The main problem with the Affordable Care Act is that Democrats assumed that when the government provided health insurance subsidies for people without employer plans and for low/moderate income people offered small group plans, that states and insurance companies would act as they have in the past, take the money and participate in the program.

But the tea party bullshit caused all the Republican governors and legislatures to completely lose their minds so they not only refused the Medicaid expansion, they also obstructed the formation of competition in the insurance exchanges in their states.

Much of the insurance industry also did not participate, even with federal subsidies because the truth is they do not want to cover low-income people or people with chronic health problems, or anyone else but young, healthy people with good incomes.

The insurance industry did, however, take advantage of the ACA as an excuse to raise premiums in plans outside the exchanges as much as allowable and make changes in their plans that would increase the out of pocket costs for older workers as a way of discouraging them from participating.

All of that would have been solved with a public option, but that could not get through the Senate.

How can anyone think that involving insurance companies will reduce health care costs?

Insurance companies add the cost of administering insurance PLUS profits to the entire system. Period.

We need government health care.

Anonymous wrote:

Anonymous wrote:The biggest problem is that we did not do this post-WWII when other Western democracies did. It's hard to imagine how the many-headed hydra (in terms of the payment apparatuses) we have has develop since then can be turned into something else and where all the wasted dollars that support that beast will be clawed back from it.

The German approach, inasmuch as I understand it, would probably be the most workable. But I would be completely in favor of Medicare for All, whether as a buy-in or as universal coverage.

+1

I am not sure we can ever have a sound German-like system here, because our political class is essentially useless at policy-making and implementation.

Look at public education. There we tried a more universal approach, and still our system is worse and more expensive than in any other developed country.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everybody is getting their panties in a twist about health insurance costs, but what we actually need is a national discussion about health care costs. Why is it so expensive to have any health care procedure done here, especially when compared to the rest of the world? We can moan about health insurance, but until health care costs are brought under control, nothing will change. Bring down health care costs, and people will not be going bankrupt. Insurance should be for "major stuff" like cancer treatment, surgery, etc. We should not be using it for checkups, flu shots, etc. However, we can't pay for these things out of pocket right now because they are priced too high.

+ a million.

Obamacare ignored this basic fact, creating an even less affordable healthcare system.

+1. Yes! And no one ever wants to discuss this. Until this is addressed, all of these plans are just cost-shifting with different winners and losers.

+1!!!!! Unfortunately, our political system has degenerated to a point where this is not possible.

Pro tip -- lobbyists love this partisan circus which allows them to do their business in the dark

Yet another +1 to the need to actual control healthcare costs

I take a medicine that has a $100 monthly co-pay, which is a huge amount of money until you see the list price is $900 a month (over 10k a year!). I assume the insurance company gets some of that knocked off but it’s still probably many hundreds of dollars a month. For one drug - crazy.

This is the root issue. Too much money going into big pharm, insurance, and lobbyist pockets. And the Rs and most of the Ds are fine with that.

Obamacare passed because Dems (not R) made an obscene pact with pharma and insurers and hospitals. They would support ACA and get filthy rich in exchange.

The "affordable" thingy was a joke from day 1.

The GOP must have a great plan proposed to reduce costs and get everyone's hands out of the cookie jar. Oh wait! Their hands are in the cookie jar too and they have no plan!!

Anonymous wrote:The biggest problem is that we did not do this post-WWII when other Western democracies did. It's hard to imagine how the many-headed hydra (in terms of the payment apparatuses) we have has develop since then can be turned into something else and where all the wasted dollars that support that beast will be clawed back from it.

The German approach, inasmuch as I understand it, would probably be the most workable. But I would be completely in favor of Medicare for All, whether as a buy-in or as universal coverage.

+1

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everybody is getting their panties in a twist about health insurance costs, but what we actually need is a national discussion about health care costs. Why is it so expensive to have any health care procedure done here, especially when compared to the rest of the world? We can moan about health insurance, but until health care costs are brought under control, nothing will change. Bring down health care costs, and people will not be going bankrupt. Insurance should be for "major stuff" like cancer treatment, surgery, etc. We should not be using it for checkups, flu shots, etc. However, we can't pay for these things out of pocket right now because they are priced too high.

