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[quote=Anonymous][quote=Anonymous][quote=Anonymous]OP your story is very moving.  A sick child is a heartbreaking situation.  No one wants a child to suffer, and I wish your child the best possible outcome.

There are several questions that need to be answered with this example:

1.  If healthcare is an entitlement, are we entitled to have any and all treatment that we want?  There is a difference between giving any and all treatment and alleviating suffering.

2.  Resources ARE limited, even with pooled resources from taxes. Resources are limited by merely the number of hospital beds available, the time and appointment slots for specialists and other providers, the amount of money for equipment, facilities, and medication.  Who decides the cost/benefit of treatment? Who decides who gets priority treatment?

As an aside, the portable care act, passed years ago, insures patients will not be denied coverage for pre-existing conditions if continuous coverage is maintained.  It is very important that consumers are aware of their rights and obligations in using and maintaining health insurance.

I think people imagine that Medicare for all means you will get any treatment that you desire at any time.  That is not what it means.  In fact, Medicare for all will have a strict formulary, strict requirements for qualifying for certain treatments, strict requirements for accessing specialty care, and cost/benefit analysis driven care.  OP, your daughter would likely benefit from such a plan, but there will be other patients who would be losers.

OP, understandably, you want the best for your daughter, but a planning a comprehensive healthcare strategy can’t be accomplished through an emotional lense.  FWIW, I am republican who wants some form of high deductible universal catastrophic coverage for all and a separate government pool for high risk coverage, for patients like your daughter.  I also think insurance should be uncoupled from employment for greater coverage security.

Obamacare was very ambitious and got some things right, but it also is very flawed.  It is flawed in it’s cost shifting.  It is flawed in it’s failure to control costs.  So, as part of a community, OP, I want your daughter to have care.  However, I do not believe Obamacare achieves care equity or is the best use of our community resources.[/quote]

Pp, I appreciate your response, but I wonder when all these great Republican ideas will be passed.  I have done my part- I pay for insurance and I always have.  Now I have Republican legislators who want to take that away.  Don’t show me your preferred ideas about healthcare- show me the legislation. Obamacare is what is standing between me and financial ruin, so your perfect is the enemy of the good objections do little to convince me.

Also, the separate government pool idea has been thoroughly debunked by people much smarter about policy than me- show me the legislation because why argue about something that isn’t going to happen?  Obamacare is inadequate but it is real.  Other ideas- not sure why they are worth discussing if Republican legislators won’t bother debating them.

Also, come on.  Sometimes you can not maintain continuous insurance coverage.  I don’t understand why anyone would think this is a reasonable requirement.  What if someone with an illness simply loses their job?

Further, as you state, costs are out of control.  My daughter had an 8 hour surgery- approximately $30-40,000.  5 days in the children’s hospital?  $70,000.  Why does it cost more than $10,000 a night to sit in a hospital room?  Why do you think rationing is a bad thing?  Rationing is already happening, but it’s people with lousy insurance who are taking the bulk of the burden.  Don’t worry- the hospital was no where near full, and already have to wait several months for surgery for many reasons.  This system is not working.  We would not have to be so scared of “rationing” if costs made any sense at all.[/quote]

Your further comments show why this system is broken.  We are using resources to try to provide access to healthcare for everyone when it costs $70,000 a pop for one surgery for one patient, for example.  Obamacare did not control those costs, so we are depleting all of our resources by sticking with this failed patch-worked plan, which you insist we must because, well, you have your coverage. You state exactly why I think Obamacare does not provide equity and cost-shifts - the people with lousy insurance who are now “underinsured” with their new expensive Obamacare plans.

High risk pools have been used in states prior to Obamacare, in fact, in the northeast.

If employment and insurance were uncoupled, losing a job would have less of an impact on continuous coverage. As you said, everyone has unplanned emergencies, however, a process for emergency coverage in those circumstances could be implemented.

Hospitals not being full is not what you think.  An empty bed is not empty because there are not patients.  It is empty because there is not the right kind of staff to staff it.  Hospitals become “full” when all their staff and resources are utilized, not literally when every physical bed has a patient.

Repeal and replace might be better termed as repair and revise.   Regardless, both Democrats and Republicans need to be working together.  Healthcare requires two major reforms to be functional:  cost control at both the institutional side and on the consumer side.  Consumers of healthcare have some responsibility in this also, and while it may not seem important, a 10% reduction in overall costs due to controlling preventable disease frees billions of dollars of resources.  Obamacare is simply not sustainable in it’s current form.

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