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post #51 of 266
Quote:
Originally Posted by neil spurn View Post

Yes, I certainly agree, and yes, that would be extremely difficult to get through, what with decades of opposition smear campaigning.

Which worked like gangbusters.

 

So why isn't the narrative that the ACA is basically lipstick on a toxic fucking pig?  Because that's what it is.  It makes a terrible system slightly more palatable.  Why do I never, ever hear anyone say this?  

 

I really have a hard time mustering any enthusiasm for the ACA.  I'm basically like "eh, better than the alternative." 

post #52 of 266
Thread Starter 
Quote:
Originally Posted by Overlord View Post
 

 

So why isn't the narrative that the ACA is basically lipstick on a toxic fucking pig?  Because that's what it is.  It makes a terrible system slightly more palatable.  Why do I never, ever hear anyone say this?  

 

I really have a hard time mustering any enthusiasm for the ACA.  I'm basically like "eh, better than the alternative." 

 

For millions of people the alternative is NO healthcare so yeah, maybe it is better than the alternative.

 

IMO, it was a first step and it may have led to single payer but the odds of seeing this happen has dropped to slim and none with the GOP fascists in charge.

post #53 of 266
Obama's thinking was, "I'll never get Republicans on board with single-payer. So, I'll use a Republican health care plan and get Republican support because Republicans..."

WHOOPS!
post #54 of 266
Quote:
Originally Posted by VTRan View Post
 

 

For millions of people the alternative is NO healthcare so yeah, maybe it is better than the alternative.

 

IMO, it was a first step and it may have led to single payer but the odds of seeing this happen has dropped to slim and none with the GOP fascists in charge.

 

Well, it starts with actually talking about the real problem.  Which, for some reason, I almost never see anyone do.

 

I think a big issue is that the people who stand to gain the least from singlepayer (large corporations, people employed by large corporations, etc.) are also the ones who tend to dominate media and sociopolitical narrative.  

post #55 of 266
Thread Starter 
Quote:
Originally Posted by Overlord View Post
 

Well, it starts with actually talking about the real problem.  Which, for some reason, I almost never see anyone do.

 

I think a big issue is that the people who stand to gain the least from singlepayer (large corporations, people employed by large corporations, etc.) are also the ones who tend to dominate media and sociopolitical narrative.  

 

The one real problem with the health insurance industry is just that....it's an 'industry'. An industry whose one main goal is to make as much $$$ as possible.

 

If denying care to someone will help raise the profits, so be it....."that person shouldn't have gotten sick in the first place"

 

So, talking about the 'real problems' with healthcare is all well and good if everyone can agree what the problem is. For the healthcare industry this unrelenting pursuit of profit isn't a 'bug' in the system to be 'fixed', it's  a 'feature' that needs to be exploited.  To them, nothing needs to be 'fixed'.

 

The healthcare industry, left to their own devices...just like much of Wall Street...will continue to fuck over the American public any chance they get. 

 

Do I like that the gov. got into bed with the healthcare insurance industry to pass the ACA....no, but maybe now that we have millions of people's feet wedged into that door that wouldn't have otherwise....maybe this will wake people up and get some real and substantive single payer options in this country.

 

But all the above is moot now that we have neo-fascists running the country. 

 

 

post #56 of 266
Quote:
Originally Posted by Bradito View Post

Obama's thinking was, "I'll never get Republicans on board with single-payer. So, I'll use a Republican health care plan and get Republican support because Republicans..."

WHOOPS!

Fucking bingo right there
post #57 of 266

I've been meaning to share this.  Washington had almost this exact experience in the early 90s.  Democrats passed a health law, the people got scared and voted in Republicans, the new politicians decided to keep the things people liked about the law, a death spiral happened without the things people didn't like:

 

http://www.seattletimes.com/seattle-news/politics/dismantling-of-states-health-reforms-in-1993-may-offer-lesson-for-obamacare-repeal/

 

Quote:

As congressional Republicans look to repeal the Affordable Care Act (aka Obamacare), Washington’s experience with health-care reform in the 1990s offers an illustrative example of the possible consequences of repealing only the unpopular parts of a law designed with many interlocking pieces.

 

What began as the most ambitious health-care overhaul in the nation was hacked away to the point where it became impossible to buy individual health insurance anywhere in the state.

 

Here’s what happened:

 

The Legislature passed a comprehensive health-care law in 1993, after several years of study and debate.

 

More than 15 years in advance, it looked a lot like the ACA.

 

It required most employers to provide health insurance to employees. It required individuals to get health insurance or pay a penalty. It required insurance companies to sell policies to anybody — whether they had pre-existing medical conditions or not. It required those policies to cover a set of basic benefits — things like prescription drugs and maternity care. It expanded Medicaid to give insurance to those who couldn’t afford it.

