The most plausible path forward would be to pass the 2023 Medicare for All act (introduced by US representatives Pramila Jayapal, Debbie Dingell, and Bernie Sanders).
this post was submitted on 17 Oct 2023
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I'd love to see this pass.
Here are links to see who has co-sponsored these bills: House / Senate
If your senator or legislator has not sponsored that could be one action - call or write them asking them to support the bill.
That said, I volunteered with a group for a few years trying to pass an unrelated bill at the state level, which in at least one session had more than 50% of the chamber co-sponsoring, but we still couldn't get our bill out of committee. Eventually, the bill actually was voted out of committee, only to add amendments that made our bill do the opposite of what it was intended to, and then we had to rally votes against it. Eventually I moved and kind of dropped out of that organization, but the reform we support still has not been passed. And that was for a non-partisan issue.
I don't know the methodology that govtrack uses, but they give the Medicare for All act a 0% chance of being enacted. So I'm interested in more ideas on the nuts and bolts of passing a bill like this.
People need to vote.
If all the eligible people voted in the US, we could have universal healthcare in a year. Biden needs a super majority in both Houses.
You're not wrong. At the same time, I'm looking for steps, specifics.
That's not how our democracy works unfortunately. We are a representative democracy, and regardless of the way the majority vote, our representatives can and do act against the general populace on a consistent basis.
What are the odds people actually vote for it though? I’m of the impression that most Americans would rather to pay for healthcare than have it taken out of their taxes.
I mean with all the republicans competing to defend the most departments, 2024 might be our year. Then again there's a fuckload of people in the United States who still worship Reagan so who the hell knows.
Fuck I hope so this sucks. My mother just fucked up her ankle and refuses to go to the doctor because we can't afford it. I'm afraid it's gonna be something bad that ends up being permanent if she doesn't seek treatment. Makes me feel sick.
Expand Medicare. It is already in place.
Move to Europe
The fastest way, certainly.
Not available to non-yuppies though.
Removing the 37 middle men between the docs and the patients would be a good start.
First you do Universal Pet Health, which you push by just talking about how good it would be for dogs and ranch families.
Then you talk about how silly it is that we have UPH, but not UBH, especially when UBH would help with our nation's combat readiness.
Nah fuck that. Everyone benefits from universal human healthcare, but free vets overwhelmingly benefit wealthy and rural people.
What are the steps / methods most likely to get us there?
The steps others have already successfully taken in other countries. Even when the contexts are different, there is often something to be learnt by looking at previous battles.
Some starting points:
- Brief universal healthcare history overview. I think it's also interesting to see that most countries started picking up adoption after WW2.
- I think it's also worthwhile looking to the people who have been watching the topic for a very long time, like the UN's International Labor Organization who will have a more in depth understanding of the issues and problems.
There are other sources of data in this international comparison but I think ultimately it's about looking at this graph and figuring out what the biggest policy differences are: Health System Comparison OECD life expectancy vs cost
Thanks for the helpful links! Some of the comparison charts are pretty grim for the U.S.
Are you aware of any sources on the ins and outs of public support for universal care when it was being implemented in other countries, or the political climate? I think knowing the destination is one thing, but getting there is more what I was focused on when talking about a pathway.
I guess that's sort of the problem here, I want to but this is not my area of expertise and it happened in my country too long ago for me to tell you much first or second-hand about specific events. Wikipedia is already a far better source for social context info on the events than most people will ever be, because for most places it was so long ago. That's why I think it's important to directly ask the historians / data analysts of the other countries, and the experts in comparative global health policy exactly the same question.
You have asked a really good question and you need good answers from people who really know the topic well.
Some sort of strike. Either a general labor strike, or a debt strike. A general strike of laborers will be hard to organize, and there will always be scabs.
But a debt strike ia easier. Although I should probably say "Bill strike". It goes like this: don't pay four or five figure medical bills. Just put them in the shredder. If a significant portion of the population does this, it will force change. Just like the courts getting backed up because there were too many evictions, they will get backed up by all the wage garnishment cases that I'm sure someone is typing a reply about. If nobody pays, there isn't much of a way to enforce it.
Take example from France's social security system: https://en.wikipedia.org/wiki/Social_security_in_France
State level systems. Some Canadian provinces had universal healthcare before Canada had it nationwide.
