Finally. Good riddance to Obamacare.

[Shadow Wolf]

So much for good ideas. ;0)

If people cooperate in it, it does work wonders. The Dutch, for example, enjoy one of Europe's finest health care systems, and the ACA was modeled after their system.

 

[esmith]

If people cooperate in it, it does work wonders. The Dutch, for example, enjoy one of Europe's finest health care systems, and the ACA was modeled after their system.

Comment of the following?

The Drawbacks of Dutch-Style Health Care Rules: Lessons for Americans

 

[Underhill]

I'll believe it when it happens.
But it would be nice to see cheaper & more numerous choices for insurance.

I'm curious why people believe it will mean cheaper coverage? The only thing that will be cheaper is garbage plans.

The problem was not Obamacare driving up cost. It was that Obamacare didn't do enough to cut cost (after all, Obama swept into the presidency largely based upon the need for health care reform). I don't know that it could. This notion of cutting cost with a private system is nonsense. You cannot cut cost unless you control the system.

 

[metis]

If people cooperate in it, it does work wonders. The Dutch, for example, enjoy one of Europe's finest health care systems, and the ACA was modeled after their system.

And this was confirmed to me when talking with a woman in Amsterdam who grew up in NYC.

No one in the Netherlands goes bankrupt because of health-care costs, but between 70-80% of all personal bankruptcies here in the States have health-care costs as a major contributor.

 

[metis]

I'm curious why people believe it will mean cheaper coverage? The only thing that will be cheaper is garbage plans.

The problem was not Obamacare driving up cost. It was that Obamacare didn't do enough to cut cost (after all, Obama swept into the presidency largely based upon the need for health care reform). I don't know that it could. This notion of cutting cost with a private system is nonsense. You cannot cut cost unless you control the system.

I want to repost the above for its simplicity and correctness. The CBO ran an analysis of what would happen if the ACA was just dropped, and the effect would be financially catastrophic.

 

[Revoltingest]

I'm curious why people believe it will mean cheaper coverage? The only thing that will be cheaper is garbage plans.

How do you know the plans we lost or have been kept from us are worse?
People I know are now paying more for less under Obamacare.

The problem was not Obamacare driving up cost. It was that Obamacare didn't do enough to cut cost (after all, Obama swept into the presidency largely based upon the need for health care reform). I don't know that it could. This notion of cutting cost with a private system is nonsense. You cannot cut cost unless you control the system.

Obamacare actually did drive up costs.
- Directly with an excise tax on medical devices, & with requiring unneeded coverage.
- Indirectly by eliminating competition.

 

[Twilight Hue]

I want to repost the above for its simplicity and correctness. The CBO ran an analysis of what would happen if the ACA was just dropped, and the effect would be financially catastrophic.

It's catastrophic now. Look at deductibles. Look at the increases slated for 2017.

 

[Shadow Wolf]

Comment of the following?

The Drawbacks of Dutch-Style Health Care Rules: Lessons for Americans

It's very outdated and today the Dutch system is consistently ranked as one of Europe's best across many groups and organizations.

 

[Monk Of Reason]

It's very outdated and today the Dutch system is consistently ranked as one of Europe's best across many groups and organizations.

I'd still prefer a single payer. It cuts costs better for the overall.

 

[Underhill]

How do you know the plans we lost or have been kept from us are worse?
People I know are now paying more for less under Obamacare.

Two reasons. First, the cost increases (the rate of increase) have not escalated under Obamacare. Before Obamacare the cost were going up at a crazy rate (thus all the complaining), after Obamacare it went up at roughly the same rate. So yes, they are getting less for more, but they would have anyway due to cost increases year on year that were 3-4 times the inflation rate.

Second because the plan didn't do much to increase cost. Oh there were a few things like covering those with preexisting conditions. But there were also some legitimate cost cutting measures (like forcing more healthy people to pick up insurance) to offset them.

I've heard reports on both ends of the spectrum but I suspect over it's life it has basically been a wash. When it first came out, insurance companies were convinced cost would fall. But the lack of young people signing up initially meant they didn't. So they had to raise prices dramatically the second year. It has been more of the same. But overall I think the average increase hasn't changed much.

Obamacare actually did drive up costs.
- Directly with an excise tax on medical devices, & with requiring unneeded coverage.
- Indirectly by eliminating competition.