 

Like the passage of the ACA, the 1993 law led to huge Republican victories in the next election.

 

In 1994, Washington Republicans won their biggest victory in nearly 50 years, winning back the state House and coming within one seat in the state Senate.

 

They campaigned on ditching the unpopular parts of the health-care law, most specifically the mandates.

 

And they followed through.

 

And:

 

Quote:

The 1993 law, unlike Obamacare, never went into full effect.

 

The 1995 Legislature repealed most of it, including the individual mandate to carry health insurance. But they kept the ban on denying insurance for pre-existing conditions, known in insurance-speak as “guaranteed issue” — you’re guaranteed to be offered insurance, regardless of your health.

 

“Republicans came in, and they decided to gut the bill, not dissimilar to right now,” said Dr. Bob Crittenden, an aide to Gov. Jay Inslee, who, working for then-Gov. Booth Gardner, wrote the original version of the health-care bill. “They took out the mandate and left the guaranteed issue. The market went into a tailspin one-and-a-half years later.”

 

The defanged health-care law cratered the market for individual insurance policies (as opposed to employer-provided insurance or government-provided insurance, like Medicare and Medicaid, which was largely unaffected). 

 

By 1998, three years after the changes to the law went through, 17 of the 19 insurers selling individual policies in Washington had left the state, according to a study by an insurance-industry group.

 

By 1999, it was impossible to buy an individual policy in Washington. Every insurer had pulled out.

 

Premera Blue Cross said it lost more than $120 million in Washington before it stopped selling individual policies.

 

With no requirement to buy insurance — and the guarantee that people could buy insurance if they got sick — healthy people could hold off, only signing up if they needed medical care.

 

A sicker population of people buying insurance pushed premiums up. Which, in turn, led more healthy people to hold off. Which pushed premiums up.

 

“They call it a death spiral,” Crittenden said.

post #58 of 266

A death spiral is what we're in the early sign of now.  If you get out and talk to small business owners and independent contractors, they'll tell you.  It is becoming harder and harder to financially justify not just paying the penalty and figuring you can buy insurance during open enrollment if you you get ill.  What's my premium going to be next year?  Can my coverage possibly get worse?

 

The penalties in the ACA are WAAAY too miniscule and toothless to mean anything to the sorts of people that insurance companies need (young, healthy, and typically either not making much or in a cash business).   

post #59 of 266
Stronger penalties and subsidies for higher income brackets would have gone a long way. Had Clinton won, good midterm gains for the Democrats could have made those reforms possible.

The ACA was compromised from the begining. I think it's done a lot of good - covering more people and costing less than initial CBO projections - but Republicans couldn't get on board with a fairly moderate proposal because the sitting president was a Democrat.
post #60 of 266
post #61 of 266

500,000 less people signed up this year because of the Trump downplay:

 

https://twitter.com/ASlavitt/status/827628099617579008

post #62 of 266
Thread Starter 

happening now...

 

CNN to Host Debate Night with Bernie Sanders and Ted Cruz

 

https://www.youtube.com/watch?v=SNovtcAyv6g

post #63 of 266
Quote:
Originally Posted by VTRan View Post
 

happening now...

 

CNN to Host Debate Night with Bernie Sanders and Ted Cruz

 

https://www.youtube.com/watch?v=SNovtcAyv6g

 

Bernie, I'm going to need you to start an honest discussion of the fact that a private insurance system is fundamentally a broken concept, the ACA included.  You're my only hope.  

post #64 of 266

A hell of a question about the possibility of bringing back high-risk pools from a concerned constituent at a Tennessee town hall:

 

https://twitter.com/mj_lee/status/829884141046996998

post #65 of 266
Thread Starter 

It's a cliche term but..."voting against their best interests..." comes to mind.

 

-FreshAir/NPR

 

Republicans Want To Get Rid Of Obamacare. But Then What?

 

For some perspective on what's happening in Washington and how it might affect our health care, we turn to Sarah Kliff, a senior policy correspondent at vox.com. Before joining Vox, Kliff covered health policy for The Washington Post and for POLITICO and Newsweek. She co-hosts a policy-oriented podcast for Vox called "The Weeds." Kliff and co-host Ezra Klein recently interviewed President Obama about the debate over health care and the possible repeal of the Affordable Care Act. I spoke with Sarah Kliff Tuesday.

 

Quote:

DAVIES: You spoke to a woman who owns a furniture store who has an interesting story because she's somebody with a pre-existing health condition. Tell us about her.

