard in other wealthy countries). It is bad enough that they must ask people to pay extra for Medicare Advance package (which excludes low income elderly persons). And weirdly enough they did not let cost-efficient Medicare handle the additional packages. No. Expensive private insurers were handed that "monopoly" on a silver platter. If the consumers do not have the most important choice - NOT BUYING AT ALL - it does not matter how many insurers offer their overpriced additional packages. (that includes all medications, I think that is the trick how they keep Medicare from negotiating drug prices). Only the option of consumers to ABSTAIN from "consuming" brings the corporations to heel (somewhat) - and in the case of healthcare consumers do not have that power.
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  2. I used to give him (and Tulsi Gabbard) the benefit of the doubt, that they didn't do their homework (how the systems have been working very successfully and for decades elsewhere). So they FELL for the arguments of the insurance lobbyists. I start to reverse my position: That Yang is a well meaning capitalists (with a LOT of blind spots though). That hat he is only woefully underinformed on the issue. Gabbard at least is consistent on the issue of regime change wars and adds value as a very much needed voice against another war in the Middle East. Yang deservers credit for promoting the idea of UBI. - BUT: it is not the most urgent issue, UBI could be in some years a tool (one of many) to help transform society - or a capitalistic bandaid, that helps those oligarchs who still produce something and want to import the stuff that is mostly produced in other countries. If people are unemployed they need to have purchasing power - and it is not coming from wages, like it used to in the time until after WW2 till the 1970s. Outsourcing could be reveresed if the voters ! get a government that makes trade deals that benefit WORKERS in the U.S. and in the countries where workers are exploited. But an UBI could placate them enough to they will not demand an overhaul of the whole system and instead accept the bandaid - bread and circus. Yang is disingenuous when he blames all the job losses on automation. Not true. STILL a lot of jobs are outsourced (right now) and the threat of doing so (and easily) keeps wages down even in times of low unemployment. Yang's glossing over on that is another red flag.
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  3. As for public option (or not even that) - it is a VERY weak and distant second best. I live in a country with single payer. Here the insurance companies are not getting away with much. They try of course to pay as little as possible in damages but are restricted in their schemes by consumer protection. They are used to not getting more than a small share of the healthcare "market" - didn't get much after WW1, and it remained like that after WW2 - so they had around 70 years to resign themselves to the fact that around 8 - 10 % of the GDP are for the most part off limits for profiteering (in most wealthy countries, in the U.S. Healthcare spendinding is more than 18 % of GDP). Here (in Austria with a very well established single payer system - or in any other country for that matter) a public option would mean a gradual detoriation of a single payer system and a 2 class medical system creeping in.
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  4. On the other hand in the U.S. a Public Option has the potential to undo the whole reform in the transition stage - much faster than in other countries. In the U.S. the predatory healthcare insurance industry has the systems already in place to screw the insured and to purge clients (persons OR companies) which are not profitable for them. They have the hordes of bean counters, statisticians, lawyers, and lobbyists the need to screw the consumers.They would of course only chose the healthy and young for insurance and make them seemingly good offers. Which also undermines political leverage because SOME are getting a deal that seems to be much better. DIVIDE AND CONQUER. The offers for the young and healthy will still be way too expensive considering the cherrypicking. The high costs for the sick and and patients with higher risks do not vanish - they just land with the public option (= the public non-profit agency = Medicare in the U.S.). With a public option the private insurance industry will have to give up a share of the "market" but they can keep the most lucrative segment of the population. And they stay relevant in the "market" - and it gives them time and space to hit back. Since the "public offer" for insurance would be burdened with all the costly patients a little defunding would go a long way to really create trouble for the public non-profit insurance agency (in the U.S. Medicare). I would also be easy to badmouth the "high costs of the agency". On a side note: private insurance is often used in misleading way. You can hear: "They still have private insurance in single payer countries" Public option means people have insurance for all that is medically warranted (= basic and that should include basic dental). And they have