> Blaming Kennedy is a take I hadn't heard before.

Carter wanted to pass legislation to give every American catastrophic healthcare coverage, so that a major medical incident would no longer bankrupt families, as a stepping stone towards universal coverage.

Kennedy opposed this, despite being on record supporting universal coverage.

It would have been a major win for Carter, but Kennedy already knew he wanted to run against the sitting President.

You can buy catastrophic healthcare coverage, can't you?

Not by itself, not anymore, because of ACA. For most people, the most cost effective insurance is catastrophic major medical + self-pay for anything else. What passes for insurance now really isn’t “insurance” in the sense that completely expected, and even likely, events are covered. It’s more like paying for discount healthcare but has the major medical built in.

Stupid question but does that mean the “discount” comes from tax dollars? i.e. medical costs are spread out more but we’re also collectively spending more of our income on it?

The discount is from a knowledgeable entity who buys lots of healthcare knowing what they are buying (theoretically preventing fraud) and what competing healthcare providers are selling at, and also negotiating with the collecting purchasing decision of thousands or millions of insureds.

Was thinking of the tax credit, but yeah that makes sense (assuming that the post-ACA unsubsidized price of a plan is lower than its pre-ACA price).

You can buy it as long as you also have an HSA account, which you should have anyway because it’s pre tax.

That is a High Deductible Health Plan, which have out of pocket maximums capped in the $10k per calendar year range. While $10k is a lot to a lot of people, it’s a drop in the bucket for an actual catastrophic healthcare event.

What are you trying to say? Max out of pocket is the max out of your pocket, not the insurance company's.

Catastrophic health insurance makes no sense as an insurance product since the probability of catastrophic health event costing hundreds of thousands of dollars is so high as one ages. Heart disease and cancer is a given, and that costs hundreds of thousands of dollars to treat, and premature babies are in the millions.

US health insurance is a combination healthcare purchasing agent/second opinion/fraud detection/insurance/tax collector.

A large part of a premium is a tax due to the maximum age rating factor that limits the prices old people pay to 3x or less what young people pay. It is also a tax because the insurer cannot underwrite the insureds, except on the basis of age, tobacco use, and location.

> Catastrophic health insurance makes no sense as an insurance product since the probability of catastrophic health event costing hundreds of thousands of dollars is so high as one ages.

Then no health insurance would make sense?

Well, as you suggest, the regulations that cap the premiums for old people at 3x those of young people seem to blame?

Insurance companies sold such plans for decades; the price goes up as you get older (==riskier from the pov of the insurer). Just like life insurance.

At some point the consumer makes a decision that the cost of insurance doesn’t justify the benefit.

Everyone already has it, the cost is just absorbed by the public instead of being taken out of the taxes of the person receiving the emergency care, assuming they can’t afford the hospital bill.

Many studies find that a majority of personal bankruptcies in the US involve medical debt with some estimates of ~500,000 medical-cost contributed bankruptcies per year. A hospital (might) not kick you to the curb if you are dying in their emergency room. However, this is not the same as catastrophic coverage.

It is functionally the same for the recipient of the medical care who wouldn’t be able to afford it out of pocket. You get the medical care, and you don’t pay for it. Then declare bankruptcy if you have to.

Having doctors treat and stabilize patients because they are required by EMTALA is an entirely different animal than having catastrophic medical insurance.

Real catastrophic medical insurance caps how much you owe whereas the debt you accumulate from a doctor who was obligated to treat you is not capped. That debt follows you until you pay it off or declare bankruptcy like the 500,000 other Americans do each year.

To add insult to injury, we already spend $5000 per capita on our publicly funded healthcare system, which is enough to fund basic universal healthcare systems in other countries.

Let that sink in. We spend $11,000 per capita on healthcare per year. 45% is publicly funded with taxes and the other 55% is privately funded.

We’re already spending enough for TWO universal healthcare systems (for many countries), yet we have 500,000 filing for bankruptcy due to medical bills each year.

Based on what we’re spending, we can afford two systems: A socialist system that covers everyone and a private healthcare systems that provides world class treatments to anyone who can afford the insurance premiums.

Instead, we have two corrupt and dysfunctional systems, a lot of gaps, and a record number of people profiting off our dysfunction.

> We’re already spending enough for TWO universal healthcare systems (for many countries), yet we have 500,000 filing for bankruptcy due to medical bills each year.

Well, you are spending approximately twice as much as the Brits in terms of percentage of GDP. (Comparing total healthcare expenditure, ie private plus public.)

But that doesn't mean that NHS-style healthcare is the best.

Singapore spends roughly health as much as Britain, and has no worse health outcomes. And we don't have a single payer system here.