 

KLIFF: Yeah. So this was a woman named Debbie, who - her husband actually got sick a few years with non-alcoholic cirrhosis of the liver. And they are a couple who generally have been pretty happy with Obamacare. They used to buy their own insurance before the health care law passed. And it got too expensive, so they went a few years without coverage. And when I talked to Debbie in Kentucky, she talked about how they were really grateful for the coverage because her husband got unexpectedly sick. He now needs a liver transplant, and that they can rely on this health insurance to cover it. And they were generally OK with the size of their premiums.

 

So we spent a while talking about that, and then I asked her who she voted for. And she told me she voted for Trump. And again, I was just kind of floored that someone who not only, you know, understood this was Obamacare - was happy with their coverage, voted for Trump. And again, she kind of heard this - she gave this explanation that I'd heard before that she, you know, has seen some jobs disappear in the area. This is an area that used to rely a lot on coal mining. And they see revenue in their furniture store go down when there's fewer coal miners buying things there. And she felt like Trump was the candidate who's going to bring back the coal industry, who was going to bring back jobs. And she watched the debates. She heard the talk about Obamacare, but she just didn't think that someone would take away her health insurance because why would someone possibly do that?

 

And that was, you know, one of the harder interviews I did during that story because I started talking about, well, they plan to repeal it, and we don't really know what they're going to replace it with. And it seemed to kind of dawn on her in the interview that their health insurance was at risk. And she was someone who seemed more nervous after we talked about what their future might look like.

post #66 of 266

Representative Jim Jordan, a Republican from Ohio, would like Ohioans to know that getting rid of Medicaid won't be so bad because de-funding Planned Parenthood will free up money to help cover rural hospitals:

 

https://twitter.com/daveweigel/status/833708796950278146

 

Later on, he admitted that other things would need to be cut too:

 

https://twitter.com/daveweigel/status/833716898747539460

 

So, um, just spitballing here without the actual numbers at my disposal, but Planned Parenthood funding is somewhere around $500 million per year (maybe even less).  Medicaid spending is, well, considerably more, like around $500 billion more.  So, yeah, Jordan's going to have to plan to cut other things.  Math is hard.

 

EDIT: For clarification, I just saw that the Medicaid expansion, itself, from the ACA costs around $70 billion.


Edited by Iron Maiden - 2/20/17 at 9:03am
post #67 of 266

What repealing the ACA would to various income brackets, according to the Tax Policy Center:

 

https://twitter.com/ASlavitt/status/815992966816952320

 

post #68 of 266
Quote:
Originally Posted by Iron Maiden View Post

What repealing the ACA would to various income brackets, according to the Tax Policy Center:

https://twitter.com/ASlavitt/status/815992966816952320



Seems like the chart is narrowly focuses on taxes and does not take into account 1.)premiums almost certainly dropping when companies can exclude pre-existing conditions and 2.)folks deciding to go without insurance and pocketing the extra 3 to 7k a year per person.
post #69 of 266
Quote:
Originally Posted by VTRan View Post

The GOP response to the above story would be something along the lines of "...well, you could just go to the emergency room" or some other piece of linguistic bullshit.

I'm thinking that a good slogan for the Dems to use regarding this whole ACA repeal bullshit -

HEY AMERICAN PUBLIC...THE GOP HATES YOU AND THEY WANT YOU TO DIE BECAUSE THEY ARE GREEDY COMPASSIONLESS FUCKS.
IT REALLY IS THAT SIMPLE


​Having been an ER doc, I think anyone who says you can just go to the ER should be punched in the face as hard as possible and then made to queue up in an ER waiting room to see how well that works out for them.

post #70 of 266
Quote:
Originally Posted by Overlord View Post


Seems like the chart is narrowly focuses on taxes and does not take into account 1.)premiums almost certainly dropping when companies can exclude pre-existing conditions and 2.)folks deciding to go without insurance and pocketing the extra 3 to 7k a year per person.

This seems extraordinarily naive. People are already paying for the premiums where they're at. What motivation is there for the insurance companies to drop them? Especially when, as you say in point 2, they're actually going to lose a ton of customers when the 25-30 age group cancels their plans because they don't think they need them.

 

Two of the bigger provisions of the ACA were designed (albeit poorly) to limit how much premiums can increase. Because premiums never go down.

post #71 of 266
Maybe. Or, maybe with the Obamacare penalty removed, subsidies removed, and the requirement to insure folks with pre existing conditions removed (meanimg insuring costs go down) people will begin cancelling like gangbusters while the insurance companies have a larger margin to reduce premiums to try to keep them or poach them.

Not saying this is a good dynamic, just saying chart ignores it.
post #72 of 266
Quote:
Originally Posted by Overlord View Post

Maybe. Or, maybe with the Obamacare penalty removed, subsidies removed, and the requirement to insure folks with pre existing conditions removed (meanimg insuring costs go down) people will begin cancelling like gangbusters while the insurance companies have a larger margin to reduce premiums to try to keep them or poach them.