The problem was that they were trying to keep cost down on the back end. Force insurers to offer cheaper plans. Many of them dropped out due to this. It doesn't work. As I said in my previous post, you cannot drive prices down if you don't have control of the system. This is why cost have gone up so quickly for the last few decades. There are so many for profit levels in the current system and all of them expect better year end results than the previous year. It's a recipe for disaster. Things were different when health care was a private doctor and a local hospital. Now it is layers of for profit corporations all working to increase those profits.

Things would look a lot different right now if Obama had gotten his single payer alternative like he originally wanted. The ironic part is that Republicans are now in a real bind. What do you replace Obamacare with, that doesn't look like socialism and doesn't cost more? They've shot themselves in the foot.

 

[Shad]

Okay, what would you have Obama do (or have had Obama done)? The back and forth, to which you are replying, is a charge that Obama is to blame for the Australian involvement in conflict abroad. Is this a charge you wish to levy as well?

Australia has an alliance, ANZUS, with America which obligates them to take part in these "wars" on terrorism. Since Obama use kid gloves rather than crushing the source of terrorism such as Iranian funding there is no resolving the conflict itself, just the flare ups as they come and go. This creates a situation in which Australia holds to it's treaty or nullifies it. If the former Australia is stuck in a conflict with no end in sight. If it nullifies it there will be political fallout.

 

[Revoltingest]

Two reasons. First, the cost increases (the rate of increase) have not escalated under Obamacare. Before Obamacare the cost were going up at a crazy rate (thus all the complaining), after Obamacare it went up at roughly the same rate.

I recall metis crediting Obamcare with reducing the rate of increase, beginning even before Obamacare took effect.
If he's correct, then Obamacare caused an increase. But let's set this aside as an error.
If Obamacare left the increase the same, I'd call that failure.

So yes, they are getting less for more, but they would have anyway due to cost increases year on year that were 3-4 times the inflation rate.

You can't simply assume the rate would be higher without Obamacare.

Second because the plan didn't do much to increase cost. Oh there were a few things like covering those with preexisting conditions. But there were also some legitimate cost cutting measures (like forcing more healthy people to pick up insurance) to offset them.

Imposing income redistribution is nevertheless a cost increase for those bearing that burden.
Moreover, it's effectively a regressive tax.

I've heard reports on both ends of the spectrum but I suspect over it's life it has basically been a wash. When it first came out, insurance companies were convinced cost would fall. But the lack of young people signing up initially meant they didn't. So they had to raise prices dramatically the second year. It has been more of the same. But overall I think the average increase hasn't changed much.

Since the plan depended upon the young subsidizing the sickly, their failure to sign up caused Obamacare's failure to be affordable for many who previously could afford it.

The problem was that they were trying to keep cost down on the back end. Force insurers to offer cheaper plans. Many of them dropped out due to this. It doesn't work. As I said in my previous post, you cannot drive prices down if you don't have control of the system. This is why cost have gone up so quickly for the last few decades. There are so many for profit levels in the current system and all of them expect better year end results than the previous year. It's a recipe for disaster. Things were different when health care was a private doctor and a local hospital. Now it is layers of for profit corporations all working to increase those profits.

Things would look a lot different right now if Obama had gotten his single payer alternative like he originally wanted. The ironic part is that Republicans are now in a real bind. What do you replace Obamacare with, that doesn't look like socialism and doesn't cost more? They've shot themselves in the foot.

We don't know if a single payer system designed under Obama would be any better.
He had no experience in system design.

 

[Shadow Wolf]

I'd still prefer a single payer. It cuts costs better for the overall.

I would too prefer single payer, but people who want to think the ACA is a complete and total disaster, that it just can't work, and that it was "wait and see legislation" just do not want to swallow reality. And instead of blaming insurance companies, Republican states that refused to expand medicare/caid and set up their own exchanges, and others who just refused to cooperate and make things worse, they'd just rather blame it all on Obama.

 

[Monk Of Reason]

I would too prefer single payer, but people who want to think the ACA is a complete and total disaster, that it just can't work, and that it was "wait and see legislation" just do not want to swallow reality. And instead of blaming insurance companies, Republican states that refused to expand medicare/caid and set up their own exchanges, and others who just refused to cooperate and make things worse, they'd just rather blame it all on Obama.