+ a million.

Obamacare ignored this basic fact, creating an even less affordable healthcare system.

+1. Yes! And no one ever wants to discuss this. Until this is addressed, all of these plans are just cost-shifting with different winners and losers.

+1!!!!! Unfortunately, our political system has degenerated to a point where this is not possible.

Pro tip -- lobbyists love this partisan circus which allows them to do their business in the dark

Yet another +1 to the need to actual control healthcare costs

I take a medicine that has a $100 monthly co-pay, which is a huge amount of money until you see the list price is $900 a month (over 10k a year!). I assume the insurance company gets some of that knocked off but it’s still probably many hundreds of dollars a month. For one drug - crazy.

This is the root issue. Too much money going into big pharm, insurance, and lobbyist pockets. And the Rs and most of the Ds are fine with that.

Obamacare passed because Dems (not R) made an obscene pact with pharma and insurers and hospitals. They would support ACA and get filthy rich in exchange.

The "affordable" thingy was a joke from day 1.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everybody is getting their panties in a twist about health insurance costs, but what we actually need is a national discussion about health care costs. Why is it so expensive to have any health care procedure done here, especially when compared to the rest of the world? We can moan about health insurance, but until health care costs are brought under control, nothing will change. Bring down health care costs, and people will not be going bankrupt. Insurance should be for "major stuff" like cancer treatment, surgery, etc. We should not be using it for checkups, flu shots, etc. However, we can't pay for these things out of pocket right now because they are priced too high.

+ a million.

Obamacare ignored this basic fact, creating an even less affordable healthcare system.

+1. Yes! And no one ever wants to discuss this. Until this is addressed, all of these plans are just cost-shifting with different winners and losers.

+1!!!!! Unfortunately, our political system has degenerated to a point where this is not possible.

Pro tip -- lobbyists love this partisan circus which allows them to do their business in the dark

Yet another +1 to the need to actual control healthcare costs

I take a medicine that has a $100 monthly co-pay, which is a huge amount of money until you see the list price is $900 a month (over 10k a year!). I assume the insurance company gets some of that knocked off but it’s still probably many hundreds of dollars a month. For one drug - crazy.

This is the root issue. Too much money going into big pharm, insurance, and lobbyist pockets. And the Rs and most of the Ds are fine with that.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op, not going to read all this crap. I lost my company provided healthcare two years ago when the cost soared to twenty plus thousand per employee. That’s not what I paid but at some point our small company of thirty employees could not support a plan. Had a few individuals but my pop with deductibles was close to twenty thousand. I am now uninsured for the first time in thirty years. I use my money to pay for a concierge doctor and hope for the best for my long term health.

Yup, another victim of Obamacare and Dem false promises.

Only Warren or Sanders would make things even worse.

Those DC folks who have never run anything don't know how to get anything done. We need some Governors in the race.

My husband too. Owns a business with about 10 full time employees. Used to provide healthcare (paid 100% employee premium, but no dependent care- employee paid for dependents). The first 2? Years or so of ACA weren’t bad (and we got a tax incentive to help, also) but it quickly became unaffordable. We now buy a (worthless) plan on the ACA. The employees go without or buy plans on the ACA (heavily subsidized). In many ways this doesn’t make sense- we used to pay something (100% of employee premium) at least, but now that is all foisted onto taxpayers. This just makes no sense (from a public policy perspective). It almost as if the government doesn’t WANT us to provide insurance at al. So the taxpayers now pick up the whole tab.

The government wanted everyone to have insurance. Hence ACA. Can you explain the R plan that allows everyone to buy insurance that actually pays for well checks, prescriptions, etc..?

The government wanted everyone to have insurance? Or they wanted everyone to have HEALTH CARE? because they are NOT THE SAME THJNG. I know tons of people (tons) who HAVE insurance but can not afford health care!!!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op, not going to read all this crap. I lost my company provided healthcare two years ago when the cost soared to twenty plus thousand per employee. That’s not what I paid but at some point our small company of thirty employees could not support a plan. Had a few individuals but my pop with deductibles was close to twenty thousand. I am now uninsured for the first time in thirty years. I use my money to pay for a concierge doctor and hope for the best for my long term health.