Not saying this is a good dynamic, just saying chart ignores it.

 

I should've linked to the original source.  I'm nowhere near finished with the methodology, so I'm not quite sure it will have the info you were looking for, but here's everything:

 

http://www.taxpolicycenter.org/taxvox/repealing-affordable-care-act-would-cut-taxes-high-income-households-raise-taxes-many-others

 

http://www.taxpolicycenter.org/simulations/distribution-affordable-care-act-taxes-dec-2016

post #73 of 266

John Boehner, who led many ACA repeal votes, thinks "repeal and replace" won't happen:

 

http://www.politico.com/story/2017/02/john-boehner-obamacare-republicans-235303

 

Quote:
“[Congressional Republicans are] going to fix Obamacare – I shouldn’t call it repeal-and-replace, because it’s not going to happen,” he said. 

 

It's amazing how quickly things change once you're not in power anymore.

 

Boehner's biggest thorn was the Freedom Caucus, though, and its members don't plan on being much of help.  If the ACA is fixed, a lot of Democratic votes will be needed.

post #74 of 266

The GOP Medicaid plan is essentially to not be poor:

 

http://www.cbpp.org/research/health/medicaid-per-capita-cap-would-shift-costs-and-risks-to-states-and-harm-millions-of

 

Quote:
House Republican leaders have announced that they plan to include either a Medicaid “per capita cap” or a Medicaid block grant, or give states a choice between the two, as part of the legislation to repeal the Affordable Care Act (ACA) that House committees will consider in March. A Medicaid block grant and a per capita cap are much more alike than different as they would both radically restructure Medicaid’s federal financing system and slash federal Medicaid funding for states.  This would shift significant costs and risks to states while harming tens of millions of vulnerable low-income beneficiaries who rely on the program.
The federal government now pays a fixed share of states’ Medicaid costs, varying by state but averaging about 64 percent.  Previous congressional Republican budget and health plans have proposed converting Medicaid into a block grant or imposing a per capita cap. Both would radically restructure Medicaid’s financing and have similar, deleterious effects on states and beneficiaries.  A block grant would cap federal funding for a state’s Medicaid program, with a state responsible for any costs above the block grant amount.  A per capita cap would cap federal Medicaid funding per beneficiary.  In other words, the federal government would pay its share of a state’s Medicaid costs only up to a fixed amount per beneficiary.  The state would be responsible for all costs above that per-beneficiary cap.

 

Also, Vox' analysis shows that the GOP's eventual ACA replacement is estimated to raise costs for 55-64-year-olds by $6,089

 

http://www.vox.com/the-big-idea/2017/2/24/14722152/obamacare-aca-health-care-costs-premiums-costs-increase

 

Quote:

Since Republicans haven’t agreed on a single replacement health care plan, it’s difficult to compare the Affordable Care Act with — well, whatever is to come. But all Republican proposals to replace or repair the ACA share a set of common elements. These elements would dramatically reduce the generosity of insurance, which would, yes, reduce premiums. But they would also increase consumers’ out-of-pocket costs, such as deductibles and copays, as well as their financial risk.

 

The ACA also subsidizes many consumers’ premiums through tax credits. The Republican plans would reduce those credits substantially for most people. Finally, the proposals would alter premiums by age, increasing premiums for older people and reducing premiums for younger people. 

 

We’re presenting here the first analysis of the net financial impact on Americans of the proposed Republican modifications to health care premiums after tax credits, plus cost sharing. We estimate that the Republican approach would increase the average total cost for an individual covered by the Affordable Care Act by $1,744 per year. The impact would be particularly severe for individuals ages 55 to 64, whose total costs would increase by $6,089 annually.

 

Although premiums would be lower under the Republican plan, this decrease would be offset by an increase in cost sharing. Once the differences in tax credits are accounted for, the Republican plan would increase total costs for every age group except for those under 25. What’s more, families — as opposed to individuals — would see an even larger spike in total consumer costs. For families of every age (as determined by the age of the head of household), total costs would increase.

post #75 of 266

Oh, and the Trump Train has stopped.  It's being towed by the Paul Ryan Express:

 

https://twitter.com/jaketapper/status/835154465112088576

 

So, "access" it is.  Those promises Trump made about Social Security and Medicare on the campaign trail need to be in every Democratic commercial from here until 2020.

post #76 of 266

At this point, I would welcome the complete abolition of Medicare and Medicaid as a crowbar to get things rolling on single payer.  I cannot imagine having to deal with the constant flux of private insurance woes for the next several decades.  

post #77 of 266

Getting single payer as a result of all of this messiness would make Irony my one true god. 

post #78 of 266
post #79 of 266

http://www.motherjones.com/kevin-drum/2017/03/republican-health-care-plan-political-genius

 

Quote:

Obamacare provides subsidies to those who need it most. The Republican plan provides subsidies to everyone, even if they're already well off.

