The Dem plans for health care and the ACA

[jaeger19]

The rest of the first world receives similar care for a fraction of the cost.

No they don't. Their single payer plans are a lot less than what most americans have.

 

[jaeger19]

We'd pay for it the same way the rest of the first world does.

Well.. that would mean: Reducing the number of providers and paying those left.. a lot less than now (which will decrease supply further)
Closing rural specialities and hospitals.
Reducing the insurance coverage that most americans have.
Increasing taxes dramatically
Shifting costs for educating providers to the public education system

Just not as simple as you make out.

 

[washunut]

Single-payor healthcare insurance is the answer? You've got to be kidding me. Have I posted this on this thread already? Single-payor healthcare is cheap healthcare insurance for all but does not provide for good healthcare. Rather is rations healthcare. There it is. Do you want healthcare insurance for all that is cheap (single-payor healthcare) or do you want good healthcare? You can't have both if the gov't runs healthcare.

Just as Medicare has different supplemental plans so would a single payer system in my view. Yes I would buy the gold plan.

It is either single payer or mandates with tax penalties in order to have a true fix for pre-existing conditions.

 

[Helix]

Those UHC systems vary considerably and you know it - define which specific other country you think has it right, what their 'out of pocket' care costs are and how they fund (subsidize?) it. When you say Medicaid "for all" that means a system with no premiums, no co-pays and no deductibles - I doubt that "the rest of the first world" has that as their UHC plan.

i'd like to see us take the best parts of each one for a custom fit solution. the bare bones :

1. health care would be removed from specific employment. i'm aware that some single payer nations still rely on employment-specific insurance to a lesser degree, but i'd like to see it go completely. my quality of care should have nothing to do with where i work.

2. some sort of single payer with significant negotiating power. that's the only way that we will be able to stop paying twice what most other countries pay for basically the same care.

3. i'd like to see prescription drug coverage, as well.

as for what that will cost each of us personally, i'd be surprised if it would be more than what i'm currently paying in premiums, copays, and generally avoiding care other than checkups since it's potentially so ****ing expensive. a system like this would put us closer to the first world standard. i know that the right will fight it tooth and nail, so debate is pretty much pointless. the ways to do it are to wait for our system to collapse under its own weight or elect a lot of Democrats and force it through. i'd prefer the latter. there might be a way to transition to it incrementally, as well, but i prefer the "fix it already" strategy.

 

[Helix]

Well.. that would mean: Reducing the number of providers and paying those left.. a lot less than now (which will decrease supply further)
Closing rural specialities and hospitals.
Reducing the insurance coverage that most americans have.
Increasing taxes dramatically
Shifting costs for educating providers to the public education system

Just not as simple as you make out.

i'm aware of your reliance on catastrophism. in reality, it will make our health care system accessible the same way that it is in other countries. as for rural hospitals closing, i think that it would have the opposite effect. and honestly, when did the right start caring about that anyway?

https://www.nytimes.com/2018/10/29/upshot/a-sense-of-alarm-as-rural-hospitals-keep-closing.html

 

[jaeger19]

i'm aware of your reliance on catastrophism. in reality, it will make our health care system accessible the same way that it is in other countries. as for rural hospitals closing, i think that it would have the opposite effect. and honestly, when did the right start caring about that anyway?

https://www.nytimes.com/2018/10/29/upshot/a-sense-of-alarm-as-rural-hospitals-keep-closing.html

Yawn.. yeah.. its not about catastrophism... its what other countries do to get the savings they have.

But.. why do you think it would have the opposite effect on rural hospitals? rural hospitals are less efficient.. lots of hospital for few people mean less efficiency..

And you plan to get a savings of half of what we pay now. So.. who do you think its going to be affected when you reduce reimbursement by half?

As far as the Right? Well the right believes in the Santa Claus tax cut.. that reduces taxes without increasing the deficit

And liberals believe in the Single Payer Fairy.. in which we can reduce healthcare spending by half.. without an hospital closures.. etc.

 

[Greenbeard]

Hard working families will still reject high premium costs and high deductibles necessary to provide universal care for all at lessened government expense. Still, the government will have to fork over more than $30 trillion to make any plan work, according to reported official estimates.

Again, though you wouldn't know it from reading the last few pages, this not a thread about single-payer. It's a thread about Dem proposals for immediate changes to the ACA that can be made to make private insurance more affordable (both in terms of premiums and deductibles) for individuals and families.

 

[Helix]

Yawn.. yeah.. its not about catastrophism... its what other countries do to get the savings they have.

But.. why do you think it would have the opposite effect on rural hospitals? rural hospitals are less efficient.. lots of hospital for few people mean less efficiency..

And you plan to get a savings of half of what we pay now. So.. who do you think its going to be affected when you reduce reimbursement by half?

