FT 10-05: Medical Care Act 2.0 (Debating)

[ON Progressive]

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Sponsor: YE

24 hours to advocate

[YE]

Healthcare is an issue that was addressed by now FM Scott and current Southern Senator NC Yankee back in August 2017. I initially as FM, I wished to avoid the issue, although as I was considering higher office, I started to think about it more. I opposed efforts by a faction of the Labor Party establishment to switch  to a single payer system for a variety of reasons, one of them being it wouldn't allow regions to control who is allowed on the exchange, or even to have one at all.

Fundamentally, the biggest difference between the US and every other major country on Earth is that special interests buy our politicians (and you can thank the Supreme Court for this). This in turn has, especially since 1980, shifts the overall policy to what those corporate interests want. In some industries, especially telecommunication, they push for monopolization so they can price gouge/influence the common. With healthcare, they wish to profit off of your illness, disability, or in some cases occupation. Why should someone make money off of a Wyoming coal miner who gets black lung disease?

As such, I want to kick out the price gouging middle man known as the for profit health insurance industry off of the preventive care exchange in Fremont.

[The world will shine with light in our nightmare]

This bill has my full support and I thank Vice President YE for proposing it.  Simply put, separating access to health care from the profit incentive is the right and moral thing to do, and (although we already maintain a sizeable budget surplus), adopting this change would not impact our budgetary standing thanks to the federal AtlasCare program.

Still, passing this bill would mean a significant change to Fremont's healthcare system and I would like to hear any possible objections from our MPs or others.  If no one speaks up, I will assume that support for the bill is unanimous and request a vote, but I do hope that all our members publicly submit their input on this very important bill.

[ON Progressive]

Since there hasn't been much debate, can we do a final vote?

[YE]

I just want to point out one thing. This is not singe payer, as co-ops that Kent Conrad pushed for in 2009can still be on the exchange.

[Lumine]

I'd like to hear a bit more before entering a final vote if that's alright, I remain somewhat uncertain in my vote. Mostly, I'm concerned about excessively restricting the role of the private sector within Health Care in Fremont and because of my admittedly very limited knowledge on the for profit health insurance industry, and if possible I should like to ask the Vice-President just how large the practical restrictions on the private sector might be and whether we might expect some degree of trouble on implementation or abandonment of the region of a part of the health care industry.

[YE]

I'd like to hear a bit more before entering a final vote if that's alright, I remain somewhat uncertain in my vote. Mostly, I'm concerned about excessively restricting the role of the private sector within Health Care in Fremont and because of my admittedly very limited knowledge on the for profit health insurance industry, and if possible I should like to ask the Vice-President just how large the practical restrictions on the private sector might be and whether we might expect some degree of trouble on implementation or abandonment of the region of a part of the health care industry.

It's hard to say for sure since how successful implementing this would be since no country IRL has ever had private healthcare the way the US has. Considering we have a government run health care to fall back that is properly funded, a decrease in non-government funded healthcare would lead to an increase in the latter, so the health care industry would shift from profit to non-profit or public.

[Mr. Reactionary]

I'd like to hear a bit more before entering a final vote if that's alright, I remain somewhat uncertain in my vote. Mostly, I'm concerned about excessively restricting the role of the private sector within Health Care in Fremont and because of my admittedly very limited knowledge on the for profit health insurance industry, and if possible I should like to ask the Vice-President just how large the practical restrictions on the private sector might be and whether we might expect some degree of trouble on implementation or abandonment of the region of a part of the health care industry.

I did legal work for Blue Cross Michigan for about a year. The vast majority of price gouging comes from providers (doctors, hospitals, and producers) rather than insurers.

[Lumine]

I'm afraid the more I think about it this the more irresponsible it seems, and I don't think I can support it on its present form nor consider it the best road forward. We certainly shouldn't be limiting the field of healthcare to the point of outright banning private efforts in entire areas as this bill purports to do in a rather sweeping yet surprisingly detail-free manner.

It seems clear from the statement of intent as well as the words of past orators like the First Minister that this is indeed a major change to how we operate health care in the Commonwealth, and yet it seems that said change is being proposed unilaterally.

Indeed, there's no dates or estimations, no process, just an outright immediate ban which is bound to cause implementation issues and certainly a lot of confusion, not to mention businesses that might feel strongly discouraged to remain in the region if the rules of the game are going to be changed - on a critical area of policy no less - so suddenly and so radically, even if they're not on the health care context.

I rather fail to see the intentions of the bill overriding serious implementation questions, the possible economic cost and damage, and of course, the punishment of the private sector and its ban from an entire area of activity, and so I do think this is actually oversimplifying the issue in a manner which might prove costly to the region in different contexts.

[Southern Senator North Carolina Yankee]

I'd like to hear a bit more before entering a final vote if that's alright, I remain somewhat uncertain in my vote. Mostly, I'm concerned about excessively restricting the role of the private sector within Health Care in Fremont and because of my admittedly very limited knowledge on the for profit health insurance industry, and if possible I should like to ask the Vice-President just how large the practical restrictions on the private sector might be and whether we might expect some degree of trouble on implementation or abandonment of the region of a part of the health care industry.