 

Politically, you can see the attractiveness of the Republican plan. One of Obamacare's major failings is that its subsidies phase out too soon. The poor get Medicaid and the near-poor get generally decent subsidies, but the working class gets very little and the middle class is left out entirely. The Republican plan provides bigger subsidies for working and middle-class families, and does it by cutting subsidies for the poor.

 

In other words, it helps two groups who vote at high rates, and who often vote Republican.1 It hurts a group that doesn't vote much, and votes Democratic when it does. It's immoral on almost every level, but it's political genius. 

post #80 of 266

The many faces of health care in the GOP right now:

 

https://www.washingtonpost.com/blogs/plum-line/wp/2017/03/02/republicans-already-think-obamacare-repeal-is-a-nightmare-its-about-to-get-worse/?utm_term=.f52156680cb2

 

Quote:
For instance, Freedom Caucus members in the House (the chamber’s most extreme conservatives) have threatened not to support any bill that doesn’t repeal the ACA’s expansion of Medicaid, which has resulted in around 14 million additional poor Americans getting covered. Your average Republican doesn’t like the Medicaid expansion either, but many of them also realize that now that all those people are covered, kicking them off would be a political (not to mention a humanitarian) disaster. For example:

“I’m very concerned about [a proposal] that would repeal Medicaid expansion,” Sen. Shelley Moore Capito (R-W.Va.) said Wednesday. “I don’t think we’re going to go that direction. I hope not, in the House or here, but that would be a major source of concern for me.”

 

Asked if she is concerned about the House plan, which would repeal the extra federal money for Medicaid expansion, Capito said, “Yeah, I mean we need the extra federal money.”

 

Sens. Dean Heller (R-Nev.), Lisa Murkowski (R-Alaska) and Rob Portman (R-Ohio) also have concerns about repealing the Medicaid expansion. Three of them voting no would be enough to sink a bill in the Senate.

 

But conservative senators, who demand that the Medicaid expansion be repealed, also have enough votes to sink a bill. Sens. Ted Cruz (R-Texas), Rand Paul (R-Ky.) and Mike Lee (R-Utah) say that Republicans must vote again on the sweeping repeal bill passed in 2015, which did away with the Medicaid expansion.

 

What do West Virginia, Nevada, Alaska and Ohio have in common? They all accepted the law’s expansion of Medicaid, so those members’ constituents are at risk. And that’s not all. Cruz, Paul and Lee also object to a provision in the emerging plan that would replace the ACA’s subsidies for middle-class people with tax credits that could be used to buy insurance. Even though the tax credits would be far less generous and wouldn’t be given according to income (so Bill Gates would get the same credit that someone of his age working at McDonald’s would), that’s still too much for those conservatives, who consider it an “entitlement” that violates their small-government principles.

 

So you’ve got ultra-conservatives who aren’t willing to accept a half-measure (backed up by right-wing pressure groups) at odds with ordinary conservatives who’d like something that minimizes the upheaval and political risk of repeal. Their differences look irreconcilable, and if either group bails, repeal is dead. It’s even possible that what Ryan and other leaders come up with will be unacceptable to both groups, losing support from both the right and the left within the GOP. If there’s a solution to that conflict, no one seems to have located it yet.

post #81 of 266

I was reading an interesting hypothesis today that the "real" positive effect of Obamacare (people who could not previously obtain insurance due to pre-existing conditions being able to do so) is actually not an insurance issue.  

 

If someone has pre-existing/current healthcare needs, and they are now allowed to buy insurance, is it really insurance?  Arguably, it isn't.  Insurance is a guarantee against future unknown risks.  If you know the risks/treatments at the time you buy the policy, you aren't really buying insurance at all, what you're actually buying is health care (albeit one that is organized through an insurance entity).  

 

This whole system is such a fucking disaster.  We have a fractured mess of private and public insuring entities, none of which is efficient and all of which leads to market distortions.  


Edited by Overlord - 3/3/17 at 11:15am
post #82 of 266

Here's a long interview with Rep. Kevin Brady, the Chairman of the House Ways and Means Committee, on taxes.  On health care, he essentially admits that he's okay with coverage loss:

 

http://www.vox.com/policy-and-politics/2017/3/3/14772242/republicans-tax-cuts-reform-kevin-brady-corporate-border-adjustment

post #83 of 266
Quote:
Originally Posted by Iron Maiden View Post
 

Here's a long interview with Rep. Kevin Brady, the Chairman of the House Ways and Means Committee, on taxes.  On health care, he essentially admits that he's okay with coverage loss:

 

http://www.vox.com/policy-and-politics/2017/3/3/14772242/republicans-tax-cuts-reform-kevin-brady-corporate-border-adjustment

 

So what do you think we should do, Iron Maiden?

post #84 of 266
Thread Starter 

For all intents and purposes, the GOP is the actual 'death panel' that they were going on and on about prior to the rollout of the ACA.