As far as the Right? Well the right believes in the Santa Claus tax cut.. that reduces taxes without increasing the deficit

And liberals believe in the Single Payer Fairy.. in which we can reduce healthcare spending by half.. without an hospital closures.. etc.

rural hospitals benefit a lot when poor people have medicaid. as for doing something more similar to what the rest of the first world is doing, i would be surprised if we can't achieve similar results.

 

[jaeger19]

rural hospitals benefit a lot when poor people have medicaid. as for doing something more similar to what the rest of the first world is doing, i would be surprised if we can't achieve similar results.

yes they do.

But.. they also are very inefficient.. and Medicaid and medicare are the lowest payers.. and most have difficulty making it financially on low reimbursement. And you plan on reducing their reimbursement by half.

You think that rural hospitals are closing because of the few patients they see that don't have insurance.. (just the expanded Medicaid patients).? Well that pales in comparison to reducing their reimbursement by 1/2!

 

[Helix]

yes they do.

But.. they also are very inefficient.. and Medicaid and medicare are the lowest payers.. and most have difficulty making it financially on low reimbursement. And you plan on reducing their reimbursement by half.

You think that rural hospitals are closing because of the few patients they see that don't have insurance.. (just the expanded Medicaid patients).? Well that pales in comparison to reducing their reimbursement by 1/2!

i don't see why it wouldn't work like it's already working in other countries. shall i post the charts again for you to dismiss?

 

[Chomsky]

You understand of course that this is just a cheap political stunt with no hope of passage. Notice your buddy forgot to mention cost. Insurance companies won't pick up the tab, you DID notice the word subsidized didn't you?

I have from the beginning of this joke called ACA said single payer is the true answer. However you have to get through two hurdles. One, who pays. Currently most private insurance is paid for largely by corporations. So whomever changes that will be attacked as a corporate stooge. That is why Warren Buffett wanted this over tax cuts. Next is accessibility. When something is free clearly usage goes up. Where will the increased supply of doctors come from.

Most hard questions have a thousand easy answers. Sadly they are almost always wrong. Wish I had the silver bullet to fix this problem. Alas I do not.

Yes HC is a hard problem to fix.

Very good post, washunut.

 

[washunut]

Very good post, washunut.

Thanks!

 

[marke]

Again, though you wouldn't know it from reading the last few pages, this not a thread about single-payer. It's a thread about Dem proposals for immediate changes to the ACA that can be made to make private insurance more affordable (both in terms of premiums and deductibles) for individuals and families.

Maybe the democrats are finally admitting their crappy ACA plan was a huge ripoff of young American workers. But I fail to see how democrats are going to get premiums lowered to below what they were before Obamacare and, if they do, how in the world the US government is going to be able to keep supplying Medicare benefits to recipients without going broke.

 

[jaeger19]

i don't see why it wouldn't work like it's already working in other countries. shall i post the charts again for you to dismiss?

Oh it can work.. that's what you don't seem to get..

sure.. it can work here.. just like it works in other countries.. ABSOLUTELY/.

but to do that.. the system WOULD HAVE TO ACTUALLY DO WHAT OTHER COUNTRIES DO.

Which means.. it would have reduce rural hospitals, because they increase the cost of healthcare with their inefficiency. they would have to reduce the number of specialists (again.. to inefficient). this lowers the cost.. but also potentially increased wait times.

It would mean that the government single payer insurance would have to be LESS that what most americans already have.. because that's what most other countries do. For example Canada.. no medication outside the hospital. no outpatient therapies. home health etc.

It would mean severely reducing provider pay.. which would decrease access and increase wait times especially for rural areas.

You can't have single payer "work like in other countries".. if you are not willing to accept HOW those countries work their single payer.

 

[jaeger19]

Maybe the democrats are finally admitting their crappy ACA plan was a huge ripoff of young American workers. But I fail to see how democrats are going to get premiums lowered to below what they were before Obamacare and, if they do, how in the world the US government is going to be able to keep supplying Medicare benefits to recipients without going broke.

Hmmm.. yeah.. I think the democrats feel pretty confident that the ACA plan was not a :huge ripoff to young workers. IF it was.. why couldn't the republicans repeal it? Why not replace it? 6 years we have had to come up with an alternative plan.. and nothing but a fart in the wind.

the democrats could lower premiums lower than they were before obamacare.. but to do that.. they would have to introduce more competition into the market. OBamacare started doing that with exchanges.. with supports to insurance companies going into new markets and competing, with supporting coops for insurance. All market based solutions. Interestingly.. the parts of the ACA that the republicans have managed to disable.. are mostly the PROVISIONS THAT ENCOURAGED MARKET COMPETITION.

