Is Obamacare as we know it doomed?

SouthernDemocrat said:

One of the biggest problems with the ACA is that they dropped the public option. Had there been a public option, the older / sicker members that currently are driving up insurance costs across the board would have it as an option and premiums would be more reasonable for everyone else on the exchanges.

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Uhm no,the public option wasn't dropped. States could opt out of ObamaCare entirely by odopting their owm single payer system.

VT tried, even passed a single payer option. The Governor signed it into law.

So what happened ??? Where VTs single payer system now ?

Fenton said:

Uhm no,the public option wasn't dropped. States could opt out of ObamaCare entirely by odopting their owm single payer system.

VT tried, even passed a single payer option. The Governor signed it into law.

So what happened ??? Where VTs single payer system now ?

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What the hell does that have to do with anything? A public option would not be a single payer healthcare system for everyone. So its not at all comparable to what they attempted to do in Vermont.

antiquity said:

Let me get this straight...why did a super majority of congressional democrats in 2010 vote for the ACA, when they could at the time voted for single payer system, over a powerless republican party to have it covered entirely by your pay roll tax and subsidized by the government in more hidden taxes under the guise of having it fail? Besides putting millions out of work in the private sector and increasing public employment by million more?

I mean what could possible go wrong with that?

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Because the Dems did not have a super majority nor was the public ready to accept a socialized system. Maybe you don't remember but several Dem senators had to be bribed, with hundreds of millions of dollar projects being handed to their states, to support Obama-care. Because the socialist dems knew that, they created a mess that was sure to bring a bigger mess to the system and thus bolster more public support for a socialized system.

DVSentinel said:

Because the Dems did not have a super majority nor was the public ready to accept a socialized system. Maybe you don't remember but several Dem senators had to be bribed, with hundreds of millions of dollar projects being handed to their states, to support Obama-care. Because the socialist dems knew that, they created a mess that was sure to bring a bigger mess to the system and thus bolster more public support for a socialized system.

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You are right that the public was not ready for a socialized health care system in 2010 and still aren't. But you are wrong about the democratic not having a super majority in both houses. In the Senate they had a filibuster proof Senate and in the house besides a road blocking Nancy Pelosi they had 257 votes. Every democrat voted for the ACA and every Republican wisely voted against. In the Senate... Republicans were blocked by Harry Reid on any amendments presented.

By the way the only people who support a socialized system in Health Care are Progressives. Hardly a majority....

Fenton said:

So what happened ??? Where VTs single payer system now ?

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Open a newspaper, dude. Vermont just signed today an agreement with the feds that achieves most of the point of doing single-payer in the first place: Vermont's all-payer ACO will begin in January.

Smeagol said:

I've always thought The Afford Care Act better known as Obamacare was a nice effort of had to changed. I'm a Republican had have also always believed it would have been changed already except for the fact that Republicans in Congress, driven by the agenda set by conservative media pundits, have insisted on a letting the American people suffer financially while further insisting on the "total repeal" of the Obamacare brand instead of working modifying the Affordable Care Act in the spirit of cooperation so that the President is humiliated. Now even Bill Clinton is criticizing it and Health and Human Services is predicting a 25% increase in premiums. Do you think Obamacare is seeing its last days?

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No, it isn't seeing its last days. Obamacare is much bigger than just the exchanges, though presumably that's all we're talking about so I'll limit my response to that.

There is no reform on either side of the spectrum that doesn't involve exchanges so those aren't going anywhere. The question at hand is really just how to make participation (for insurers and, to some degree, potential enrollees) attractive, or non-participation unattractive. It shouldn't be too hard to figure out the more obvious ways to do that.

Greenbeard said:

Open a newspaper, dude. Vermont just signed today an agreement with the feds that achieves most of the point of doing single-payer in the first place: Vermont's all-payer ACO will begin in January.

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Oh dude, VT can only make their single payer initiative work with a handout from the Feds. So the rest of us get to pay for VTs wonderful single payer system.

Thats the same Gov that signed Green mountain care into law, amiright ?

Jeez, you people never learn from your mistakes.

Fenton said:

Oh dude, VT can only make their single payer initiative work with a handout from the Feds

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1115 waivers are budget neutral. They're just getting some of the money they're already owed upfront.

Thats the same Gov that signed Green mountain care into law, amiright ?

Jeez, you people never learn from your mistakes.

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By keeping it multi-payer and not having the state government assume costs currently born by private payers, it seems like they've learned their lesson very well actually.

Greenbeard said:

1115 waivers are budget neutral. They're just getting some of the money they're already owed upfront.



By keeping it multi-payer and not having the state government assume costs currently born by private payers, it seems like they've learned their lesson very well actually.

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The State Govt wasn't going to assume the cost with Green mountain care either.

The tax payers were, remember ?? Thats why it failed. Because that level of taxation would have destroyed their local economy and with no economy, there's no revenues.

And all the sudden these handouts are " budget nuetral " Lol ! Like ObamaCare was supposed to be budget nuetral

Yea we've heard these lies before.

If the people of VT want to go down this road then more power to them. Im all for States rights

They should reap the rewards OR suffer the consequences and the American people shouldn't be forced to bail their asses out when this turns out south

This ideological attempt to abandon for profit Healthcare should stand on its own feet if its truly a workable solution, right ?