Revolution, probably. We are too oppressed by the ruling class.
In the U.S. seems like we're a long way from that
Not just a long way. No visible way at all.
You need to fix your political landscape first, for example have > 2 parties, and have other than these two ultra conservative parties. Only then will you be able to make significant changes in your country.
You're 100% correct on principle. The problem is that given our electoral system, third parties end up taking votes from viable candidates, and we end up with terrifying people running things.
We can't change the electoral system, because we've never actually had an Article V convention (Constitutional Convention) so we don't know what would happen there. We'd get an entirely new constitution, and it would not be a better one. You've probably seen how dysfunctional our republicans are, I'm not about to let them tear up e.g., my right to free speech or a fair trial.
Given the current makeup of the Supreme Court, what would come out of that convention would be provide zero protections for anything.
But yes, we need third parties. I just don't see a plausible way to get them without taking on an amount of risk that most people aren't willing to take.
"All" is an awfully large group - perhaps start with "some", e.g. "all in Maine" (and likely some subset of that even, like those who have lived there for 5+ years already, to avoid someone getting cancer first, then suddenly moving to Maine, then once the expensive treatments are over with go back home, etc.), and then if people enjoy seeing it be done well, expand our from there. I dunno... it's a thought, at least.
No, we don't need to see if public healthcare works. We already know that it's cheaper than private healthcare and that it works better than private health care.
Other countries have been proving that for generations and the numbers prove it in our country.
We just have to do it.
I think comment above yours has a point. It's not a question of whether or not it works, it's a question of getting people on board, and fending off vested interests like insurance companies. So maybe getting it done in one place would be more attainable, and serve as an advertisement. For me at least, I'm asking how we do it. Saying "we just have to do it" isn't actionable advice.
We know how to do it, we already have Medicare and all of the first world countries have proven that as long as you give funding to the medical industry, public health care works, the same as libraries receiving funding or fire departments receiving funding.
You can take a look at any referendum to see how specifically we would transition to that system, but it would basically be expanding Medicare to Medicare for all, and later removing the remaining restrictions for pre-existing conditions.
It would be a very simple transition, and more productive for the country and cheaper for everyone.
The only reason we're not doing it are profit driven motives by people making money off of the private health care industry.
Sorry, I think we're talking past each other. I'm not asking how the mechanics of the healthcare would work once a bill is passed. How do we even get that far? Our elected representatives don't seem to have substantive interest (a few bright spots aside) and while polls often show majority support amongst the public, the results can vary a lot based on how the question is asked. So big picture / long term just as a start we need more perfect democracy, and we need better awareness and advocacy of the idea. In terms of first steps and short term (I think regretfully a decade or two is short term) I could see an argument to implement it in a specific state, or expanding medicare for certain age groups or something like that. But I don't know! That's why I'm asking.
Oh I see. I was literally putting together a list of the developments Cypress took when they enacted universal healthcare in 2019 and the Medicare for All bullet points to explain the initial steps more clearly.
You're actually curious how we can foment support for such a bill, if I understand correctly.
Ideally, you attend rallies and town hall discussions about health care and call up your senators and public officials and radically advocate for it and get enough people to join forces to convince politicians to vote for it.
Practically? We have two options. 1) getting lucky and voting in someone as focused on positive progress as Bernie or 2) in the United States, where economic dominance is the primary factor that shifts private interests, just like recently with sustainable energy, just like with transportation infrastructure, we're going to see the point where large corporate interests and our government simultaneously realize that they're losing capital ground to international competitors because they refuse to make progress on the key issue of health.
Once they realize that the incredibly cheap healthcare offered to first world citizens supports the interest of the upper class by keeping a healthy and happy proletariat is complimented by the international embarrassment of having the only wealthy population that often can't financially or medically survive a fairly innocuous malady like a broken leg or diabetes, we're going to very rapidly see sweeping reforms that will actually be taking a step in the right direction because the forces that be are retreating in fear from seeing the end of the road they're forcing the rest of us to walk down(they lose power).
It sounds bleak, but it's actually a good thing. Target will have big placards with doctor saying "and it doesn't cost anything!" putting a Band-Aid on a kid's knee, you'll see speeches by politicians about how we've always had the best healthcare system, and now you're getting better than the best, even though they'll just be playing catch up with first world countries .