> taken out of the taxes of the person receiving the emergency care,

if it's that catastropic, I imagine their income would fall drastically that year, or years. What taxes?

Taxes from their income they’ve been paying their whole lives

Nope. EMTALA means hospitals have to evaluate, and if necessary, stabilize you, and that’s it. If you’ve got a growing cancer or some expensive chronic disease that’s causing serious problems, they’ll do what they can to stop those problems from killing you in any given visit, but they absolutely will not treat cancer with the intent of curing it or help you control a chronic disease knowing they’ll never recoup payment. They’ll give you a prescription for insulin but they’re certainly not going to fill it for you, no matter how big of an emergency it is or how much the hospital visit cost. Even then, they still bill you for all of the services they do render and medical bills still bankrupt people. Needing to make sure someone isn’t going to die in the next few hours is very different from taking the financial responsibility for treating a very expensive medical problem.

This is not much different from how many insured people approach their healthcare. My friends who live paycheck to paycheck do not seek medical attention unless it is some extreme life or death situation. Even though they are insured, they are afraid of paying copays and deductibles of $100-$500 for routine visits. If their annual physical results in even just a $50 bill, they will not go. Only when they are in severe 10/10 pain will they start to think about seeing a doctor.

And at that level of expense, having no insurance, bad regular insurance, and catastrophic insurance is not much different. However, if you get into a car accident, have diabetes, eat a burger with E. coli oh157 which destroys your kidneys and you need dialysis to stay alive, get appendicitis, get HIV, get cancer, or possibly get exposed to rabies and need human rabies immune globulin, having no insurance is very very very very very different. If you have bad insurance you haven’t used that year, it will cost you $500 or whatever your deductible is. More than that with catastrophic insurance. When my wife and I were exposed to rabies during a fantastic stay at a super clean and well-run air bnb and needed the shots, the insurance company portion of our bill was $38,000.

> Confirming Mr. Barnes’s account is problematic after so much time. Mr. Connally, Mr. Casey and other central figures have long since died and Mr. Barnes has no diaries or memos to corroborate his account. But he has no obvious reason to make up the story and indeed expressed trepidation at going public because of the reaction of fellow Democrats ...

> None of that establishes whether Mr. Reagan knew about the trip, nor could Mr. Barnes say that Mr. Casey directed Mr. Connally to take the journey. Likewise, he does not know if the message transmitted to multiple Middle Eastern leaders got to the Iranians, much less whether it influenced their decision making.

"Historical fact" is a very strong way to say "one man's story recounted 40 years later and backed by modest circumstantial evidence", and even to the extent the story is true as told in that article, Reagan's backers didn't "conspire" with anyone—as recounted, they never spoke with the Iranians, they told other Arab leaders to let the Iranians know.

If true, this is still worth recounting, but you're not helping anything by overstating the degree to which we know this to be fact nor by overstating the crime.

Further it’s far from given that had the hostages been released Carter would be re-elected. 1980 was the second straight year of double digit inflation.

Reagan was elected with 51% of the popular vote to Carter’s 41% and carried 44 states to Carter’s 6(+DC), tallying 489 electoral votes to Carter’s 49. This was not a close election.

Yeah, at those kinds of margins blaming any single factor is... a stretch.

There is a good chance that if the hostages had been released before election day that Carter would have won.

Hamilton Jordan, his chief of staff, wrote a book about Carter's last year in office. A lot of people thought Reagan was a clown. He was not as popular as his worshippers in the GOP like to think. Reagan was usually ahead of Carter in polls before the election, but usually by a few points, not the same margin as the final count.

The hostage crisis started on Nov 4, 1979; the one year anniversary of the hostages being taken was right on election day. A lot of media was running stories on the hostages in the week leading up to the election, particularly over the weekend. Jordan says there was a shift that took them all by surprise in its speed and magnitude. When you spend months only a point or two behind, it is easy to think you might win.

Blame John Anderson as well.

Maybe so. But Anderson also pulled votes from more-or-less Republicans who didn't believe Reagan's assertion that cutting taxes and increasing spending would narrow the deficit.

> But Anderson also pulled votes from more-or-less Republicans who didn't believe Reagan's assertion that cutting taxes and increasing spending would narrow the deficit.

When Reagan's own people said his economics were bullshit…

> Following Reagan's election, the "trickle-down" reached wide circulation with the publication of "The Education of David Stockman" a December 1981 interview of Reagan's incoming Office of Management and Budget director David Stockman, in the magazine Atlantic Monthly. In the interview, Stockman expressed doubts about supply side economics, telling journalist William Greider that the Kemp–Roth Tax Cut was a way to rebrand a tax cut for the top income bracket to make it easier to pass into law.[25] Stockman said that "It's kind of hard to sell 'trickle down,' so the supply-side formula was the only way to get a tax policy that was really 'trickle down.' Supply-side is 'trickle-down' theory."[25][26][27]

* https://en.wikipedia.org/wiki/Trickle-down_economics#Reagan_...

