Expanding medicaid in Virginia.

[No. 1 son]

Looks like the Richmond gang is still battling this out. Here's a few sources I've used to try and figure it out. Here, and here, and here's another one, all kinds of info and spin. From what I can discern, which isn't much, is that the states need to apply and do a cost estimate and if they are approved will get "matching funds" for subsidies based on some population demographics inherent in that state. No states are equal, but as I understand it, the baseline for funding is 70% graduated up to 90% according to state wealth, density and a whole bunch of parameters. 

I do think this has some merit, and needs to be really looked at. To look at this federal funding as "free money" is not rational, considering where federal revenue comes from. Virginia, as most states, has a balanced budget amendment, and the feds do not. That is a huge difference. That means that we will be on the hook for increased taxes locally, and accept more federal debt by our compliance. 

My main problem with the ACA was that the real problem is not who pays for it, but that the pharmaceutical and insurance corporations were heavily, and I mean HEAVILY influential in writing it. The government isn't getting between you and your doctor, as the media has drummed into us, the insurance underwriters are in the way. In a true capitalist society the law of supply and demand would bring prices to a reasonable level, but regulations are preventing this by influence from the insurers, like creating zones from which you can't cross to shop for coverage. I don't know how you can maintain a free economy if the governing body is so heavily influenced by corporations. 

I guess my thoughts on this ( expanding coverage) is like gun control, transparency, and everything else. Do I favor reasonable gun laws? Yes. Do I trust the government to enact them?No.  With every  law passed there are 25 pork and make sausage  amendments, and yes I know that's how it works but that doesn't make it right or even close to right.  

[Dave's Not Here Man]

It almost makes you wonder how just about every other modern economy is able to do it without collapsing their society. Of course, they don't have the worries of an enormous, corporate, for-profit health brokerage industry involved in the process, let alone funding their perpetual political campaigns. Or even worse, the other guy's.

[bobathon]

Insurance is not capitalism. Health care delivery doesn't work in a true free market. Rally would have had to mortgage his home to fix his prostate, and then what happens if he breaks a leg or gets the diabeedus? Hosed. Free market cannot deliver health care, and insurance is socialism with a profit skim - just like the old USSR.

[bobathon]

Blame Kaiser Wilhelm, larry.

[Dave's Not Here Man]

It kind of is and kind of isn't (capitalism), depending on how you look at it. Like if it were a product, say a car dealership. Or a service, like the extended warranty...

[bobathon]

That's not capitalism. Capitalism is I have something you want/need, and vice versa. I have cancer, you have chemo. For one gazillion dollars a treatment. I'm going to die, like most cancer patients would if they had to pony up the payment themselves. That's what insurance is for - a collective fund to defray costs for all the participants (but you know that). From each according to actuarial tables and contracts with employers, to each according to need and some caveats, and profit. Marx would recognize it.

PS Know what else happened with PPACA, that wasn't even a benefit to insurers or providers? Reduced medical bankruptcies, which is a Good Thing, bigly. Can't have that now, can we?

[Dave's Not Here Man]

Word.

I do know.

The model is recognizable...but it's being run by capitalists.