Setting aside the “zero cost sharing = appointments for stubbed toes” issue, and even setting aside the holy hell which would be raised by rich people and powerful corporations over the tax hikes (not to mention the entire health insurance industry over a move which would put them all out of business and by the pharmaceutical and hospital industries over yet another major overhaul just a few years after the last one), notice that such a system would completely wipe out/replace every single healthcare coverage law or ordinance passed by the federal, state or local governments; every union contract made between the federal, state or local governments or by any private corporation in the country; every contract signed by any private insurance carrier with either companies or individuals, and so on.
Medicare? Replaced. Medicaid? Replaced. ACA exchanges? Replaced. The VA and TriCare? Replaced. Private Large Group coverage? Replaced. Private Small Group coverage? Replaced. Off-exchange Individual Market? Replaced.
All of this replaced, all at once.
Remember the several million people whose pre-ACA policies were cancelled back in December 2013 for not being compliant with the new law? Remember how the backlash to those several million having their policies taken away after the “if you like your plan you can keep it” brouhaha? Even though the vast majority of them ended up replacing their old policies with new ones which, for the most part, have better coverage (not to mention protection from being dropped via rescission, denial for having a pre-existing condition, maximum caps on their out of pocket expenses and, for many people, lower premiums thanks to financial assistance), the fact remains that when it comes to healthcare coverage, most people take it very personally.
That was only a few million people (plus a few million more since 2013 due to the 3-year “transitional period” extension granted in response to the backlash.
Now imagine not a few million, but 300 million people having their policies shut down and replaced with a new one all at once. Imagine the anger, the chaos, the confusion…even if the new system turns out to be better, more efficient, less expensive and less confusing across the board.
How many regulations will have to be re-written? How many contracts rendered null and void? How many lawsuits would be filed over breach of contract?
So far it doesn’t sound like I’m a single payer advocate after all, right? Wrong. I’m all for it…but it’s going to take years, possibly decades, to get to even in the best of circumstances. Here’s how I could see doing it:
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