 

 

The GOP's Obamacare repeal plan is out--and it's even worse than anyone expected

 

 

--summary from the above LATimes piece--


-The proposal defunds Planned Parenthood.
-The bill effectively shuts down private health insurance coverage for abortion.
-The individual and employer mandates are eliminated.
-Essential health benefit rules are repealed.
-Income-based premium subsidies would be replaced by age-based subsidies
-The Medicaid expansion is killed.
-All of Obamacare’s taxes are repealed, another boon for the rich.

post #85 of 266
Quote:
Originally Posted by VTRan View Post
 

For all intents and purposes, the GOP is the actual 'death panel' that they were going on and on about prior to the rollout of the ACA.

 

So what do you think we should do about the healthcare situation in this country VTRan?

post #86 of 266
Thread Starter 
Quote:
Originally Posted by Overlord View Post
 

 

So what do you think we should do about the healthcare situation in this country VTRan?

 

First, all the retrograde and ignorant Republicans need to be voted out.


Then a good first step would be to cut the insurance industry out of the picture all together and adopt 'medicare for all'....single payer.  We've tried the health ins. industry way of doing things and it's shown to be unsustainable in it's current incarnation.

Rates go up,

more people can't afford ins.,

health ins. industry raises their prices to maintain their profits with less people on their roles,

more people drop their insurance because it becomes unaffordable

repeat.

 

FWIW- I have directly benefited from the implementation of the ACA and continue to do so.....so, getting rid of it hits home for me.

I feel that healthcare should be a human right for everyone.

 

So, howabout you, OverL? What should we do? 

post #87 of 266
Quote:
Originally Posted by VTRan View Post

 

FWIW- I have directly benefited from the implementation of the ACA and continue to do so.....so, getting rid of it hits home for me.

I feel that healthcare should be a human right for everyone.

 

Since we appear to be on a "full disclosure" kick: I have directly been harmed by the implementation of the ACA, and this will continue.

 

This dynamic of different segments of U.S. society being adversely affected by private health insurance regulations is going to repeat over and over again until there is a recognition that the only mechanism to ensure a uniform, fair distribution of health costs across society is with a single payer system.

 

And the absolutely best way to ensure that an honest discussion of this topic never happens is for Kang v. Kodos/Republican v. Democrat discussions to continuously occur over and over again.  The Democrats had the best chance ever to demolish the private insurance oligopoly and they fucking blew it with what appears, more and more, to be a terribly flawed half-measure.  If I'm 25, why the fuck am I even considering signing up for any private health insurance plan currently being offered?  And don't tell me about the mandate, there are no enforcement provisions and the monetary penalty is too low to matter.  

post #88 of 266
Thread Starter 

I used to pay out of pocket for better part of a decade for health ins.  Every year, the costs went up at least 10-15%....and this was long before the world ever heard of the ACA....and the amount of coverage was going down. Higher co-pays, higher deductibles, more expensive prescriptions.

 

The old way wasn't working and while the ACA is, admittedly flawed, it was the only way to stick a foot in the door of the health ins. industry....and FOR PROFIT industry that would just as soon only insure people that are 100% healthy. Even then, this same industry, when confronted with having to pay out for coverage, would bend over backwards to NOT pay out.  I had a friend that worked as a claims adjuster and one of the main components of his job was to deny payments and/or negotiate the lowest possible $$ possible. 

 

The only chance the Dems had to start a reform of the healthcare ins. industry was/is the ACA. Any other options would not have passed. There was little to no chance of having a single-payer/medicad/cal legislation pass thru congress.

 

I'm all for having a politically bi-partisan plan for universal healthcare in this country....but that isn't going to happen because the GOP is so adamantly opposed to any change to the status quo. 

The GOP had seven years....SEVEN FUCKING YEARS...to offer up any sort of alternative to the ACA. What we got was them voting, what 50+ times to blindly repeal it. 

 

I'm sorry but recent history shows that conservative republicans don't really give a shit about the American people....unless of course those people are unborn fetuses or big business $$$ donors.

Name one positive program that the Republicans have implemented in the last decade....

 

IMO...it is Repub vs. Dem and it's only been the Dems that have shown themselves (flaws and all) to have any sort of vision for the future.

