Affordable Care Act in jeopardy?

Anonymous
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Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:1. Democrats had a once-in-fifty years filibuster-proof control of the legislature and the White House. Congrats could have easily passed single payer but--in hopes of retaining political power--Obama and the Democrats blinked. Yet posters in this thread are mostly blaming republicans.

2. The government doesn't do anything efficiently. The idea that Healthcare will get better in terms of service and/or cost under government control is borderline looney.

3. It isn't fair that a poor person could be stuck wolithout healthcare due to means. Likewise, it isn't fair that healthy people who take care of themselves would be forced to pay for the bad lifestyle choices of others. I get the idea of universal care. any proposed solutions for making people lead healthier lifestyles if we're all going to be on the hook for the repercussions of bad lifestyle decisions?


1. Agree. They could and should have passed both single payer and immigration reform. Instead we got some Frankenstein-like health insurance laws and a Deporter-in-Chief

2. Disagree. Government can run things well WHEN led and managed by professionals, not by egomaniacs or amateurs.

3. Agree.


And when has that been the case? Can you give an example?


Canada
Most European countries
Singapore
Japan
China

? I don't think China's healthcare system is great.


True, but compare where it is today and where it was 30 years ago. They have made significant progress while we are stagnant, at best.


Those aren't examples of government efficiently administering anything. And I was much more interesting in our own country and an example there since it is OUR government that would be managing, not someone from Singapore.

As for Canada. I personally know some who moved to the U.S. after retirement and a prime reason was healthcare availability.


Sure Europe's health care is efficient. They live longer than we do, and they pay half as much. Better outcome at less cost is the definition of efficiency.


Has anyone looked at the actual health of the citizens in all this

When 1/3 of the US is obses of course our healthcare costs are going to be higher than other places. And using the 90/10 rule that 90% of costs are by 10% of the sickest/fattest/dumbest it makes even more sense why US healthcare costs are so high


Exactly. We aren't unhealthy because of poor health care but poor diet and habits. I would bet we also have more able bodied individuals who don't work, but could, than other industrialized nations.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:1. Democrats had a once-in-fifty years filibuster-proof control of the legislature and the White House. Congrats could have easily passed single payer but--in hopes of retaining political power--Obama and the Democrats blinked. Yet posters in this thread are mostly blaming republicans.

2. The government doesn't do anything efficiently. The idea that Healthcare will get better in terms of service and/or cost under government control is borderline looney.

3. It isn't fair that a poor person could be stuck wolithout healthcare due to means. Likewise, it isn't fair that healthy people who take care of themselves would be forced to pay for the bad lifestyle choices of others. I get the idea of universal care. any proposed solutions for making people lead healthier lifestyles if we're all going to be on the hook for the repercussions of bad lifestyle decisions?


1. Agree. They could and should have passed both single payer and immigration reform. Instead we got some Frankenstein-like health insurance laws and a Deporter-in-Chief

2. Disagree. Government can run things well WHEN led and managed by professionals, not by egomaniacs or amateurs.

3. Agree.


And when has that been the case? Can you give an example?


Canada
Most European countries
Singapore
Japan
China

? I don't think China's healthcare system is great.


True, but compare where it is today and where it was 30 years ago. They have made significant progress while we are stagnant, at best.


Those aren't examples of government efficiently administering anything. And I was much more interesting in our own country and an example there since it is OUR government that would be managing, not someone from Singapore.

As for Canada. I personally know some who moved to the U.S. after retirement and a prime reason was healthcare availability.


Sure Europe's health care is efficient. They live longer than we do, and they pay half as much. Better outcome at less cost is the definition of efficiency.


+1.

Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:1. Democrats had a once-in-fifty years filibuster-proof control of the legislature and the White House. Congrats could have easily passed single payer but--in hopes of retaining political power--Obama and the Democrats blinked. Yet posters in this thread are mostly blaming republicans.

