*Maybe* things won’t end with a grossly punitive bill, but that would certainly be a late development and not at all in the original plan.

i’d rather see progressives define ourselves by the policies we develop and advocate

Unfortunately, “progressive” organizations in the last year have been defined more by the policies they develop and abdicate.

I just fear that there will be enough folks, who will “retain” private insurance and its higher reimbursement rates, whether because they’ve got some sort of contract that provides them this coverage, or because they are rich enough to pay for it themselves.

To me it seems like a twist on the “boutique” doctors concept [certain doctors who, for a big up-front payment, will assure you that they'll see you, etc.].

I know that logically, enacting Medicare for all suggests that there won’t be competing programs, and thus doctors will HAVE to accept Medicare patients and their shitty fee payment rates. But I think that even “Medicare for All” doesn’t mean “and ONLY Medicare will be available.”

you are exactly right about the problem of “boutique” healthcare in any kind of multi payer system. i guess that is what we are starting to see now with medicaid and medicare patients being refused.

hr 676, and other single payer / “medicare for all” systems, do address this by preventing private insurance companies from competing with the gov plan. that is why it is called “single payer.” unfortunately, in the past year, public-option-in-a-multi-payer-system have been co-opting the rhetoric of the single payer movement (hr 676 has always, since 2003, been “expanded and improved medicare for all act”) and that has confused the issue somewhat in many people’s mind.

anyway, for an example, here is the relevant bit from hr 676:

SEC. 104. PROHIBITION AGAINST DUPLICATING COVERAGE.

(a) In General- It is unlawful for a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act.

(b) Construction- Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, such as for cosmetic surgery or other services and items that are not medically necessary.

there can be a tendency to underfund gov insurance programs, but at least with us all in the same program everyone’s incentives are aligned because we all want adequate funding for the program we’re in, and we’re all in the same program.

just my opinion, but i think multi payer systems make for stupid healthcare financing policy (even if there is a public option) and you’ve put your finger on one of the many reasons why.

To me it seems like a twist on the “boutique” doctors concept [certain doctors who, for a big up-front payment, will assure you that they'll see you, etc.].

I know that logically, enacting Medicare for all suggests that there won’t be competing programs, and thus doctors will HAVE to accept Medicare patients and their shitty fee payment rates. But I think that even “Medicare for All” doesn’t mean “and ONLY Medicare will be available.”

Unfortunately, because Obama ceded “control” over this entire issue to the corrupt and inept Congress, there’s no series of issues that must be addressed. If, instead of his oh-so-smart-Rahm-foolery, Obama had begun with a list of problems that needed to be solved by any health care reform legislation, then whatever proposals were put forth could be evaluated in that light. [For instance: cover uninsured, no exclusion for pre-existing conditions; no cancellation upon sickness; control over premiums/deductibles; AND doctors must accept patients on Medicare.

I don’t think anyone has looked at this “but I can’t find a doctor who takes Medicare” problem, and I’d like someone to do so.

“Free your mind and your ass will follow”

folks who care about peace, social justice, the environment, health care for all, need to free themselves from their unreciprocated devotion to the Democratic Party.