 

The GOP just wants to start a new Gilded Age by destroying any sort of progressive societal advances. Fuck the GOP.  

post #89 of 266

post #90 of 266

post #91 of 266
Quote:
Originally Posted by Overlord View Post
 

 

So what do you think we should do, Iron Maiden?

 

Sorry, I missed your post.

 

Single payer is the dream, but I'm not quite sure we'll ever see it.  Sorry to hear you were personally affected by the ACA.  It's certainly not perfect, and you're not the only person I know who's been affected.

 

Considering who's in charge right now, I'll take any positives we can get.  I think tonight's bill won't ever get through for many reasons; too many Republicans have already said they won't vote for a plan that nixes Medicaid and there are many who won't support anything less than fully getting rid of the expansion.  Sens. Bill Cassidy of Louisiana and Susan Collins of Maine - Republicans - probably have the closest plan I would accept under the circumstances:

 

http://www.theadvocate.com/baton_rouge/news/politics/article_81b05c86-e176-11e6-a0a0-939ef973cac2.html

 

Quote:

Two Republican senators said Monday that they'll propose legislation that lets states keep former President Barack Obama's health care overhaul or opt for a new program providing trimmed-down coverage.

 

The plan by Sens. Bill Cassidy, of Louisiana, and Susan Collins, of Maine, would retreat from years of GOP cries to repeal Obama's law and replace it with a still undefined Republican alternative. It comes as GOP lawmakers face pressure from President Donald Trump to quickly void and replace the health law and as Republicans continue hunting for a proposal that would unite them.

 

Cassidy seems to be interested in making sure a lot of people stay insured:

 

https://twitter.com/StevenTDennis/status/838917952149798912

post #92 of 266

Reason isn't thrilled with the bill, if everyone was wondering what the conservative outlook is on this:

 

https://reason.com/blog/2017/03/06/the-gops-obamacare-repeal-bill-is-here-i

 

Quote:

The bill would replace Obamacare's subsidies with a system of tax credits and halt the law's Medicaid expansion at the end of the decade while grandfathering in many beneficiaries over the long term and giving states $100 billion in funding to work with to care for hard case patients. All in all, it's a fairly conventional Republican plan, modified in ways designed to mitigate recent political objections.

 

The tax credit is, for the moment, the most controversial component of the legislation. As in previous drafts of the bill, the credits are refundable, meaning that individuals will be eligible for them even if their total tax liability is lower than the amount of the credit. The federal government would pay people, even if their federal tax bill was zero. It's a subsidy, basically, rather like the one in Obamacare. Conservative legislators have argued that such a system would be little more than Obamacare lite. Sen. Rand Paul (R-Kentucky) has complained that any refundable credit is tantamount to "a new entitlement program."

 

Unlike Obamacare, which bases its credits on income, the GOP bills we've seen so far are based on age. That creates another set of political headaches, because it means that wealthier folks get tax credits, and because it means that older people would get less help than under Obamacare, in hopes of creating a scheme that lures more young and health people into the system.

 

The bill released tonight attempts to mitigate these problems by capping the refundable credit so that households earning more than $150,000 would be reduced, and individuals making more than $215,000 would get nothing at all. But that still leaves a credit that is refundable for most people, and adds a bit of additional administrative work: Under Obamacare, judging an individual's employment and income has proven more than a little difficult, and the same would continue to be true here.

 

So Republicans would be replacing one set of insurance subsidies with another set of insurance subsidies, while killing the individual mandate but leaving many of the law's insurance regulations intact (with a penalty for insurance gaps). There's a reason that legislators like Michigan Rep. Justin Amash are already referring to it as "Obamacare 2.0."

post #93 of 266

Look at this:

 

https://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/

 

 

It's so backwards.  How did we get here?  At some point over the last 60-70 years, has it not been made abundantly clear that healthcare is too expensive and too difficult of a question to be left up to consumers and private industry to self-regulate?  How have we, as a nation, not collectively realized that core healthcare services simply should not be a for-profit industry.  There isn't even a public option to buy into the medicare or medicaid systems, for fuck's sake.  How obvious of a stopgag solution is that?  I mean, HOW COMPLETELY FUCKING OBVIOUS.  Just let Medicare/Medicaid set a price and let people buy in.  At least that would give people an alternative from the private insurance monolith.  

 

I am so exhausted by the Obamacare debate when it's obvious the ACA was a half-assed compromise designed to put a band-aid on the real problem.  Our system of health care in this country is fundamentally broken.  The ACA absolutely did two or three necessary things that would be absolutely terrible to get rid of ... but it's really tough to get excited or enthusiastic about it.