2. The government doesn't do anything efficiently. The idea that Healthcare will get better in terms of service and/or cost under government control is borderline looney.

3. It isn't fair that a poor person could be stuck wolithout healthcare due to means. Likewise, it isn't fair that healthy people who take care of themselves would be forced to pay for the bad lifestyle choices of others. I get the idea of universal care. any proposed solutions for making people lead healthier lifestyles if we're all going to be on the hook for the repercussions of bad lifestyle decisions?


1. Agree. They could and should have passed both single payer and immigration reform. Instead we got some Frankenstein-like health insurance laws and a Deporter-in-Chief

2. Disagree. Government can run things well WHEN led and managed by professionals, not by egomaniacs or amateurs.

3. Agree.


And when has that been the case? Can you give an example?


Canada
Most European countries
Singapore
Japan
China

? I don't think China's healthcare system is great.


True, but compare where it is today and where it was 30 years ago. They have made significant progress while we are stagnant, at best.


Those aren't examples of government efficiently administering anything. And I was much more interesting in our own country and an example there since it is OUR government that would be managing, not someone from Singapore.

As for Canada. I personally know some who moved to the U.S. after retirement and a prime reason was healthcare availability.


Sure Europe's health care is efficient. They live longer than we do, and they pay half as much. Better outcome at less cost is the definition of efficiency.


+1.


It can vary. My ILs live in the UK, and each "trust" runs independently. Treatment varies by trust. Some hospitals will offer great treatment for cancer, for example, whereas others might now offer certain types of treatment for the same issue. And you can't go to whatever hospital you want for treatment. A friend there has cancer, and he said he was lucky to live in the city he does because their hospital offers a certain treatment that he couldn't get in the neighboring town. It's weird.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:1. Democrats had a once-in-fifty years filibuster-proof control of the legislature and the White House. Congrats could have easily passed single payer but--in hopes of retaining political power--Obama and the Democrats blinked. Yet posters in this thread are mostly blaming republicans.

2. The government doesn't do anything efficiently. The idea that Healthcare will get better in terms of service and/or cost under government control is borderline looney.

3. It isn't fair that a poor person could be stuck wolithout healthcare due to means. Likewise, it isn't fair that healthy people who take care of themselves would be forced to pay for the bad lifestyle choices of others. I get the idea of universal care. any proposed solutions for making people lead healthier lifestyles if we're all going to be on the hook for the repercussions of bad lifestyle decisions?


1. Agree. They could and should have passed both single payer and immigration reform. Instead we got some Frankenstein-like health insurance laws and a Deporter-in-Chief

2. Disagree. Government can run things well WHEN led and managed by professionals, not by egomaniacs or amateurs.

3. Agree.


And when has that been the case? Can you give an example?


Canada
Most European countries
Singapore
Japan
China

? I don't think China's healthcare system is great.


True, but compare where it is today and where it was 30 years ago. They have made significant progress while we are stagnant, at best.


Those aren't examples of government efficiently administering anything. And I was much more interesting in our own country and an example there since it is OUR government that would be managing, not someone from Singapore.

As for Canada. I personally know some who moved to the U.S. after retirement and a prime reason was healthcare availability.


Sure Europe's health care is efficient. They live longer than we do, and they pay half as much. Better outcome at less cost is the definition of efficiency.


+1.


It can vary. My ILs live in the UK, and each "trust" runs independently. Treatment varies by trust. Some hospitals will offer great treatment for cancer, for example, whereas others might now offer certain types of treatment for the same issue. And you can't go to whatever hospital you want for treatment. A friend there has cancer, and he said he was lucky to live in the city he does because their hospital offers a certain treatment that he couldn't get in the neighboring town. It's weird.


That's in fact great news.

The US system gets sold as "great choice," when what we really want, and Europeans get, is "great care at little cost."