There is the reality.. is that the republicans have disabled the provisions of the ACA that promoted a free market solution.

 

[Helix]

Oh it can work.. that's what you don't seem to get..

sure.. it can work here.. just like it works in other countries.. ABSOLUTELY/.

but to do that.. the system WOULD HAVE TO ACTUALLY DO WHAT OTHER COUNTRIES DO.

Which means.. it would have reduce rural hospitals, because they increase the cost of healthcare with their inefficiency. they would have to reduce the number of specialists (again.. to inefficient). this lowers the cost.. but also potentially increased wait times.

It would mean that the government single payer insurance would have to be LESS that what most americans already have.. because that's what most other countries do. For example Canada.. no medication outside the hospital. no outpatient therapies. home health etc.

It would mean severely reducing provider pay.. which would decrease access and increase wait times especially for rural areas.

You can't have single payer "work like in other countries".. if you are not willing to accept HOW those countries work their single payer.

Costs have to be forced down either way, as they are ridiculously unsustainable. As for the rest, I don't buy the catastrophism. There's no reason that we can't make it work here.

 

[marke]

Hmmm.. yeah.. I think the democrats feel pretty confident that the ACA plan was not a :huge ripoff to young workers. IF it was.. why couldn't the republicans repeal it? Why not replace it? 6 years we have had to come up with an alternative plan.. and nothing but a fart in the wind.

the democrats could lower premiums lower than they were before obamacare.. but to do that.. they would have to introduce more competition into the market. OBamacare started doing that with exchanges.. with supports to insurance companies going into new markets and competing, with supporting coops for insurance. All market based solutions. Interestingly.. the parts of the ACA that the republicans have managed to disable.. are mostly the PROVISIONS THAT ENCOURAGED MARKET COMPETITION.

There is the reality.. is that the republicans have disabled the provisions of the ACA that promoted a free market solution.

Obama introduced forceful government controls into the formerly free insurance market, much to the dissatisfaction of millions of Americans who were forced to give up cheaper and better plans in exchange for the unpopular Obamaplan crap. The good that came out of it all for democrats is that the leftist media allowed Obama to lie about his plan while democrats began blaming the serious flaws in the plan on the republicans.

 

[JasperL]

Obama introduced forceful government controls into the formerly free insurance market, much to the dissatisfaction of millions of Americans who were forced to give up cheaper and better plans in exchange for the unpopular Obamaplan crap. The good that came out of it all for democrats is that the leftist media allowed Obama to lie about his plan while democrats began blaming the serious flaws in the plan on the republicans.

Health insurance was heavily regulated pre and post-ACA. If you got healthcare at work, the law required your employer and insurer to accept everyone without regard to pre-existing conditions, for example. Every state also had insurance regulators which imposed their own requirements. This idea that healthcare and/or healthcare insurance has really EVER been a "free market" is a myth, wrong, false.

 

[Lethargic Aptitude]

A message from the local Communist Party.

Cool game: A message from the local Neo-Nazi Party.

 

[jaeger19]

Costs have to be forced down either way, as they are ridiculously unsustainable. As for the rest, I don't buy the catastrophism. There's no reason that we can't make it work here.

Why are they unsustainable... Please give me exactly why its "unsustainable".

And I didn;t give you catastrophism.. I gave you reality.

You can make it work here. IF you are willing to do the things.. like reduce the number of rural beds.. etc.. or decrease the insurance coverage that most americans have... that other countries do.

 

[jaeger19]

Obama introduced forceful government controls into the formerly free insurance market, much to the dissatisfaction of millions of Americans who were forced to give up cheaper and better plans in exchange for the unpopular Obamaplan crap. The good that came out of it all for democrats is that the leftist media allowed Obama to lie about his plan while democrats began blaming the serious flaws in the plan on the republicans.

Yeah.. pretty much bull.

1. The insurance market prior to obamacare was certainly not a free market. There was low competition.. and insurance premiums were skyrocketing as a result. Leaving a good portion of americans without health insurance.. who then went into the ER etc.. and then ended up costing the taxpayers or the insurance companies more money.

And certainly millions of americans were not forced to give up cheaper and better plans. There were a few.. that initially were forced to give up catastrophic plans or very high deductible plans. But in general.. all those plans they went to were BETTER. No pre existing condition exclusions,, and guaranteed benefit coverage.. or essential benefits.

I get a kick about the "allow Obama to lie about his plan".. Look.. I am republican.. BUT I have read the ACA.. actually read it. AND if you want to know who really spent a lot of time lying about obamacare.. its my fellow republicans. Remember the "it has death panels"? :roll:

Republicans have lied and given misinformation about Obamacare.. for 6 years. funny enough. the bad things in obamacare.. they largely kept.. the good things? They tried to get rid of... and partially succeeded.

but at the end of the day.. after 6 years of telling everyone how bad obamacare was and how it needed to be repealed and replaced... what happened when they had Congress and the presidency? Nothing.