But that's fine because our dumb system and the people who believe they control it will be learning. They're just learning the hardest, stupidest way, that doing the right thing actually benefits everybody.
I think the same thing will happen with education, we're already dumb as hell compared to other countries because we don't offer affordable education, and we're already past the point that we've lost an entire generation of professionals because of it.
TLDR: critical mass will be reached as other countries outpace us because their citizens don't die from colds, and those in control will change their minds.
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Gotta convince the voters around you. Talk to your coworkers, friends, etc. Be prepared to receive pushback, and a lot of ignorance, but occasionally, people that are trying to zoom out on the problems they're seeing. I used to lean pretty right, but it wasn't the Michael Moore types that brought me around; it was the Bertrand Russell types. People are plenty smart, but often need help connecting the dots. If you are condescending, you'll get resistance. If you show them the right direction, they'll find their own path, naturally.
It's cheaper to have free health care than it is to have our current system and more productive for our country, so it's really just a matter of following through on any of the public health care referendums.
What referendums are you referring to? In my state at least we don't have the ballot initiative.
The Medicare for All act has been introduced multiple times since 2003 and is a great intermediary step to true comprehensive health care for all. Another comment linked to that above.
Ah, so a referendum is a direct vote by the population on a given issue - for example a lot of states have passed recreational marijuana referendums, in my opinion at least because a lot of lawmakers didn't want to to be seen as supporting it, but you can't get blamed if the public approved it directly.
I'm not aware of any state level referendums on universal healthcare (which doesn't mean that there haven't been any) and there isn't a national level referendum. (Although in googling this to confirm that I found an interesting article about implementing a national referendum)
With the Medicare for All Act it's been introduced as a bill, but as I understand the process it first needs to be reviewed by a committee and voted out of that committee before the senate or house can consider it to possibly hold a vote. Then it needs to do the same thing in the other chamber of congress. So you can imagine that's a lot more convoluted process than a referendum, and while voters may ask their representative to pass it, plenty of opportunities for legislators to say, "oops, some technicality or person who's not me has stalled the process."
Oh I understand the confusion. That's my bad, yes, the bills I'm referring to are not actually public referendums, I was using that word loosely.
Boy, I would prefer referendums on a lot of our public issues though.
You know I just found out today the Louisiana actually basically has referendum based elections?
In Louisiana, all the government candidates appear on the same ballot and if they win 50% plus one vote, then they win.
There's a short majority runoff if it ties or if nobody gets 50%.
First step would probably be to decouple healthcare from being company, so people realize how expensive their health plans are and how much they pay for stuff most people don't end up needing. Pretty sure for most people it's more expensive than their single yearly checkup would be out of pocket.
Then, make state-wide and state-owned insurance plans that are capped in profits, so the rates have to match the true cost of things.
Let it simmer for a bit, get people to get used to the idea that the government provided service is actually good and cheaper for once.
Then make it mandatory for every state resident to be covered by it.
The big problem with universal healthcare in the US is the strong individualistic mindset, those that go "but I don't want to pay for other people's hospital bills". Ease all those people that think they'll suddenly be paying way more to subsidize other people's health care into realizing it ends up cheaper because the costs are amortized over way more people. It needs to be spun up as a benefit to them, they're getting a better deal on their health insurance. Because they simply don't care about other people's problems.
One thing that struck me living in the US is just how much distrust there is for anything government operated, even though it's usually the companies they love so much that nickel and dime them. Although seeing how the politics are going right now, I kind of understand that sentiment. And pretty much every company does try to squeeze you out of your money, which makes people want to screw the companies over. Land of the fees.
Bipartisan collaboration for a public option that provides everything that the AMA says is necessary.
The biggest step is breaking the taboo on bipartisanism
- Train a lot more doctors.
That is not the problem in this country keeping us from public health care. With the money we saved transitioning to public health care away from private health care, we could fund the tuition of as many doctors as we wanted.
It's not tuition, but rather openings for students and residents. If you want more people to receive more health care, you need more doctor hours. Which means more doctors. Which means there need to be more spots in medical schools and residencies. These are currently scarce.
In the same way other public services are funded, fund the education of your medical professionals like they do in other countries, and you will have plenty of doctors.
Put the money saved by transitioning to public health care to good use.
A more lethal pandemic than Covid 19 would be a faster track.
Massive unemployment.
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