I am not a big fan of it overall. There were many stipulations that were added that made it less desierable. The major one was the removal of the public option. Also there was zero control or regulation on the deductable and minimal/lackluster on the premiums. For example if you work and get insurance through your job they can charge you up to I think 15% of your monthy income prior to taxes? It might be 20 but I think its 15%. This is good. It means that a job that is providing your health insurance can't give you a plan that exceeds that amount or they have to adjust it as well. However we have 3 major problems with this plan.
1st- The maximum is personal only. Children and other dependents can in total exceed that 15%. It was closer to 35% for my dad to cover my mom and my two siblings.
2nd- This often makes insurance companies choose worse insurances so that they get the cheapest and worst plans out there. This also as part 2 of the 2nd point caused many buisinesses to hire more part time employees and make sure to work them only 29 hours and less to dodge the stipulation of offering health insurance.
3rd- They cut off all help and options of the government funded subsidies if you have a job that offers you health insurance. This does not matter how much you make. In most states medicaid was not expanded and if you were not disabled and did not have children you did not qualify.

So if you had someone who worked 31 hours a week at mcdonalds and brought home (lets say they made 8 bucks an hour) 240 a week and 960 a month. They can charge a prmium of up to 36 dollars a paycheck or 144 a month for insurance. Then we take out taxes which is usually low but ends up coming to about 36 bucks in most states. So they get 204 a week but are forced to give up 36 bucks of it a week to insurance so they are left with 168 a week to live off of. If they are not disabled and do not have children they are not eligible for food stamps or medicaid. This puts them in a bind.

Here is why it works for the Dutch. In Norway for example the minimum wage is 17.29 an hour. Average cost of living is fairly low and they don't have to pay for college out of pocket. We have massive income inequality and a TREMENDOUS amount of people who make next to nothing in our current job market. Democrats are wrong when they say our economy is doing well. The majority of the new jobs we have are low paying service jobs. Aboutt 30% of our hourly workers that are over the age of 18 are working for minimum wage or near it. The majority of our workers are hourly workers. This is a huge chunk of the population. One huge problem with people who don't get off welfare is becaues they know that they make about as much money getting a thousand dollar check from the government than if they worked full time at mcdonalds or some other local job. HOwever then they don't have any time and added expenses of having to travel. I can't blame someone for making that choice really.

So our healthcare issue is a reall issue but the ACA is not anywhere near as functional as it should be because of our **** economic situation.

 

[Shadow Wolf]

So if you had someone who worked 31 hours a week at mcdonalds and brought home (lets say they made 8 bucks an hour) 240 a week and 960 a month. They can charge a prmium of up to 36 dollars a paycheck or 144 a month for insurance. Then we take out taxes which is usually low but ends up coming to about 36 bucks in most states. So they get 204 a week but are forced to give up 36 bucks of it a week to insurance so they are left with 168 a week to live off of. If they are not disabled and do not have children they are not eligible for food stamps or medicaid. This puts them in a bind.

I'm in that situation myself. Insurance from an employer could potentially mean a huge hit in monthly expenses as well as a reduction in the quality of my insurance, because if your employer offers insurance you are not eligible for HIP.

 

[Monk Of Reason]

I'm in that situation myself. Insurance from an employer could potentially mean a huge hit in monthly expenses as well as a reduction in the quality of my insurance, because if your employer offers insurance you are not eligible for HIP.

Yep. This honestly is far worse than the obligatory stipulation with a fine if you are noncompliant. Well...it at least makes it far worse. Many people out there aren't just lazy when they don't have insurance. Some just aren't in a position to get it without breaking the bank.

 

[Shadow Wolf]

Yep. This honestly is far worse than the obligatory stipulation with a fine if you are noncompliant. Well...it at least makes it far worse. Many people out there aren't just lazy when they don't have insurance. Some just aren't in a position to get it without breaking the bank.