Fenton said:

This ideological attempt to abandon for profit Healthcare should stand on its own feet if its truly a workable solution, right ?

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All 14 hospitals in Vermont are not-for-profits, as are the two major insurers. The problem is a little more complicated than whatever morality play is going on in your head.

Greenbeard said:

No, it isn't seeing its last days. Obamacare is much bigger than just the exchanges, though presumably that's all we're talking about so I'll limit my response to that.

There is no reform on either side of the spectrum that doesn't involve exchanges so those aren't going anywhere. The question at hand is really just how to make participation (for insurers and, to some degree, potential enrollees) attractive, or non-participation unattractive. It shouldn't be too hard to figure out the more obvious ways to do that.

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1. They can modify it, which would be better:

- Allow Sam's, Costco, AARP, AAA, etc. to offer group rates to its members. These would be huge groups with national membership, provided they don't break up groups into regions.
- Allow health insurance to be sold across state lines.
- Get serious about the individual mandate by taking it out of their payroll deductions and tax refunds.
- Scrap the exchanges for a government run program (cringe) that hopefully few people would need considering employer-based and Sam's, Costco, AARP, AAA, etc.would be more appealing.

2. Replace it with flat fee hospital memberships that work like gym memberships but are individually mandated, which would be best. Hospitals would compete with each other with the best rates and strengths. Some may tout their superior pediatric services, others might be the best in cancer treatment while others specialize in generous rebates to non-smokers and people who work out proved by smart device monitoring and partnerships with fitness centers that keep track of visits.

Smeagol said:

1. They can modify it, which would be better:

- Allow Sam's, Costco, AARP, AAA, etc. to offer group rates to its members. These would be huge groups with national membership, provided they don't break up groups into regions.
- Allow health insurance to be sold across state lines.
- Get serious about the individual mandate by taking it out of their payroll deductions and tax refunds.
- Scrap the exchanges for a government run program (cringe) that hopefully few people would need considering employer-based and Sam's, Costco, AARP, AAA, etc.would be more appealing.

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These are very different impulses. The point of the exchanges, generally speaking, is to (1) create a structured individual market for health insurance, and (2) provide financial assistance to low-to-middle income people who don't have an offer of coverage somewhere else.

Your first bullet is designed to pluck healthy people out of the exchanges, further destabilizing them, while your third is presumably to push more people into them. Of the two, I'd go with the latter.

Your second bullet is standard deregulation fare, which again undermines the point of having a structured market that anyone can shop in. And of course the final bullet gets rid of markets in favor of a government program. Other than perhaps strengthening the mandate, all of your potential modifications are just ways to phase out the concept of a competitive structured market.

2. Replace it with flat fee hospital memberships that work like gym memberships but are individually mandated, which would be best. Hospitals would compete with each other with the best rates and strengths. Some may tout their superior pediatric services, others might be the best in cancer treatment while others specialize in generous rebates to non-smokers and people who work out proved by smart device monitoring and partnerships with fitness centers that keep track of visits.

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That's essentially a hospital system offering its own insurance product to compete with established insurers. Which is already happening. They're called provider-led plans and they're available in lots of exchanges, as well as the Medicare and Medicaid spaces.

DVSentinel said:

Obama care was designed from the beginning to fail. It's designed purpose was to get more people to support a socialist system. The left does not really care about fixing problems with the medical care, they only want to push the socialist option. If they really cared, then they would go back and repeal laws which caused the massive surge in medical cost to begin with. I have posted the chart before, several times. Medical costs were comparable with many other countries prior to about 1975, with Germany actually have higher cost several times prior to that. Then, at that point, the cost just start skyrocketed. The left never looks at going back and repealing laws causing it, they only want to push towards socialism.

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I dont think it was to push socialism so much as is it was to buy votes. Who are you going to vote for, the person who says take care of yourself, or the person who gives you a handout?

Depends who is elected as our next President.

Clinton it stays

Trump good bye Obamacare

jonny5 said:

I dont think it was to push socialism so much as is it was to buy votes. Who are you going to vote for, the person who says take care of yourself, or the person who gives you a handout?

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Me personally? The one that says take care of yourself.

DVSentinel said:

Me personally? The one that says take care of yourself.

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No, you as in millions of uninformed takers.

Most people seem to not understand that heath care reform was a necessity, and the Republican's plan of Health Care Savings Accounts and other ideas would do NOTHING to reduce the ever increasing costs of health care in this country. In 1980, a mere 36 years ago, the TOTAL cost of health care in this country was $250 Billions, or about 12% of GDP. By 2010, just thirty years later, that health care cost rose to $2.6 Trillion, or 16% of GDP, a 903% increase. The Congressional Budget Office did a report in 2008 stating that if health care reform were not passed, that the cost of health care in this country would grow to 25% of GDP by 2035, just 18 years from now. They also projected the cost to be 35% of GDP by 2050.

This country simply can't afford to spend 25 cents of every dollar spent on everything going to health care. Our 'for profit health care system' has been an abject failure, while making many people very rich. Republicans will state that we have the best health care system in the world, yet the truth is far from that. The little poor country of Cuba has a better infant mortality rate than that of the great United States. Not only that, there are 85 other countries that have better per capita infant mortality rates than that of the US. We are 87th on the list, according to the CIA World Book of Facts. What's WRONG with this picture?