This is the perfect time to get out of the business of providing benefits.

I think that the designers of Obamacare went into the 2008-2009 legislative process and did hope to come out with something like single payer.

But they found out they had no ability to raise taxes to single payer level — i.e. about 14% of payroll — and with the financial crisis at that time, they were afraid to put the insurance companies out of business — which single payer would surely bring about.

So, they designed a hybrid plan that uses private insurance companies and employer plans, but regulates and subsidizes and nudges and supervises and taxes just about everyone in the process.

When you look at the countries which actually have single payer plans, what these nations have in common are strong left-wing parties and strong unions. This is true in Germany, France, England, Canada, and Sweden to name a few.

Also, some countries have single payer because their private insurance system collapsed during war and depression. Japan is the most ironic of all — their single payer plan was installed by American lawyers working for McArthur during our occupation.

I bring up this history to suggest that no matter how clever we think Obama is, he cannot bring about single payer on his own!

Before election 2003:
re single payer: “we may not get there immediately”

2009:
“I have not said I was a single payer supporter”

Both speeches are on the same video, 2003 follows 2009
http://www.youtube.com/watch?v=-hsqzSKuC44

Obamacare: Built to fail so that it can be replaced with single payer.

I prefer Obamacare rather than some half way reform that does not resolve anything. It is up to us how will this system work. I´m for the higher taxes for better government services (this topic is well elaborated in fight against the economical crisis).

Dr. Goodman has done his usual good job highlighting the internal problems of Obamacare.

My only quibble might be that the “716 billion in cuts to Medicare” only refer to changes in the fee schedule. In the history of Medicare, changes in the fee schedule have very rarely reduced total costs. History shows that medical providers will adjust the volumes of care. It is also easy for many providers to quietly move over to the kinds of care where fees have NOT been reduced.

Washington bureaucrats are absolutely no match for 500,000 doctors and 5,000 hospitals who have a lot of money at stake in defeating fee controls.

Ron Bachman’s post is a blockbuster in its quiet way. For three years now everyone has been assuming that the private insurance industry was eager to get those extra customers from Obamacare and its mandates.

Ron points out that health insurance is a very unique product, in that some customers are very unprofitable. This is not the same as computers or paper clips. In these industries, you sell to anyone you can, it is all profit if you have costed it right.

But in health insurance, there are customers you do not want. Back in 1994, someone said, “What if you gave a managed care party and no one came.”

The middle class really needs it’s own party since both parties are shafting these people including me