The real-world alternative to "great care at little cost' is often "many options -- all substandard and crazy expensive"
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:1. Democrats had a once-in-fifty years filibuster-proof control of the legislature and the White House. Congrats could have easily passed single payer but--in hopes of retaining political power--Obama and the Democrats blinked. Yet posters in this thread are mostly blaming republicans.

2. The government doesn't do anything efficiently. The idea that Healthcare will get better in terms of service and/or cost under government control is borderline looney.

3. It isn't fair that a poor person could be stuck wolithout healthcare due to means. Likewise, it isn't fair that healthy people who take care of themselves would be forced to pay for the bad lifestyle choices of others. I get the idea of universal care. any proposed solutions for making people lead healthier lifestyles if we're all going to be on the hook for the repercussions of bad lifestyle decisions?


1. Agree. They could and should have passed both single payer and immigration reform. Instead we got some Frankenstein-like health insurance laws and a Deporter-in-Chief

2. Disagree. Government can run things well WHEN led and managed by professionals, not by egomaniacs or amateurs.

3. Agree.


And when has that been the case? Can you give an example?


Canada
Most European countries
Singapore
Japan
China

? I don't think China's healthcare system is great.


True, but compare where it is today and where it was 30 years ago. They have made significant progress while we are stagnant, at best.


Those aren't examples of government efficiently administering anything. And I was much more interesting in our own country and an example there since it is OUR government that would be managing, not someone from Singapore.

As for Canada. I personally know some who moved to the U.S. after retirement and a prime reason was healthcare availability.


Sure Europe's health care is efficient. They live longer than we do, and they pay half as much. Better outcome at less cost is the definition of efficiency.


+1.


It can vary. My ILs live in the UK, and each "trust" runs independently. Treatment varies by trust. Some hospitals will offer great treatment for cancer, for example, whereas others might now offer certain types of treatment for the same issue. And you can't go to whatever hospital you want for treatment. A friend there has cancer, and he said he was lucky to live in the city he does because their hospital offers a certain treatment that he couldn't get in the neighboring town. It's weird.


That's in fact great news.

The US system gets sold as "great choice," when what we really want, and Europeans get, is "great care at little cost."

The real-world alternative to "great care at little cost' is often "many options -- all substandard and crazy expensive"

Except it sucks for you if you need that treatment, and the hospital that you have to go to doesn't offer it.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:1. Democrats had a once-in-fifty years filibuster-proof control of the legislature and the White House. Congrats could have easily passed single payer but--in hopes of retaining political power--Obama and the Democrats blinked. Yet posters in this thread are mostly blaming republicans.

2. The government doesn't do anything efficiently. The idea that Healthcare will get better in terms of service and/or cost under government control is borderline looney.

3. It isn't fair that a poor person could be stuck wolithout healthcare due to means. Likewise, it isn't fair that healthy people who take care of themselves would be forced to pay for the bad lifestyle choices of others. I get the idea of universal care. any proposed solutions for making people lead healthier lifestyles if we're all going to be on the hook for the repercussions of bad lifestyle decisions?


1. Agree. They could and should have passed both single payer and immigration reform. Instead we got some Frankenstein-like health insurance laws and a Deporter-in-Chief

2. Disagree. Government can run things well WHEN led and managed by professionals, not by egomaniacs or amateurs.

3. Agree.


And when has that been the case? Can you give an example?


Canada
Most European countries
Singapore
Japan
China

? I don't think China's healthcare system is great.


True, but compare where it is today and where it was 30 years ago. They have made significant progress while we are stagnant, at best.


Those aren't examples of government efficiently administering anything. And I was much more interesting in our own country and an example there since it is OUR government that would be managing, not someone from Singapore.

As for Canada. I personally know some who moved to the U.S. after retirement and a prime reason was healthcare availability.


Sure Europe's health care is efficient. They live longer than we do, and they pay half as much. Better outcome at less cost is the definition of efficiency.


+1.



