ObamaCare ruined primary care medicine

[Anonymous]

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

[Anonymous]

Anonymous wrote:What if we went single payer just for primary care to start? 10-year transition, rich subsidies for medical school and residency in primary care, they become federal employees.

How about instead eliminating the waste fraud and abuse in Medicare, instead of claiming you will do this in the rest of the health care system?
Insurance company profits are pretty small compared to health care spending.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What if we went single payer just for primary care to start? 10-year transition, rich subsidies for medical school and residency in primary care, they become federal employees.

How about instead eliminating the waste fraud and abuse in Medicare, instead of claiming you will do this in the rest of the health care system?
Insurance company profits are pretty small compared to health care spending.

So no real argument against it, just that it should happen via Medicare? Like Medicare begins directly employing all PCPs for all ages, and also runs insurance for the aged?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had no idea people in DC were getting hustled into paying a $2k concierge fee for a primary care provider. That's pretty sad.

I live in DC and have no problem finding doctors who aren’t part of concierge practices.

Also just because a practice doesn’t *take* insurance doesn’t mean that insurance won’t *pay.*. Drs are just tired of the paperwork. We have a doctor than one person in our family uses but who doesn’t take insurance. They give us the right documentation and I can either mail it in or scan it and get reimbursed.

I’m a new transplant to the area.

Trying to find a PCP that actually takes new patients is hellacious. It is all concierge. Or you are funneled into seeing a nurse practitioner. Sorry, no offense, but I want to see a doctor, not a nurse practitioner. Your insurance website can list all the PCPs they want that supposedly hake your insurance, but have you actually tried to be a new patient recently? They never call you back. Or they’re full and no longer take new patients. Or the only ones left have horrible reviews.

You are being herded like cattle more and more to concierge docs, because they’re the only real MD PCPs left who are decent and still take patients. You just gotta be a wealthy elitist now for access.

You sound like an elitist for dissing NPs.

I decided to switch to seeing NPs becuase it was taking over 2 months to get an appointment with my PCP that I had been with for over 10 years. I absolutely believe those that are frustrated that health insurance palns fail to set folks up with a physician that will see them in a timely way. I'm sure they could use technology that would show the scheudles for all their available doctors in an area and help members get set up with that doctor, but for some reason they act like it's impossible and instead members have to call and call and call to track down a PCP.

ANyway, I decided to instead go with One MEdical which costs $200 per year and uses NPs. They have a great app that shows the availability of NPs and their locations. Very easy to use.

Plus I feel like the NP is actually better than my PCP-- takes more time and listens to be and asks questions beyond just the exact reason I scheduled the visit.

I encourage you to reconisder your take that NPs are "less than" PCPs-- my NP is just as able to refer me to a specialist as a PCP.

And you sound like a pretentious dbag who makes grand assumptions regarding someone’s health whom you have never even met in real life. How do you know I don’t t have very complicated medical issues and a rare disease? NPs are ok for cuts and bruises. When things are more complex, I want a doctor please.

Because those are treated by specialists.

Besides you already said you CAN find a PCP who is an MD but you didn’t like their reviews. Your problem is your champagne taste on a beer budget.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

DP.. the problem with trying to implement this is in the US is that it's too much too quickly. Americans aren't used to the very high tax rates today. They did pay them pre 1960s. But, most people today would balk at such high tax rates. Europeans are used to high tax rates, so it doesn't bother them as much.

IMO, we should start raising taxes bit by bit, and at the same time, expand medicare bit by bit. That is more palatable to most Americans than a quick "rip the band aid" off approach.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Blame the insurance industry that REPUBLICANS won't regulate.

Obama just made sure more Americans had ANY coverage.

He did not dictate how much private companies reimburse.

Health care should NOT be a for-profit industry.

It is capitalism at work OP, not socialism.

The mistake was getting the govt involved. That instantly raised the cost of services across the board.

Obama had a good goal of expanding coverage and the way he could have done it was by implanting a caps for basic services costs - routine office visit for example and allow specialty services to continue to billed at the prevailing rates, and make insurers cover pre-existing conditions with the stipulation they could charge a certain percentage over the regular rates.

The truth is insured people were already paying the costs for the uninsured and now we still do and with the added burden of pitching in for those who get the coverage but receive subsidies for premiums.

Costs were exponentially growing prior to ACA. The rate has slowed.

The rates slowed but are still increasing. Add to that additional taxes to cover the subsidies. So now we pay higher rates and higher taxes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

DP.. the problem with trying to implement this is in the US is that it's too much too quickly. Americans aren't used to the very high tax rates today. They did pay them pre 1960s. But, most people today would balk at such high tax rates. Europeans are used to high tax rates, so it doesn't bother them as much.