Yup, another victim of Obamacare and Dem false promises.

Only Warren or Sanders would make things even worse.

Those DC folks who have never run anything don't know how to get anything done. We need some Governors in the race.

My husband too. Owns a business with about 10 full time employees. Used to provide healthcare (paid 100% employee premium, but no dependent care- employee paid for dependents). The first 2? Years or so of ACA weren’t bad (and we got a tax incentive to help, also) but it quickly became unaffordable. We now buy a (worthless) plan on the ACA. The employees go without or buy plans on the ACA (heavily subsidized). In many ways this doesn’t make sense- we used to pay something (100% of employee premium) at least, but now that is all foisted onto taxpayers. This just makes no sense (from a public policy perspective). It almost as if the government doesn’t WANT us to provide insurance at al. So the taxpayers now pick up the whole tab.

The government wanted everyone to have insurance. Hence ACA. Can you explain the R plan that allows everyone to buy insurance that actually pays for well checks, prescriptions, etc..?

Hahahahaha the ACA pays for prescriptions? News to me. Sure- after I meet our 14k deductible, or whatever it is. We’ve been on ACA (pay full premium- no subsidies) since the beginning. Our insurance has never even once paid for anything besides “well checks”
And vaccines. Which is great and all, but those things are rather inexpensive. We have paid OOP for every.single.prescription. and every.single.sick visit. 100% of it. For how many years now...all the ACA is to us, is extremely expensive bankruptcy insurance. Mid 40s couple, 3 kids, all healthy no pre-existing conditions.

Abh but you must be middle clsss. The group that now can not afford care. But if you were poor? Everything is free. Bill Clinton said it best. Absolutely insane d.

The biggest problem is that we did not do this post-WWII when other Western democracies did. It's hard to imagine how the many-headed hydra (in terms of the payment apparatuses) we have has develop since then can be turned into something else and where all the wasted dollars that support that beast will be clawed back from it.

The German approach, inasmuch as I understand it, would probably be the most workable. But I would be completely in favor of Medicare for All, whether as a buy-in or as universal coverage.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op, not going to read all this crap. I lost my company provided healthcare two years ago when the cost soared to twenty plus thousand per employee. That’s not what I paid but at some point our small company of thirty employees could not support a plan. Had a few individuals but my pop with deductibles was close to twenty thousand. I am now uninsured for the first time in thirty years. I use my money to pay for a concierge doctor and hope for the best for my long term health.

Yup, another victim of Obamacare and Dem false promises.

Only Warren or Sanders would make things even worse.

Those DC folks who have never run anything don't know how to get anything done. We need some Governors in the race.

My husband too. Owns a business with about 10 full time employees. Used to provide healthcare (paid 100% employee premium, but no dependent care- employee paid for dependents). The first 2? Years or so of ACA weren’t bad (and we got a tax incentive to help, also) but it quickly became unaffordable. We now buy a (worthless) plan on the ACA. The employees go without or buy plans on the ACA (heavily subsidized). In many ways this doesn’t make sense- we used to pay something (100% of employee premium) at least, but now that is all foisted onto taxpayers. This just makes no sense (from a public policy perspective). It almost as if the government doesn’t WANT us to provide insurance at al. So the taxpayers now pick up the whole tab.

Indeed.

As Bill Clinton memorably said, this ACA thing is a crazy thing.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op, not going to read all this crap. I lost my company provided healthcare two years ago when the cost soared to twenty plus thousand per employee. That’s not what I paid but at some point our small company of thirty employees could not support a plan. Had a few individuals but my pop with deductibles was close to twenty thousand. I am now uninsured for the first time in thirty years. I use my money to pay for a concierge doctor and hope for the best for my long term health.

Yup, another victim of Obamacare and Dem false promises.

Only Warren or Sanders would make things even worse.

Those DC folks who have never run anything don't know how to get anything done. We need some Governors in the race.