This argument assumes that healthcare drives outcomes. While that is true in some cases (e.g., life-saving surgery outcomes will be driven by healthcare), I think more often than not, the relationship is reversed and outcomes drive care. If I drink a six pack of beer and eat at McDonald's three times a day, odds are that my health outcome will suck regardless of form of healthcare I receive.

I do recall that in 2009 one of the main arguments for the ACA was that access to preventative care would lead to a healthier population AND reduced overall overall healthcare costs. As far as I can tell, neither of those predictions have turned into reality 7 years later. Perhaps those that supported the ACA are ready to admit that this stuff is much more complicated that they originally thought and perhaps they should stop offering bad solutions?
Anonymous
The bottom line - the ACA is unsustainable for even the short term.
It needs a total revision. TOTAL.
This is what many of us have been saying for years.
Anonymous
Anonymous wrote:
Anonymous wrote:1. Democrats had a once-in-fifty years filibuster-proof control of the legislature and the White House. Congrats could have easily passed single payer but--in hopes of retaining political power--Obama and the Democrats blinked. Yet posters in this thread are mostly blaming republicans.

2. The government doesn't do anything efficiently. The idea that Healthcare will get better in terms of service and/or cost under government control is borderline looney.

3. It isn't fair that a poor person could be stuck wolithout healthcare due to means. Likewise, it isn't fair that healthy people who take care of themselves would be forced to pay for the bad lifestyle choices of others. I get the idea of universal care. any proposed solutions for making people lead healthier lifestyles if we're all going to be on the hook for the repercussions of bad lifestyle decisions?




What's not fair is declaring half the country poor and deciding to give them "free stuff". Yes, saying you are going to bill someone a couple of thousand for yearly health insurance and then declaring them poor at the drop of a hat and therefore subsidize their plan is free stuff.

Remember, Obama front loaded this by stealing $700 Billion from medicare and giving it to Obamacare. To say this was all and accident and there's no way to know Obamacare would never work is a crock-o-shit.

These mental giants in gubmint couldn't even put the healthcare.gov website together for $600 million, three years and nearly unlimited resources and people. Is anyone surprised by this?

3,000 pages that linked to another 20,000 pages of BS policy. Another gubmint debacle.


Honorable people like a PP bought coverage when available for those with a pre-existing condition under the ACA. Many without a pre-existing condition did not. Perhaps penalties are too low for NOT purchasing coverage. I assume they will buy when an issue presents. However this doesn't spread risk-it creates automatic claims with inadequate reserves. Of course insurers want out. $2085...... http://www.modernhealthcare.com/article/20151031/MAGAZINE/310319963
Anonymous
Anonymous wrote:The bottom line - the ACA is unsustainable for even the short term.
It needs a total revision. TOTAL.
This is what many of us have been saying for years.



What revision would you like to see?

Anonymous
Anonymous wrote:
Anonymous wrote:The bottom line - the ACA is unsustainable for even the short term.
It needs a total revision. TOTAL.
This is what many of us have been saying for years.



What revision would you like to see?



Revisions. Plural.

Remove all the stupid mandates like birth control and pediatric dental coverage.
Keep the preexisting condition piece.
Sell policies across state lines. It’s crazy that you have to get a brand new policy when you move 20 miles across state lines.
Add tort reform.
Sell health insurance much like car insurance or homeowners insurance - rates are higher for those who have higher risks. Sorry, but that is how insurance generally works. The healthy should not be subsidizing the unhealthy.
Make hospitals/doctors more accountable by including itemized treatment items to patient. Transparency. Insurance companies can even provide incentives for those who find errors.
These are just ideas for a start.
Permit the customer to select the benefits. Novel idea, I know, that people know better what they need than the government.

In the end, we need to make health insurance more competitive.
Anonymous
Those sound like good ideas. If we start over, where does the money come from for this new program? That had to front load Obamacare and it still broke down.

Do we take another one trillion from medicare or insist it be revenue neutral right out of the gate?