Describes my father who voted for Anderson. He didn’t trust Reagan at all

But he didn't vote for Carter either.

That's maybe almost implied already.

It is true that Reagan campaigned against Carter's 'profligate' spending. But then it's also a fact that Carter (2.6% in 1980) had reduced Ford's deficit (4.1% in 1976) and then Reagan's deficit (5.9% in 1983) greatly increased Carter's. Reagan's Secretary of Defense Dick Cheney summarized the Reagan governing philosophy as deficits don't matter.

Almost 50 years later, borrow-and-spend politicians still sell themselves to US voters as fiscally responsible.

Reagan's entire administration was swamped in corruption and scandals. People really don't remember just how many investigations, charges, and convictions there were. People only remember Iran-Contra and the hostage crisis; it was so much worse. Reagan even cheated in a televised debate; someone stole Carter's notes and gave them to Reagan.

https://en.wikipedia.org/wiki/Scandals_of_the_Ronald_Reagan_...

Ronald "Small Government" Reagan ballooned the national debt by 160-180%, depending on who's counting. That's higher than any other president by a massive amount: https://www.data-z.org/library/imglib/National-debt-growth-b...

Then there was his disassembling the national mental healthcare system with no substitute, causing a national crisis - and in a real case of irony - getting shot by a mentally ill person who should have been committed.

Then there was him ignoring the AIDS epidemic because it only seemed to affect gay people.

Then there was him coming down with Alzheimer's with symptoms cropping up during his first term, according to his own son and video from his debate against Mondale. At some point the country was effectively being run by Nancy Reagan and her astrologist. Hell, there's hot mic footage of her telling him word for word what to say to the press...

"That's higher than any other president by a massive amount" - Any modern president. Abraham Lincoln had a 2859.40% increase. Martin Van Buren had a 1458.32% increase. We've had quite a few over 200%.

One wonders what was going on during Lincoln's presidency that could have contributed to such a massive increase.

Something about State's rights. It's a mystery.

Lincoln was president during the US Civil War

He was being sarcastic

I was being sarcastic (well, playing the straight man)

Ignoring [the AIDS epidemic] is putting it mildly, IMO

All that is saying is that back then the Democrats engaged in lawfare. Nothing new.

Sarcasm doesn't come across well in written comments.

When I was taught the Metric System in elementary school it felt like we were being whisked into the future. I know it may sound like I'm putting too fine a point on it, but by joining the rest of the developed world (and more specifically, the scientific community) it felt like a step along a path to a global community.

Reagan tossed the whole thing and we were snapped back to feet, inches, ounces, pounds, Fahrenheit.

I have photos from road trips in the late 70's where Federal highway signs, like on mountain passes, have the elevation indicated in Meters. When I used Google street view I see we're back to regressive signage.

I know, a minor nit.

I tried to track down the reasoning (I mean you would think a right-leaning pro-business president would support the Metric system), this came up:

https://themetricmaven.com/terminating-metric-with-extreme-p...

He did sign the Omnibus Trade and Competitiveness Act of 1988 into law. The measure declared that the metric system of measurement to be the preferred measurement system for U.S. trade and commerce.

But he also defunded the US Metric Board.

I suspect he didn't care about metric enough to fight other conservatives over it.

"Reagan’s education advisor, Roger A. Freeman stated, “We are in danger of producing an educated proletariat. That’s dynamite! We have to be selective on who we allow [to go through higher education].” This belief has shaped higher education to become a privilege of the upper class, with tuition serving as a barrier to those from working-class backgrounds.

When Reagan became president, he continued his efforts to dismantle the public education system, targeting federal aid to students. "

from: https://newuniversity.org/2023/02/13/ronald-reagans-legacy-t...

I think it was also retribution against college kids deferring the Vietnam war draft. The student deferment was supposed to be a rich-only loophole..

OTOH, Carter pardoned Vietnam war draft dodgers.

https://en.wikipedia.org/wiki/Proclamation_4483#:~:text=Jimm....

(I foresee a similar decision needing to be made in Russia soon..)

yeah, seeing the situation 40-50 years later... maybe history really does rhyme

> Blaming Kennedy is a take I hadn't heard before.

It was a broadly established take, and the reason why there's a superstition about sitting Presidents having opponents in primaries.