Think about that for a minute.

 

[Dittohead not!]

Yeah.. pretty much bull.

1. The insurance market prior to obamacare was certainly not a free market. There was low competition.. and insurance premiums were skyrocketing as a result. Leaving a good portion of americans without health insurance.. who then went into the ER etc.. and then ended up costing the taxpayers or the insurance companies more money.

And certainly millions of americans were not forced to give up cheaper and better plans. There were a few.. that initially were forced to give up catastrophic plans or very high deductible plans. But in general.. all those plans they went to were BETTER. No pre existing condition exclusions,, and guaranteed benefit coverage.. or essential benefits.

I get a kick about the "allow Obama to lie about his plan".. Look.. I am republican.. BUT I have read the ACA.. actually read it. AND if you want to know who really spent a lot of time lying about obamacare.. its my fellow republicans. Remember the "it has death panels"? :roll:

Republicans have lied and given misinformation about Obamacare.. for 6 years. funny enough. the bad things in obamacare.. they largely kept.. the good things? They tried to get rid of... and partially succeeded.

but at the end of the day.. after 6 years of telling everyone how bad obamacare was and how it needed to be repealed and replaced... what happened when they had Congress and the presidency? Nothing.

Think about that for a minute.

Nothing but rhetoric and political grandstanding. Repeal and replace with something better! Oh, wait. We don't have a better plan. We have no plan at all, in fact. Oh, well, let's repeal, then try to come up with something else later. What? That didn't pass? Oh, damn obstructionist Democrats! Oh! Hey, people seem to actually like Obamacare, despite the Democratic cooties all over it! People seem to think that it's OK if people with pre existing conditions can get health care without going bankrupt! Well, then, let's sell the idea that it is the Republicans who want pre existing conditions provisions in the law! That's easy, just a few misleading ads.

All Trump and his minions have been able to do is to reduce the tax paid by people who choose not to have health insurance to zero. Now, they can still be treated at the ER, but don't have to pay a tax to defray the cost to the rest of us. Trump seems to love freeloaders.

And the public, at least a lot of them, have no idea what the ACA really is. A lot of them think the ACA is history because Trump has been elected. Other than the pro freeloader action mentioned above, they haven't done squat.

 

[cabse5]

You can't have it both ways. Pre-ACA and post, healthcare in the U.S. is also rationed. The biggest rationing happens with the 25-30 million severely rationed because they currently have no insurance. But even those with insurance have all kinds of limits on care, so does Medicare/Medicaid/VA. Pre-ACA, rationing was far worse, with some "insurance" plans not even covering hospitalization, laughably low annual and lifetime dollar limits, excluding things like having a baby, or huge lists of drugs that are costly.

The minimum benefits requirements in ACA killed off a lot of the worst "rationing" in fact. But the bottom line is any healthcare system must by definition "ration" in some way, and they do.

I want it both ways. I want the previous healthcare system reinstated which was provided, mostly, by businesses with Medicaid being offered to the low-incomed and an expansion of Medicaid for those with pre-existing conditions. There was no need to blow up the previous healthcare system to include pre-existing conditions. Expand Medicaid. Have the gov't handle, IMO, approximately 25 percent of healthcare claims and have the previous healthcare system handle the rest.

 

[Helix]

Why are they unsustainable... Please give me exactly why its "unsustainable".

And I didn;t give you catastrophism.. I gave you reality.

You can make it work here. IF you are willing to do the things.. like reduce the number of rural beds.. etc.. or decrease the insurance coverage that most americans have... that other countries do.

it's unsustainable because it's an essential service with inelastic demand, and the costs are going up a lot faster than the ability for the average person to pay for them. you don't see it because you don't want to.

we aren't going to agree on this topic. ever. i remember telling you in the last thread that i was done with our discussion, but unfortunately, i temporarily forgot. i won't forget next time. quote someone else. goodbye.

 

[marke]

Health insurance was heavily regulated pre and post-ACA. If you got healthcare at work, the law required your employer and insurer to accept everyone without regard to pre-existing conditions, for example. Every state also had insurance regulators which imposed their own requirements. This idea that healthcare and/or healthcare insurance has really EVER been a "free market" is a myth, wrong, false.

I see the problem. The government foolishly inserted itself into the private insurance market and from that time forward the prices are high, the coverage is limited, and the government is going broke trying to cover those who cannot cover themselves. Obamacare did not change that. It just turned insurance premiums into a government tax and doubled or tripled the payments young healthy workers must pay to be covered, while doing nothing to get the government out of Medicare debt.

The government created a huge insurance mess and then Obama came along and made it worse.