My husband too. Owns a business with about 10 full time employees. Used to provide healthcare (paid 100% employee premium, but no dependent care- employee paid for dependents). The first 2? Years or so of ACA weren’t bad (and we got a tax incentive to help, also) but it quickly became unaffordable. We now buy a (worthless) plan on the ACA. The employees go without or buy plans on the ACA (heavily subsidized). In many ways this doesn’t make sense- we used to pay something (100% of employee premium) at least, but now that is all foisted onto taxpayers. This just makes no sense (from a public policy perspective). It almost as if the government doesn’t WANT us to provide insurance at al. So the taxpayers now pick up the whole tab.

The government wanted everyone to have insurance. Hence ACA. Can you explain the R plan that allows everyone to buy insurance that actually pays for well checks, prescriptions, etc..?

Hahahahaha the ACA pays for prescriptions? News to me. Sure- after I meet our 14k deductible, or whatever it is. We’ve been on ACA (pay full premium- no subsidies) since the beginning. Our insurance has never even once paid for anything besides “well checks”
And vaccines. Which is great and all, but those things are rather inexpensive. We have paid OOP for every.single.prescription. and every.single.sick visit. 100% of it. For how many years now...all the ACA is to us, is extremely expensive bankruptcy insurance. Mid 40s couple, 3 kids, all healthy no pre-existing conditions.

Anonymous wrote:Not going to happen. Supplemental policies will be offered just like for employees over 65 now.

This, or we’ll end up with a public option/Medicare for those who want it.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op, not going to read all this crap. I lost my company provided healthcare two years ago when the cost soared to twenty plus thousand per employee. That’s not what I paid but at some point our small company of thirty employees could not support a plan. Had a few individuals but my pop with deductibles was close to twenty thousand. I am now uninsured for the first time in thirty years. I use my money to pay for a concierge doctor and hope for the best for my long term health.

Yup, another victim of Obamacare and Dem false promises.

Only Warren or Sanders would make things even worse.

Those DC folks who have never run anything don't know how to get anything done. We need some Governors in the race.

My husband too. Owns a business with about 10 full time employees. Used to provide healthcare (paid 100% employee premium, but no dependent care- employee paid for dependents). The first 2? Years or so of ACA weren’t bad (and we got a tax incentive to help, also) but it quickly became unaffordable. We now buy a (worthless) plan on the ACA. The employees go without or buy plans on the ACA (heavily subsidized). In many ways this doesn’t make sense- we used to pay something (100% of employee premium) at least, but now that is all foisted onto taxpayers. This just makes no sense (from a public policy perspective). It almost as if the government doesn’t WANT us to provide insurance at al. So the taxpayers now pick up the whole tab.

The government wanted everyone to have insurance. Hence ACA. Can you explain the R plan that allows everyone to buy insurance that actually pays for well checks, prescriptions, etc..?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op, not going to read all this crap. I lost my company provided healthcare two years ago when the cost soared to twenty plus thousand per employee. That’s not what I paid but at some point our small company of thirty employees could not support a plan. Had a few individuals but my pop with deductibles was close to twenty thousand. I am now uninsured for the first time in thirty years. I use my money to pay for a concierge doctor and hope for the best for my long term health.

Yup, another victim of Obamacare and Dem false promises.

Only Warren or Sanders would make things even worse.

Those DC folks who have never run anything don't know how to get anything done. We need some Governors in the race.

My husband too. Owns a business with about 10 full time employees. Used to provide healthcare (paid 100% employee premium, but no dependent care- employee paid for dependents). The first 2? Years or so of ACA weren’t bad (and we got a tax incentive to help, also) but it quickly became unaffordable. We now buy a (worthless) plan on the ACA. The employees go without or buy plans on the ACA (heavily subsidized). In many ways this doesn’t make sense- we used to pay something (100% of employee premium) at least, but now that is all foisted onto taxpayers. This just makes no sense (from a public policy perspective). It almost as if the government doesn’t WANT us to provide insurance at al. So the taxpayers now pick up the whole tab.

ETA: and several employees would be much WORSE off if we did offer heath care. They’d lose their subsidies. 2 single moms of moderate income. In what world does this make ANY sense!?