I did legal work for Blue Cross Michigan for about a year. The vast majority of price gouging comes from providers (doctors, hospitals, and producers) rather than insurers.

This is very true.

[Southern Senator North Carolina Yankee]

There is a typo in the text. It says "provides" instead of "providers".

[Southern Senator North Carolina Yankee]

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On a general note, it please me greatly to see regions taking advantage of the provisions of the 2017 law and exploring ways to improve their systems.

[Fmr. Representative Encke]

Can the sponsor clarify what the amendment itself does, in the context of the original bill (FT 4-11)?

So I looked through FT 4-11 (the original FremontCare bill) and I see the following:

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As a side note, and unless I'm missing something here, the Federal Act is divided into Parts I, II, and III, with both parts I and II having sections labeled 2.1(b), so FT 4-11 is ambiguous about which of these sections it is referring to.

Making the logical assumption that it is referring to Pt II, Section 2.1(b), which outlines elements covered by AtlasCare:

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 FT 4-11 extends those requirements to all licensed private insurers via Section 3.i (quoted earlier).

However, this bill (FT 10-05) completely replaces that section with the following:

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despite the fact that the previous iteration of FremontCare already included preventive care as one of the requirements by extending the RRPH AtlasCare requirements to private insurers.

Am I missing something here? I'm confused about how this bill does what you say it's going to do, from a purely legislative standpoint.

Edit: And yes, I see that FT 10-05 is just Part I, Section 2.1(a) of the RRPH with the phrase 'private insurer' removed. I'm not sure if that is relevant or not, because there are still a number of provisions in FT 4-11 that apply to private insurers.

[YE]

Amendment:

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Amendment that someone's gonna need to formally sponsor.

[YE]

Someone introduce an amendment to fix the bit Eckne brought up. Change "private" insurance to "co-ops".

[Fmr. Representative Encke]

Someone introduce an amendment to fix the bit Eckne brought up. Change "private" insurance to "co-ops".

So is this a confirmation that the intent of the bill is indeed to eliminate private insurers simply by removing the word 'private' from the original FremontCare? If that's the intent, why not just get rid of Section 3 and just state directly which types of insurers are allowed on the exchange?

[tmthforu94]

If you're trying to target price-gouging, that usually is coming from the providers, not the insurers.

[ON Progressive]

Amendment:

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Amendment that someone's gonna need to formally sponsor.
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I'll sponsor it myself.

[Southern Senator North Carolina Yankee]

Someone introduce an amendment to fix the bit Eckne brought up. Change "private" insurance to "co-ops".

So is this a confirmation that the intent of the bill is indeed to eliminate private insurers simply by removing the word 'private' from the original FremontCare? If that's the intent, why not just get rid of Section 3 and just state directly which types of insurers are allowed on the exchange?

For the life of me I cannot understand why the regions didn't just have an explicit, clear and simple section in each of their laws that states clearly what types of insurance are allowed on their exchange. It was the most basic of responses to the 2017 health care law and it is also one of the simplest aspects to write.

However it is obscure or often spread out through multitudes of backhanded references at best. Again don't get me wrong, I fully intended and desired regions to get into the nitty gritty on healthcare and try to address issues that need more work, but it surprised me that nature or kind of providers aspect was handled in such fashion.

[Southern Senator North Carolina Yankee]

If you're trying to target price-gouging, that usually is coming from the providers, not the insurers.

The standard practice and approach by the left on health care is to murder the insurers and then squeeze the balls off the providers through leveraged dictations on prices. 2020 trend maps are going to be so delicious to look at, I can almost taste them.

The stupid thing is we don't do this with any other industry. We don't threaten to nationalize grocery chains and then dictate lower prices to farmers, meat packing and canning industries. We just give people food stamps and they buy what they need in the private sector grocery store.

Both are essential to live and both are time sensitive. The big difference is the skill level involved to produce is much greater for health care. If you want to get prices down, you need to target actual gouging by the root causes and you need more doctors, medicine and supplies at lower prices.

Health care policy in my opinion works like a horseshoe politically. The policies on both the extreme right and the extreme left leave people dead in the street from denied care, just for different reasons.

[AustralianSwingVoter]

1 week with no debate.

This is quite clearly poorly thought out legislation, with a great many flaws. Can we please either table this bill, or vote it down.

[YE]

Someone introduce an amendment to fix the bit Eckne brought up. Change "private" insurance to "co-ops".

[ON Progressive]

Someone introduce an amendment to fix the bit Eckne brought up. Change "private" insurance to "co-ops".

I'm confused here. I don't see "private" in the bill as it currently stands (although I do in the original FremontCare, just not this bill), though I can amend it if this is clarified.

[YE]

Someone introduce an amendment to fix the bit Eckne brought up. Change "private" insurance to "co-ops".

I'm confused here. I don't see "private" in the bill as it currently stands (although I do in the original FremontCare, just not this bill), though I can amend it if this is clarified.

Yes, that's what I'm referring to.

[AustralianSwingVoter]

I move that this deeply flawed bill be tabled.