What do we do with the 20% of the people who will use 80% of the benefits, since we keep the pre-existing conditions stuff?

Anonymous
correction "They had to front load"
Anonymous
Anonymous wrote:Those sound like good ideas. If we start over, where does the money come from for this new program? That had to front load Obamacare and it still broke down.

Do we take another one trillion from medicare or insist it be revenue neutral right out of the gate?

What do we do with the 20% of the people who will use 80% of the benefits, since we keep the pre-existing conditions stuff?



I truly don’t know the answers to your questions.
But, I do know that we don’t continue with this monstrosity of a program just ..... because.
As a senior myself, I also believe that we should pay more into medicare.

And,,, those 20%.....they do need to pay more.

Also, I think health savings accounts should be encouraged.... strongly. When you are paying your own money for something, you tend to take care of it better.
I am with Ben Carson on the health savings accounts. And, they should be able to be bequeathed to heirs. A reward for doing something right.
Anonymous
I think those are all good points.

I believe that we need many smaller systems in different states all competing with each other. Competition is key.

When you have central planning from a large bureaucracy in Washington DC, they become a self-fulfilling prophecy and stop listening to the people in the hinterlands (anyone who is not within a stones throw of DC) and they rule by fiat and edict because it sounds good on paper.

Many of the problems we have are because of out of touch people who think they know how to rule us and it makes them feel good and they believe they're doing it for the greater good when all they're doing is damage.

Central planning by bureaucrats brought down the iron curtain countries, Russia and even China had to find better ways. I hope we do before we allow the statists to kill us for the Free Shit Army (FSA).
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:1. Democrats had a once-in-fifty years filibuster-proof control of the legislature and the White House. Congrats could have easily passed single payer but--in hopes of retaining political power--Obama and the Democrats blinked. Yet posters in this thread are mostly blaming republicans.

2. The government doesn't do anything efficiently. The idea that Healthcare will get better in terms of service and/or cost under government control is borderline looney.

3. It isn't fair that a poor person could be stuck wolithout healthcare due to means. Likewise, it isn't fair that healthy people who take care of themselves would be forced to pay for the bad lifestyle choices of others. I get the idea of universal care. any proposed solutions for making people lead healthier lifestyles if we're all going to be on the hook for the repercussions of bad lifestyle decisions?


1. Agree. They could and should have passed both single payer and immigration reform. Instead we got some Frankenstein-like health insurance laws and a Deporter-in-Chief

2. Disagree. Government can run things well WHEN led and managed by professionals, not by egomaniacs or amateurs.

3. Agree.


And when has that been the case? Can you give an example?


Canada
Most European countries
Singapore
Japan
China

? I don't think China's healthcare system is great.


True, but compare where it is today and where it was 30 years ago. They have made significant progress while we are stagnant, at best.


Those aren't examples of government efficiently administering anything. And I was much more interesting in our own country and an example there since it is OUR government that would be managing, not someone from Singapore.

As for Canada. I personally know some who moved to the U.S. after retirement and a prime reason was healthcare availability.


Sure Europe's health care is efficient. They live longer than we do, and they pay half as much. Better outcome at less cost is the definition of efficiency.


+1.


It can vary. My ILs live in the UK, and each "trust" runs independently. Treatment varies by trust. Some hospitals will offer great treatment for cancer, for example, whereas others might now offer certain types of treatment for the same issue. And you can't go to whatever hospital you want for treatment. A friend there has cancer, and he said he was lucky to live in the city he does because their hospital offers a certain treatment that he couldn't get in the neighboring town. It's weird.


That's in fact great news.

The US system gets sold as "great choice," when what we really want, and Europeans get, is "great care at little cost."

The real-world alternative to "great care at little cost' is often "many options -- all substandard and crazy expensive"

Except it sucks for you if you need that treatment, and the hospital that you have to go to doesn't offer it.


If you need that treatment, you get it. That's what national health systems do very well.

If you want that treatment, that's a different story.
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