 

Everyone benefits from people being healthy, getting preventative care,and not slamming hospitals and emergency rooms with uninsured patients.  It's just so discouraging.  

post #94 of 266
Quote:
Originally Posted by Iron Maiden View Post
 

Reason isn't thrilled with the bill, if everyone was wondering what the conservative outlook is on this:

 

https://reason.com/blog/2017/03/06/the-gops-obamacare-repeal-bill-is-here-i

 

 

If Obamacare's largely toothless penalty isn't encouraging the young and healthy to purchase overpriced individual health plans, how the fuck is that version of health care reform supposed to do the trick?  

post #95 of 266
FreedomWorks, Heritage and Club for Growth are coming out against the proposal for not being conservative enough. Pence insists that this is only the first stage and some wonderful changes, including allowing insurers to sell across state lines in a race to the bottom, are forthcoming.
post #96 of 266
post #97 of 266
post #98 of 266
Quote:
Originally Posted by Draco Senior View Post

FreedomWorks, Heritage and Club for Growth are coming out against the proposal for not being conservative enough. Pence insists that this is only the first stage and some wonderful changes, including allowing insurers to sell across state lines in a race to the bottom, are forthcoming.

 

I'm really not sure "race to the bottom" is a term that applies in this context.   Allowing insurers to offer national plans is a step in the right direction of ANY healthcare reform.  

post #99 of 266
It certainly does, and it's a concern that plenty of healthcare wonks bring up whenever the GOP proposes it. https://www.bloomberg.com/view/articles/2017-03-06/selling-health-insurance-across-state-lines-won-t-save-money

http://www.latimes.com/business/hiltzik/la-fi-hiltzik-insurance-state-lines-20161114-story.html

"On the face of it, lowering state-level barriers to health insurance sales would launch a race to the bottom akin to what happened with credit-card regulations after 1978. That’s when the Supreme Court ruled that credit card regulations could be exported by banks located in one state to customers located anywhere else. (This was no reactionary ruling, by the way; it was a unanimous opinion, written by arch-liberal William Brennan.) The result was that credit card-issuing banks set up shop in places like South Dakota and Delaware, which had virtually no usury laws, effectively nullifying other states’ limits on credit card fees and interest rates.

One can envision a similar reaction in health insurance. The Affordable Care Act sets nationwide standards for minimum benefits and consumer protection that must be met by every plan in the individual market, but many states have standards even stricter than these. California, say, would still have the right to impose tough regulations on insurers domiciled in the state.

But the prospect is that Blue Shield of California would no longer be issuing policies to Californians; the state’s residents would have the choice of Blue Shield of Texas or Louisiana, or nothing. As industry expert Richard Mayhew of Balloon-juice.com observed early this year, if a law was passed granting a national license to any insurer in any state, “the state with the weakest and most easily bought regulatory structure would have 98% of the viable insurance companies headquartered there within nine months.”
post #100 of 266
Quote:
Originally Posted by Draco Senior View Post

It certainly does, and it's a concern that plenty of healthcare wonks bring up whenever the GOP proposes it. https://www.bloomberg.com/view/articles/2017-03-06/selling-health-insurance-across-state-lines-won-t-save-money

http://www.latimes.com/business/hiltzik/la-fi-hiltzik-insurance-state-lines-20161114-story.html

"On the face of it, lowering state-level barriers to health insurance sales would launch a race to the bottom akin to what happened with credit-card regulations after 1978. That’s when the Supreme Court ruled that credit card regulations could be exported by banks located in one state to customers located anywhere else. (This was no reactionary ruling, by the way; it was a unanimous opinion, written by arch-liberal William Brennan.) The result was that credit card-issuing banks set up shop in places like South Dakota and Delaware, which had virtually no usury laws, effectively nullifying other states’ limits on credit card fees and interest rates.

One can envision a similar reaction in health insurance. The Affordable Care Act sets nationwide standards for minimum benefits and consumer protection that must be met by every plan in the individual market, but many states have standards even stricter than these. California, say, would still have the right to impose tough regulations on insurers domiciled in the state.

But the prospect is that Blue Shield of California would no longer be issuing policies to Californians; the state’s residents would have the choice of Blue Shield of Texas or Louisiana, or nothing. As industry expert Richard Mayhew of Balloon-juice.com observed early this year, if a law was passed granting a national license to any insurer in any state, “the state with the weakest and most easily bought regulatory structure would have 98% of the viable insurance companies headquartered there within nine months.”

 

The regulatory/statutory structure underlying the selling of insurance policies (perhaps most importantly, the massive system of "bad faith" laws that cannot be avoided simply by relocating to another state) is not analogous to those concerning the loan industry.

 

I'm not sure why 50 different bureaucracies is, in concept, a good idea, but I suppose we have bigger problems in the health care realm right now.  

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