IMO, we should start raising taxes bit by bit, and at the same time, expand medicare bit by bit. That is more palatable to most Americans than a quick "rip the band aid" off approach.

Pp here. I agree completely. Even that would be a struggle though probably, American individualism makes it difficult to persuade people that we are only as strong as our weakest link.

For example, our military can’t recruit enough people - too fat and too unhealthy. Not good for our national security. But no one sees the value of paying for healthy lunches and diabetes and obesity prevention for all the kids in the US. Not only would that help our military, but those kids would be able to learn better, do better in life, etc, etc. All for slightly more in taxes and fewer subsidies to ag and fossil fuels industries.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

Yeah, and it's also why their economies are trash as well as their salaries and their GDPs are anemic while the US continues to outshine them all in terms of GDP and innovation.

Go lookup the median household incomes in the UK, France, Germany, Japan, South Korea, etc. where you all think they're a socialist wonderland.

They have absolutely trash wages. And you wonder why France had their Yellow vest riots a little while back? It's because their salaries are absolute garbage and the govt reams them over the coals for 50% taxes. It is crushing families and their abilities to live and raise kids even with all of the perceived benefits. Go lookup the wages in the UK. Absolutely putrid. That's why so many Brits come to the US to work, because they can make double to triple their salary that they get in the UK.

It's hilarious Americans who propose all of this socialist stuff think they'll still be getting the same level of income as they do now. How about you cut your salary in half, then tell me you still like all of this free stuff. Only then are you more comparable to all of the other countries you hold on such a high pedestal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

Yeah, and it's also why their economies are trash as well as their salaries and their GDPs are anemic while the US continues to outshine them all in terms of GDP and innovation.

Go lookup the median household incomes in the UK, France, Germany, Japan, South Korea, etc. where you all think they're a socialist wonderland.

They have absolutely trash wages. And you wonder why France had their Yellow vest riots a little while back? It's because their salaries are absolute garbage and the govt reams them over the coals for 50% taxes. It is crushing families and their abilities to live and raise kids even with all of the perceived benefits. Go lookup the wages in the UK. Absolutely putrid. That's why so many Brits come to the US to work, because they can make double to triple their salary that they get in the UK.

It's hilarious Americans who propose all of this socialist stuff think they'll still be getting the same level of income as they do now. How about you cut your salary in half, then tell me you still like all of this free stuff. Only then are you more comparable to all of the other countries you hold on such a high pedestal.

You seem pretty angry.

Most people do have lower salaries, but they don’t need money for medical bills, education. They do live in smaller apartments, and take trains instead of private jets. But for the most part they seem to have a better quality of life.

And isn’t that what it’s all about? Time to spend with friends and family and explore interests beyond your job and snooze on the beach after a relaxing lunch. Consider it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

DP.. the problem with trying to implement this is in the US is that it's too much too quickly. Americans aren't used to the very high tax rates today. They did pay them pre 1960s. But, most people today would balk at such high tax rates. Europeans are used to high tax rates, so it doesn't bother them as much.

IMO, we should start raising taxes bit by bit, and at the same time, expand medicare bit by bit. That is more palatable to most Americans than a quick "rip the band aid" off approach.

Gosh, why won't this stupid dem taking point that "BuT But BUt wE PaID >90% TaX oN tHe uPpER BraCkEt iN tHe 50s!" just die already. What they never tell you when they bring up this stupid talking point is that the tax code was radically different back then too. There were way, wayyyyyy more tax breaks and loopholes back then too that you could drive a truck through. Hardly anyone at that time was paying 90% tax. Reagan got rid of all of the tax breaks and made sure more was taxed while simultaneously reducing tax rates. In the end we got a greatly simplified tax code, which was way better than the 1950s and 60s, but it had no real impacts on total tax revenue as a percent of GDP. In fact, total taxation revenues relative to GDP has remained remarkably consistent in the US for almost 100 years.

The point being, it's such a dumb talking point when the tax rates in the 50s and 60s are brought up. The tax code was wildly different back then too. We still do pay nearly the same level of taxes now as we did back then.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

Yeah, and it's also why their economies are trash as well as their salaries and their GDPs are anemic while the US continues to outshine them all in terms of GDP and innovation.

Go lookup the median household incomes in the UK, France, Germany, Japan, South Korea, etc. where you all think they're a socialist wonderland.

They have absolutely trash wages. And you wonder why France had their Yellow vest riots a little while back? It's because their salaries are absolute garbage and the govt reams them over the coals for 50% taxes. It is crushing families and their abilities to live and raise kids even with all of the perceived benefits. Go lookup the wages in the UK. Absolutely putrid. That's why so many Brits come to the US to work, because they can make double to triple their salary that they get in the UK.