A voc rehab case manager I briefly had was blunt with me in I needed to really watch what sort of insurance is offered, because I'll loose my HIP, and since I am a "high risk" patient my costs, even with insurance, can go through the roof.
And because Indiana opted out of making it's own exchange, going to the federal exchange is royal pain. First you sign up and are told you do not qualify because the state offers HIP, and you have to go apply for that, and be denied, and then go back to the Federal site. I haven't made it back that far yet, but if it happens I know it's going to be beginning with a phone call to them explaining I need cleared because I don't qualify for HIP. And even around here, a federal plan can easily eat up about 10% of your income if you have a good paying job.
Yes, the ACA is not perfect, but the real concerns get buried over echo-chamber malarkey. Such as, it's hardly mentioned that full time employment over 25 hours a week has become rather difficult to find, making things even harder for the poor when even management positions become part time and no benefits. But, instead, people would rather blame the ACA over stuff that is really nothing. People complained about the website crashing, but that was to be expected because it was dealing with extremely heavy traffic. People don't get that, but they went on and on about how that was a failure. They want to blame the ACA for rising costs, but ignore that it actually has slowed it some and that, more or less, insurance companies and pharmaceutical companies are solely responsibly for artificially inflating the cost of health care very far beyond reason. And instead of doing what we should, which is eating better and exercising more, we'd rather just take a pill and fuel this very vicious cycle of for-profit and profit-based healthcare.

 

[Monk Of Reason]

A voc rehab case manager I briefly had was blunt with me in I needed to really watch what sort of insurance is offered, because I'll loose my HIP, and since I am a "high risk" patient my costs, even with insurance, can go through the roof.
And because Indiana opted out of making it's own exchange, going to the federal exchange is royal pain. First you sign up and are told you do not qualify because the state offers HIP, and you have to go apply for that, and be denied, and then go back to the Federal site. I haven't made it back that far yet, but if it happens I know it's going to be beginning with a phone call to them explaining I need cleared because I don't qualify for HIP. And even around here, a federal plan can easily eat up about 10% of your income if you have a good paying job.
Yes, the ACA is not perfect, but the real concerns get buried over echo-chamber malarkey. Such as, it's hardly mentioned that full time employment over 25 hours a week has become rather difficult to find, making things even harder for the poor when even management positions become part time and no benefits. But, instead, people would rather blame the ACA over stuff that is really nothing. People complained about the website crashing, but that was to be expected because it was dealing with extremely heavy traffic. People don't get that, but they went on and on about how that was a failure. They want to blame the ACA for rising costs, but ignore that it actually has slowed it some and that, more or less, insurance companies and pharmaceutical companies are solely responsibly for artificially inflating the cost of health care very far beyond reason. And instead of doing what we should, which is eating better and exercising more, we'd rather just take a pill and fuel this very vicious cycle of for-profit and profit-based healthcare.

If everyone followed the golden rule of "don't be a ****" the ACA would probably work swimmingly. But we have too many loopholes and abusable exceptions. I personally would like to scrap the whole thing and replace it with a simpler and more comprehensive plan. That is the optimal route. However this country won't as it is hell bent on destroying itself.

 

[Curious George]

Australia has an alliance, ANZUS, with America which obligates them to take part in these "wars" on terrorism. Since Obama use kid gloves rather than crushing the source of terrorism such as Iranian funding there is no resolving the conflict itself, just the flare ups as they come and go. This creates a situation in which Australia holds to it's treaty or nullifies it. If the former Australia is stuck in a conflict with no end in sight. If it nullifies it there will be political fallout.

So, you would have had Obama crush terrorism by starting a conflict in Iran and thereby involving Australia in a conflict in Iran. So, you are saying that Obama could have avoided involving Australia in conflict by involving Australia in conflict?

 

[Underhill]

I recall metis crediting Obamcare with reducing the rate of increase, beginning even before Obamacare took effect.
If he's correct, then Obamacare caused an increase. But let's set this aside as an error.
If Obamacare left the increase the same, I'd call that failure.

I'm not arguing that it was a success fiscally. Only that it wasn't a disaster. For it to be success it really needed what Obama originally wanted. The public option.

You can't simply assume the rate would be higher without Obamacare.

Right, because after 2 decades of cost going up, it would have just magically stopped.

We were spending 13% of gdp on healthcare in the late 90's, 17% in 2008 and 18% in 2015. Looks to me like the trend simply continued after Obamacare.

Imposing income redistribution is nevertheless a cost increase for those bearing that burden.
Moreover, it's effectively a regressive tax.

Since the plan depended upon the young subsidizing the sickly, their failure to sign up caused Obamacare's failure to be affordable for many who previously could afford it.

Health care has to redistribute the cost. It's the nature of the beast.

And I'm still waiting to hear what the republican plan is. Now Trump is promising lower cost, lower deductibles and health care for everyone.... sounds like a fantasy.

We don't know if a single payer system designed under Obama would be any better.
He had no experience in system design.

Right, and who does? Trump?