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While I agree with the sentiment and your point would be met in an ideal society, we live in a post-Citizens United world. So, we have to ask ourselves what is the most practicable way to get to universal health insurance today? Taking a position that the established industry would spend ungodly sums to resist? Or, do we insentivise the establishment to go along with the care plan in a manner that they could swallow (read as keep their hordes of money and still subsist today)?
Also, keep in mind, a lot of the industry has a lot of employees around the country. If you were a politician who wanted to get re-elected, what would be the best political history to have? One where you voted to kill an industry that put so many people (read as "voters") out of work? Or, one that gave health insurance to the populace in a way that had them retain their jobs, more or less?
My suggestion was lets get all just get to the first step and secure the universal health insurance first, and then worry about the vested interests AFTER we get the universal insurance. I mean, look at how society reacted when the ACA was being considered. The insurance industry exploded and whipped the populace into a frenzy.
The insurance industry is caustic to society. But, if a legislator took on the cause of killing such a profitable industry in post-Citizens United world, the industry will drop a banker’s truck on them to ensure that their reelection campaign won’t go through. They did that when the ACA was first being considered, didn’t give up after a watered down version was passed, and it’s a hill the Republican party is still willing to die on years later because they’re supported by the insurance i
There is no universe in which the insurance companies sign off on universal healthcare. It does not matter what bow you put on it. If it cuts in to the bottom line, they will aggressively oppose it.
It doesn't cut the bottom line if they no longer have to pay the obligation pursuant to the terms of the contract, and instead merely contract as a claims processor.
If it's a publicly traded company, then they are obligated to pursue shareholder value above all else. If total revenue go down, shareholder value go down. They would see some pretty marginal gains because they'd still be able to lay off most employees, but they'd practically be cutting off both of their arms.
They make their money by absolutely draining every working class American for every dollar they can afford. Most claims are handled automatically by computer, we do not need them to do that for us. The 5% of claims or so that are not automatically handled are given over to review by a pretty small group of people, we would not need 3 insurance companies to do that work nationwide.
What you're proposing is a form of universal healthcare where Americans continue to spend more than every other developed nation for similar outcomes as to what we already have.
Yes, our system is fucked up in 2 ways: (1) middlemen deny care b/c the care affects the bottom line, and (2) our care is expensive.
I'm thinking we solve problem 1 now by de-linking the care provided with the profit motive to deny care. But, if we do that unilaterally, we'll run into a wall of cash that opposes that change. We might still spend more as a society, but at least people won't be dying in the streets. The future people can work on getting the price down tomorrow. But, today? Give universal health-insurance by any means.
Kicking the can got us the ACA, it's been almost entirely gutted in under 15 years.
If we leave them in place, on the presumption that there's profit motive for them to remain, then we leave them with enough cash to claw back everything they lost, and they'd keep their cushy government contracts.
Again, there is no universe in which that wall of cash doesn't oppose this anyway. Don't negotiate with terrorists.