If we're not paying attention, we can maintain the fiction that with Medicare and the exchange we still have an insurance industry but what we have now with Medicare and will have with the exchange is closer to the UK's NHS than it is to a private insurance industry.
Most of this post is at a great tangent to my understanding of what's going on. I have neither the time nor the interest to continue that discussion.
However, I can't help but note the starkest point at which we disagree, Karen, and it's in the quote above. The only institution in the US that gets close to the British is veterans care. The present configuration of Medicare does not include doctors and nurses and other healthcare workers, working for the state. Nor does it require that hospitals be owned by the state. Or, for that matter, other institutions that provide healthcare. The closest, again, we have to that is care for veterans.
The exchanges, what little we now know about them, aren't single payer systems, as Medicare is. Best I can tell it will be a regulated market place, a not unfamiliar phenomenon for American consumers.
The only likely slippery slope here is that industry reps gain control of the regulatory process when the Reps are in control of the WH and both houses of congress. I prefer a regulatory body with that danger to the present absence of federal level regulation. We differ a great deal on this. |