It's hilarious Americans who propose all of this socialist stuff think they'll still be getting the same level of income as they do now. How about you cut your salary in half, then tell me you still like all of this free stuff. Only then are you more comparable to all of the other countries you hold on such a high pedestal.

You seem pretty angry.

Most people do have lower salaries, but they don’t need money for medical bills, education. They do live in smaller apartments, and take trains instead of private jets. But for the most part they seem to have a better quality of life.

And isn’t that what it’s all about? Time to spend with friends and family and explore interests beyond your job and snooze on the beach after a relaxing lunch. Consider it.

Yeah it's so awesome Macron almost repeated the French Revolution. Tell us genius, why did those yellow vest riots happen again? You seem oblivious to the news and how horrendous peoples' salaries are over there relative to cost of living. Even with free health and education, you still need housing, food, clothing, etc. When the govt teams you for half your paycheck and prices for other things still go up, have fun trying to raise a family like the French. Get back to me when you're content trying toam raise a family on $45k USD, after taxation, because that's more in line with all of those other countries.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

Yeah, and it's also why their economies are trash as well as their salaries and their GDPs are anemic while the US continues to outshine them all in terms of GDP and innovation.

Go lookup the median household incomes in the UK, France, Germany, Japan, South Korea, etc. where you all think they're a socialist wonderland.

They have absolutely trash wages. And you wonder why France had their Yellow vest riots a little while back? It's because their salaries are absolute garbage and the govt reams them over the coals for 50% taxes. It is crushing families and their abilities to live and raise kids even with all of the perceived benefits. Go lookup the wages in the UK. Absolutely putrid. That's why so many Brits come to the US to work, because they can make double to triple their salary that they get in the UK.

It's hilarious Americans who propose all of this socialist stuff think they'll still be getting the same level of income as they do now. How about you cut your salary in half, then tell me you still like all of this free stuff. Only then are you more comparable to all of the other countries you hold on such a high pedestal.

You seem pretty angry.

Most people do have lower salaries, but they don’t need money for medical bills, education. They do live in smaller apartments, and take trains instead of private jets. But for the most part they seem to have a better quality of life.

And isn’t that what it’s all about? Time to spend with friends and family and explore interests beyond your job and snooze on the beach after a relaxing lunch. Consider it.

Yeah it's so awesome Macron almost repeated the French Revolution. Tell us genius, why did those yellow vest riots happen again? You seem oblivious to the news and how horrendous peoples' salaries are over there relative to cost of living. Even with free health and education, you still need housing, food, clothing, etc. When the govt teams you for half your paycheck and prices for other things still go up, have fun trying to raise a family like the French. Get back to me when you're content trying toam raise a family on $45k USD, after taxation, because that's more in line with all of those other countries.

The gilets jaune protests were about fuel taxes (as I’m sure you know) and a sense that macron was out of touch. It was hardly the French Revolution 2.0. The French are enjoying their vacances as they do every summer and macron is still president.

But I get that you like supporting yourself and your family with no help for childcare or education or medical care. That you like being worried about a medical bill wiping you out economically. That you like never having a vacation. By all means, keep voting for that lifestyle. But no need to be belligerent towards those of us who would like to see our tax dollars translate into a more worry free lifestyle with better municipal services and a stronger safety net for when things go wrong.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

+1. The ACA is significant but it is not enough. Single payer already like every other modern developed nation.

What is the downside to this, which should be a basic right? That poor people might get healthcare and not suffer because they are poor? Is that it?

Take a look at tax rates in all these modern developed countries and ask if you are willing to pay that.

And in return for those higher taxes:

Medical care is free.
Education (including university and trade school) is free. In fact students get stipends.
6-8 weeks of vacation a year
People can support themselves on one job

There is less income inequality though, so fewer very rich people.

Yeah, and it's also why their economies are trash as well as their salaries and their GDPs are anemic while the US continues to outshine them all in terms of GDP and innovation.

Go lookup the median household incomes in the UK, France, Germany, Japan, South Korea, etc. where you all think they're a socialist wonderland.

They have absolutely trash wages. And you wonder why France had their Yellow vest riots a little while back? It's because their salaries are absolute garbage and the govt reams them over the coals for 50% taxes. It is crushing families and their abilities to live and raise kids even with all of the perceived benefits. Go lookup the wages in the UK. Absolutely putrid. That's why so many Brits come to the US to work, because they can make double to triple their salary that they get in the UK.

It's hilarious Americans who propose all of this socialist stuff think they'll still be getting the same level of income as they do now. How about you cut your salary in half, then tell me you still like all of this free stuff. Only then are you more comparable to all of the other countries you hold on such a high pedestal.

I guess we have to accept that there just isn't enough of everything to go around. Do you want to live in a place with extreme inequality as long as you have everything you want, or a place with more equality, and everyone has to lower their standard of living? Honestly it's a tough question.