I assume the OBUB will get passed in the House by the end of the day so Trump can sign it on July 4, as he demanded. So on a day for celebrating independence we’ll all lose some of it.
Over the years I’ve written a ton of posts about how the Right loves the word “freedom,” but only after they’ve stripped it of meaning. For example, here’s one from July 2, 2017, in which Texas governor Abbott defines “freedom” as the ability of the state to nullify local laws it doesn’t like.
And because we’re concerned about health care, let us revisit Because Freedom from April 2013. Just go read it; it’s short. You can take out “tea party” and write in MAGA, and it would be about today. “Freedom” to the Right means the freedom to shirk moral and civic responsibility. It means letting people die so as not to tax the wealthy.
Republicans still won’t admit to the truth of health care, which is that it simply isn’t possible to expect a for-profit health care system to equitably deliver medical care to an entire population. The profits come from price gouging and benefits denial. It means letting people die to benefit stockholders. That’s the plain truth. but even many Democrats don’t dare say that out loud, because someone on Fox News might accuse them of being socialists.
So a whole bunch of Red-state Republicans are passing a bill that will take medical benefits from their constituents and close rural hospitals. And most of them know this. They just don’t dare admit it. This crew is not exactly Washington and his troops at Valley Forge. .
The news rags refer to rural hospitals vanishing first, so I guess those will be the canary in the coal mine and the rest will collapse shortly after that from the shock to the system: the costs will be the same, and probably increase. The healthcare barons will do anything to keep their cushy lifestyle so that money has to come from somewhere.
Plus, when I needed hospital services recently, I noticed that 90% of the doctors on the staff were brown skinned and a good portion of those folks appeared to be recent immigrants. Yeah, land of opportunity, are we going to see ICE in the hospitals? They gotta make their quotas.
https://www.dailykos.com/stories/2025/7/2/2331422/-Wasn-t-Sure-About-Posting-This-FAFO-From-MAGA-Lady-Suzanne-But
Paul Waldman, Why They Did It
Our "right" uses whatever word works.
Back then, “freedom” was the opiate of the people. Then came cheap consumer products. Hell, I’m old enough to remember when religion was the opiate. It seems that now the opiate is hating on outsider others, MAGA-style. (For some, definitely not all of course.)
Altruistic rationals might need to study up more on what drives that kind of person, to keep up with these kleptocratic think tank machinations. Maybe provide an opiate of our own to counter, since logic doesn’t seem to work. (For some, definitely not all of course.)
And then, many of the remaining others are susceptible to outright lies. Not sure what to do about that.
Me, I’d offer the teachings of the Bible. The more peaceful parts I mean. But then we’d be back to religion as the opiate. But then, all that talk about being good to the sick, the poor, and all that, being a result of good strong faith that gits ya to eternal heaven, might not be such a bad thing. It'd sure make it easier to point out our rich as being morally insane, in their demonic sort of way.
For-profit health care can exist, and be efficient, but, it's crazy the way we do things.
What we'd need is something like the ACA: community rating (everyone in the same city, or whatever, pays the same rate), with minimal adverse selection (e.g., "smokers pay more" is okay), guaranteed issue, subsidize those who can't purchase insurance, and try to rig a penalty so, it's like, "dude, with the subsidy, you might as well just buy the policy!" because that's the point… getting money accounted for, for every person in America, so someone is paying people enough to run a business and make a profit.
Allow buy-in to medicare at 55 – that's when regular insurance really starts to skyrocket – and medicaid, so there are public employees who are trying to spend "the people's money" the most efficient way possible, without a concern for profit, who are in direct competition with insurance companies, who know a target price for a high volume customer. This will tend to squeeze money out of the system.
Finally: you NEED TO PAY PEOPLE. You need to be sure a pharmacist, and a pharmacy clerk, can make a decent wage; you need to make sure that nurses (especially) and all other skilled medical professionals are paid a commensurate wage. You need this, because otherwise, when money gets squeezed out of the system, it's taken out of these people, who aren't doctors, and therefore, aren't quite "real".
Anyway: so, Medicaid, Medicare, as "public options," slowly wring excess profits out of medicine, and soon, we'll have a good balance of medical professionals providing services at good wages, the free market will actually help find people for those roles, doctors won't be gods any longer, and we'd be pumping lots of money into rural areas that really need it.
If private insurance was succeeding, they'd basically be copying medicaid in price and service, or providing extra niceties, more massage therapy sessions, stuff like that, in return for the higher premium. It would be a lean operation, but it would be growing, if it is well run.
David Anderson at Balloon-juice could explain more, and better, but, that's the gist of it. Somehow, there's money in the system for everyone. Somehow, there are price controls that wring out excess profit. Somehow, there are protections for certain vital services meaning "the people who provide those vital services". So: how many nurses, techs, non-physician providers, etc., do you need for this many patients? There needs to be pay allocated for that many people to handle that many, without any expected overtime requirements.
Then, you can squeeze the yachts from the doctors, but they still have a fine houseboat, or sailing craft, or other toy for the well-to-do. You can squeeze the excess profits from the next pharmaceutical cash cow that comes along, while still paying plenty for R&D, "and we'll save you lots of money in direct marketing, by typically forbidding it." But make sure every patient, who has a diagnosis, can read the materials the doctor can about new drugs for their condition. If your drug is a miracle, you'll sell *plenty*, which is plenty of profit, just, not excess.
Nationalizing insurance wouldn't be easily possible, and nationalizing health care providers also isn't easily possible, so, an insurance-like accounting seems like the best way to fix things.