that coverage EITHER by a public agency (a non-profit) or they OPT OUT and have coverage by a private for-profit insurance company. I know NO wealthy country where they have that kind of system for a major part of the population. Chile seems to have it - and they are unhappy with it (the old and poor have to make do with a crappy underfunded public system). In Germany only the higher income people (plus 94,000 Euro per year that's around 100,000 USD) and some professions (that tend to have good and stable and increasing incomes) are even allowed to chose between full private insurance OR the public opiton. Well, the insurance companies chose - they determine with their offers who will become their client and who not. (They get a nice marketing database as well. people with full private insurance tend to be healthier and more educated and wealthier than the rest of the population). That weird German system has historic reasons. The affluent Germans with higher risks will invariably join the public pool. In total it drives up the total spending of the nation per person (at least a little bit), there are some regional distortions and unfairness (think areas where a lot of affluent people and civil servants live, for instance the capital Berlin). The distortions are not too bad, only 10 % of the population are fully privately insured and they enjoy the protection of the benchmark the 90 % are setting: Costs, yearly increases of premiums, what must be covered, being denied treatment is unthinkable in a country where everyone takes for granted to have the basics covered etc. There are lots of lawyers among the fully privately insured - so the insurance companies cannot play games, never mind much stronger culture in Germany regarding consumer protection. That said: the system orginated in 1884 when it was O.K. to have a 2 class medical system: one for the middle class and above and one for the unwashed masses. That weird form of opting out for the privileged (Opting Out is the other side of the coin with public option) is the historic residue of that old system. In most cases "private insurance" means: for extras and on top of the basic public coverage = supplemental insurance. For healthcare services or treatmetns that are not crucial to remain or get healthy or maintain your ability to take care of yourself and your family (expensive dental, accupuncture, better hearing aids, laser surgery for short sightedness that is not medically warranted). Does not make much sense if you do the math - the premiums are costly and if you can afford them for a long time (and you do not get the contract for 3 years where you fix your teeth with implants, do the weight loss clinic and then you cancel the contract) - you can as well pay out of pocket if and only IF and WHEN you want some extras. That way you avoid to pay for the marketing, admin etc. of the middle man. If a country has a lot of "private insurance" (which in most cases means supplemental insurance on top of a public offer that everyone has) it is a sign that the public coverage is not well funded and / or not comprehensive enough (ALL that is medically warranted). Or they do not graduate enough doctors so the providers can refuse to work with the rates of the contracts of the public agency.
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  5. When debating "public option" you have to know that 10 % of patients cause 90 % of spending * - the private insurers only have to get the purges right - and they are ALREADY really good with purges in the U.S. . They have the software and the data. They already purge companies. If some employees OR their family members (if the plan includes them) cause higher spending the whole company may get onto a "black list". They are not formally kicked out, the insurance company either drives up premiums, co-pays and deductibles or they worsen other conditions - until the company quits "voluntarily". One remedy if a company offers plans: to not employ people over 50, with higher risks, or to fire them immediately if they or family members get sick (if the treatment could be longer and costly). The insurance companies do not play that game with the giant corporations that offer the prestigious jobs (think Microsoft or Boeing). But medium sized or small companies and also ! those with the union negotiated plans. (for instance culinary workers in Nevada, who are well unionized). From what I heard those unions plans used to be good (but of course too expensive, that is even true for the plans of the large employers like Microsoft, Boeing, ... - no private company has the negotiating power a public agency has in a single payer system). But now they are also hollowed out - and the insurance companies try to deny paying for treatmens regardless. Wendell Potter whistleblower on the healthcare insuance industry: the U.S. insurance companies have no interest in controlling healthcare costs (let alone bringing them down), they want lots of plans with deductibles so they just can pass on the exorbitant costs. And they were VERY successful with that strategy. * like the Pareto Principle, but there the ratio is 20 : 80
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