People with health insurance may now represent the majority of debtors American hospitals struggle to collect from, according to medical billing analysts.

This marks a sea change from just a few years ago, when people with health insurance represented only about one in 10 bills hospitals considered “bad debt”, analysts said.

“We always used to consider bad debt, especially bad debt write-offs from a hospital perspective, those [patients] that have the ability to pay but don’t,” said Colleen Hall, senior vice-president for Kodiak Solutions, a billing, accounting and consulting firm that works closely with hospitals and performed the analysis.

“Now, it’s not as if these patients across the board are even able to pay, because [out-of-pocket costs are] such an astronomical amount related to what their general income might be.”

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20 points

My understanding was that the plan was to baby step it in.

Start with getting everyone insured, then move on to patching things until the insurers are not part of it at all anymore, and it’s just the medicare paying for it all, and being able to negotiate prices, and directly hire doctors themselves and buy out hospitals. The end goal would be for healthcare to become a service like the post office, with every address serviced regardless of the cost.

That was the dream rather.

Democrats had about 90 days in 2009 to get it done, not knowing that it would just be 90 days.

That was the last Democratic super-majority, republicans then went hard into State legislatures in order to gerrymander the US so that a Democratic super majority of both houses could never happen again.

They also went hard on the racism, because the southern strategy worked the first time.

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-3 points

That was the last Democratic super-majority, republicans then went hard into State legislatures in order to gerrymander the US so that a Democratic super majority of both houses could never happen again.

I get that you are making these points in good faith, but its really not our job to make excuses for the inability of democrats to get the work they are elected to do, done. They can’t keep getting apologized for on their own behalf. If these are the excuses they want to use, they need to be the ones to make them, because even these excuses demand further accountability.

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2 points

Several states have had their election laws ruled unconstitutional due to partisan gerrymandering. Republicans in several states said to the courts, “fuck you, we’re using the unconstitutional maps”. If those maps had been thrown out, 2022 would have seen the Democrats take the House.

Instead we had to sit and watch as Republicans have fucked around and hindered any attempts at actually running a functional government.

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2 points

Theres always an excuse.

Somehow the Republicans are the most capable, strategic, smart, and competent players to be able to accomplish these goals.

Meanwhile Democratic strategy amounts to:

sit and watch

Pretending that your current and previously elected Democratic officials aren’t a major reason why things are the way that they are is to also give Republicans credit for being masters of strategy and craft.

Neither of those things is true.

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0 points

Republican obstruction and wanton destruction is responsible for the lack of progress. Refusing Medicaid expansions and then overturning the individual mandate is what gutted the plan.

And sure you could jump right into single payer without any incremental change. But you’re going to put the 400,000 Americans currently working in the health insurance industry out of work, if you do that. Which is not a small consideration. (That’s per a CBO analysis of the feasibility of single payer, which does conclude it would save money, but it will require a massive work transition.)

https://www.healthaffairs.org/content/forefront/congressional-budget-office-scores-medicare-for-all-universal-coverage-less-spending

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4 points
*

The broader point that I’m making is that incrementalism as a philosophy has resulted in us going backwards. The acceptance of it as a viable strategy when it consistently fails to yield results is a serious problem.

A majority of successful social programs in the US did so in broad sweeping reforms that dramatically changed the way people interacted with systems.

Arguing that 400k jobs in an industry that is basically parasitic to the process seems Stockholm syndrome ludicrous, and yet unsurprising, because this is about the best that branded, ‘Democrat with a capital D’ , Democrats seem to be able to come up with.

Incrementalism sounds great on paper, it fails for two primary reasons. The first is the opponents to a program have to do far less to dismantle it, so its easy to work against. The second is that it fails to create its own proof points for why something was necessary in the first place. Obamacare is a great example of this second kind of failure. We’re still utterly fucked in terms of healthcare. Most people are more fucked than they’ve ever been in terms of healthcare. We’re worse off than we were because at least in 2008, although I didn’t have healthcare, I wasn’t paying several hundred dollars a month to basically not have healthcare. Incrementalism fails to make enough of a difference in peoples lives to show them that a given project is worth investing in.

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0 points

The Democrats + Independents had this “super majority” for a very small amount of time and that’s the only reason we even got ACA.

Americas problem is our democracy isn’t representative and too many people who should be voting choose not to.

I can blame Obama and Dems for a lot but not this and I also can’t discount all the good they’ve done.

You want better things get your friends, family, acquaintances, and neighbors to vote. Go canvas. Get an actual supermajority that stays around for at least a few years because that’s what it now takes in our polarized country.

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