Nope. I don't believe that would work.
George Bernard Shaw The Doctor's Dilemma
That any sane nation, having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity.
I live in Ontario Canada. We have a single payer medical insurance system, (OHIP)
In general, we have no co-pays, no paperwork to see a doctor—one hands the receptionist/clerk one's OHIP card, doctor apparently notes what he or she did and bill is paid. I think my clinic with 5-6 doctors, several nurses and maybe one or two other health specialists has one clerk to handle all billing.
If you want, you can even see what the Ontario-wide fee schedule is, OHIP Schedule of Benefits and fees but why would you want to?
The service is not perfect, by any means, but we are not supporting wildly rich health insurance executives and going bankrupt from medical bills is unknown. It is possible to go bankrupt from some expenses that our program does not cover but I don't think I have ever heard of anyone having it happen though it may be a near run thing in some cases.
Reminds me of the old Bowling for Columbine film, where the USA gets compared to Canada. In that one, every causal variable was deemed pretty much the same excepting a culture of fear and loathing, and the obvious gun death result. Vastly worse in the USA.
Apparently, big corporate controls outcomes by manipulating our culture. And thus, their profits. It’s easy to assume the same for socialized medicine. Now all we have to do is effectively counter their nonsense.
The medical insurance company stands between the patient and the provider, taking more in premiums than they pay to doctors and hospitals. The difference is their profit. They make a lot and they aren't interested in any modifications to a system that makes them wealthy beyond belief at the top.
They do NOTHING, contribute NOTHING. That's why every working health care system in a single-payer system of some type. If the medical insurance system survives with controls, their first order of business will be loosening those controls. They will succeed unless we run them out of business.
Now, here, I'm going to throw France at you. From what I understand, the government covers every human with a, like a 60% actuarial value policy. You also get to pick an insurance company to provide additional benefits to you.
So: the government is absorbing huge price shocks, like "OMG we can now cure Sickle Cell (with many caveats)!!!" because that's what a 60% actuarial policy basically is, is catastrophic insurance.
Then, you also can have an insurance company that handles the paperwork and so forth for you. They compete for this business, and, they know it's lean, but they know they can make it work, and if they flub, well…
Again, "60% actuarial value" is intended to cover people who suddenly need $100k in medical expenses. So the insurance companies are still making bets about what their covered population might encounter, but, they have the government as a backstop, preventing their losses from growing too bad.
And, like banks, I imagine they are regulated, with another insurance company ready to swoop in and pick up the customers, if someone screws things up.
Now: all of this, is what I heard, about a system in Europe, that I can't even read primary source material about.
But it has roughly the same parameters: the government acts as some kind of financial backstop, but, also pushes cost control. The insurance companies can't make sweetheart deals – they all have to provide the same services across the board. I assume they have salary controls for medical people – but if not, I'd also expect hospitals are squeezing the non-MD providers. It's just what they tend to do, without really thinking about it.
So there's still private money to be made, you see, just… not as much. And, if you hang out your Health Insurance shingle, you're betting you can run a more efficient bureaucracy, not that you have the right relationships with the right trade groups to make the best deals.
The doctors are not the ones on the yachts, it is the healthcare barons and gentry that make the big bucks (from denying people healthcare). I got a good friend, an old guy, who sold his practice in 1999 to retire early because the insurance goons were giving him heart problems from the stress. He says the guys who purchased it work twice as hard and make half the money he did. When he retired and started practicing medicine as a volunteer, his heart problems vanished immediately.
I'm not seeing my reply. I might have double-posted, in which case I'd appreciate it if you can delete the dupe, and this message.
There wasn't anything stuck in the spam filter. Whatever you wrote just didn't post.
Democrats need to organize with an advertising campaign built to lay the blame where it belongs. Red states are going to suffer, poor states like Kentucky, Mississippi, and Alabama. They will not turn blue, even if they are starving but they will be open to a different conservative message that promises to restore services. Split the GOP. Every last mother's son in the GOP who voted for this bill aligned themselves with DJT and the disastrous policies.
The campaign(s) should be locally tailored and most prominent where there's proof of the damage, a local hospital shut down, nnn people cut off from food stamps, nnn with reduced food stamps, nnn people without health insurance. Make it as local as you can and point the finger at DJT and the broken promises they are all victims of. If Musk backs down and does not start a new conservative party, dissatisfied voters can still abstain from voting.
From the NYT op ed of Glynnis MacNicol comes a ray of optimism from a morass of doom. Usually I curse generation theory, as many use it as a gospel not as Glynnis does, as a literary device. How did the no pain no gain politic take charge and lead us to this war on anything fun or those having fun? It has taken about 25 years. The doom of the X generation and all the horror associated with things associated with X perhaps?
Some teases:
And a spoiler alert if you intend to read it all:
Opinion | Why Are We Doomed to Keep Reliving the ’90s? – The New York Times
I find myself tempted to apply with ICE. Not that I would accept the job, but I can tie up the hiring practice, make them spend more time (if thousands of us did it.) One wonders if a qualified person is refused a job because he's a registered Democrat, is that grounds for a suit?
Yes, the whole ICE funding is obscene. SO is there a legal way to flock it up?
Happy 4th, all! If we keep the values we know this country SHOULD stand for in our hearts, we will prevail. I do not think the ethic of the 1950s can prevail. We've evolved in so many ways. I don't think it's just me, or just the gang at Mahablog. The average person is not racially bigoted. The average person, the average STRAIGHT person, backs the right of adults to choose their orientation. Same-sex marriage will survive. Attitudes on abortion will not change.