As has been said, the easiest way to solve the GOP problem with the Affordable Care Act is for Congress to give all Americans the same health care coverage that members of Congress have. Problem solved.
6
I don't understand what the problem is with paying for health care, especially on the terms the ACA has set up, with financial help for those who can't swing the total cost on their own.
I paid medical insurance costs for years - hefty ones, at that - and collected benefits only on some minor charges until I was married and then had children. Our family was generally health and now I've been with the same insurer for over 50 years. The costs have gone up over the years but now I'm a senior and my medical expenses are there to cover my needs. That's how insurance works.
If I'd waited to buy insurance until I needed it, the costs would have been prohibitive, even if I could find an insurer that would take me on.
Same story on auto insurance, and you surely can't drive around without it, even though you might never collect a penny of benefits on it. But it's there if you need it. And since there is a large pool of subscribers involved, all paying their share, the costs are diffused and everybody can rest easy knowing they're covered. So what's the big deal with Obamacare? It should work the same way private insurance does, only with the government's help for those who are needy. That way, we're all protected.
And if the GOP goes to mess with Social Security, they're going to run into a third rail that will not only curl their hair, it will remove it entirely and take their clothes with it. Be warned, GOP. We paid for our Social Security. Hands off.
I paid medical insurance costs for years - hefty ones, at that - and collected benefits only on some minor charges until I was married and then had children. Our family was generally health and now I've been with the same insurer for over 50 years. The costs have gone up over the years but now I'm a senior and my medical expenses are there to cover my needs. That's how insurance works.
If I'd waited to buy insurance until I needed it, the costs would have been prohibitive, even if I could find an insurer that would take me on.
Same story on auto insurance, and you surely can't drive around without it, even though you might never collect a penny of benefits on it. But it's there if you need it. And since there is a large pool of subscribers involved, all paying their share, the costs are diffused and everybody can rest easy knowing they're covered. So what's the big deal with Obamacare? It should work the same way private insurance does, only with the government's help for those who are needy. That way, we're all protected.
And if the GOP goes to mess with Social Security, they're going to run into a third rail that will not only curl their hair, it will remove it entirely and take their clothes with it. Be warned, GOP. We paid for our Social Security. Hands off.
2
Please note this is the Affordable Care Act and if the newspapers and TV shows would call it that it would give folks a real different perspective on what they have and what the Republicans are trying to toss out. Use it's real name
8
Trump has an out. Just prior to his departure, President Obama said the GOP could go ahead and call it Trumpcare if they wanted to...as long as people had the health insurance coverage they needed. Trying to sell Healthcare Savings Accounts to people who live paycheck to paycheck? Telling us everybody will have "access to healthcare?" They have no ideas. Health insurance policy making has been hard work in this country for a hundred years. These fools have not studied history and we are thus all condemned to repeat it...only this time with a clueless inattentive incurious rich kid at the helm.
9
Everybody worries about how to make healthcare insurance work best and about how to keep healthcare costs down -- but the answer to both issues is simple and right in front of us. Two facts:
(a) Insurance (of anything) becomes more efficient as the insured population increases in size and becomes less biased in risk terms. Thus from an actuarial/economci standpoint, the best insured population is the ENTIRE population. This math has been known for centuries.
(b) The Number-1 restraint on American healthcare costs has been Medicare's huge bargaining power.
Thus universal, single-payer healthcare systems are cheapest and/or most profitable systems possible. And a single-payer system in the US would have immense power to regulate healthcare costs. Where else could pharmaceutical companies, medical-device makers, physicians, etc. go instead, to flog their wares? Canada? Europe? Australia?
(a) Insurance (of anything) becomes more efficient as the insured population increases in size and becomes less biased in risk terms. Thus from an actuarial/economci standpoint, the best insured population is the ENTIRE population. This math has been known for centuries.
(b) The Number-1 restraint on American healthcare costs has been Medicare's huge bargaining power.
Thus universal, single-payer healthcare systems are cheapest and/or most profitable systems possible. And a single-payer system in the US would have immense power to regulate healthcare costs. Where else could pharmaceutical companies, medical-device makers, physicians, etc. go instead, to flog their wares? Canada? Europe? Australia?
1
We are busy people. We don't have time to read a novel. Can't someone shorten this to one of a sheet of paper ?
The Republicans are learning It's far easier being obstructionists.
2
Please STOP referring to Affordable Health Care as Obamacare! It has been a misleading name made up by opponents of AHC.
2
The article states, "In the end, Republicans lacked the numbers necessary to block the bill." I don't agree with this account. Although no Republicans voted an the actual legislation, the bill came to a vote because Olympia Snowe, the retiring Senator from Maine, was the 60th vote needed to bring the bill to a vote. By allowing this to happen, it was Snowe who cast the sacrificial vote for all Republicans, who at the time afraid of the backlash of the Tea Party movement, did not want to have themselves voting for the ACA going into the next election. Snow understood exactly what she was doing, she was in essence getting the ACA based, and because she was not running for reelection, her vote gave cover to all Republicans who secretly believed the ACA was a step forward for our country.
4
The Republicans should get rid of Social Security first. Once they have put Grandpa on the street, the removal of Obamacare and Medicare will be easy as the opposition to our final move into the feudalism will be almost complete.
The Republicans did it right by using the name "Obamacare". While a lot of disliked Mr. Obama it naturally carried over to hating this health care plan. Not a smart move my dear Liberals.
Give me a break. From day one it's been about the ACA taxes on rich people. Follow the damn money!
1
The Republicans, the party of NO, will repeal and replace Obamacare with......NoCare. Available to all but affordable by almost NO one.
3
No one can solve this problem of how to make medical care accessible to all if the target is insurance because the profit motive of both the insurance and medical care industry will continue to raise prices in lockstep with how much gov't money is available. The true goal is medical care - not lining the pockets of untold $300 million/year salaries of insurance executives and hospital administrators, so why not have gov't paid-for medical clinics in Walmart and CVS pharmacies across the land? Pay for young people to go to medical school and then require they staff these clinics for 3 years. Set up an Americore program for boomers who want to volunteer. Pay pharmaceutical companies a fair price for drugs and distribute them through the clinics. The cost would be less than subsidizing the ridiculously inflated costs of medical care that exist today and therefore the insurance that everyone needs because of these inflated costs would be unnecessary. If you have private insurance or are wealthy - go to your own doctor. If you don't have the resources, go to a gov't clinic. Oh horror - socialized medicine! It won't be Cadillac care, but if you are poor and sick, you won't die.
4
Heritage Action for America is neck deep in ideological quicksand. The combination in their almost religious faith in the free market, and a hard blind spot to the misery it creates, will sink a lot of people before we come to our senses.
But as the President implied, they feel it will sink all those people in alleys that we don't even know how they got there, but they are not Republicans so it won't matter.
Reality, however, is that the old system of employer based insurance is caving. Companies hire part timers and contractors to get around paying $15-$20K a pop for a family, or they just send the job overseas. More of our jobs are contracted, are part time, are for small business and start-ups, and don't carry insurance. And more of our companies are increasing premiums, co-pays and deductibles to spread the cost out, as they have aging employees and hiring freezes that keep the pool from getting younger and forces premiums higher.
When the base realizes that the replacement plan doesn't help them, that private insurance will cost their family $15 or $20K, then what happens?
Will we tell the peasants they ought to eat cake?
But as the President implied, they feel it will sink all those people in alleys that we don't even know how they got there, but they are not Republicans so it won't matter.
Reality, however, is that the old system of employer based insurance is caving. Companies hire part timers and contractors to get around paying $15-$20K a pop for a family, or they just send the job overseas. More of our jobs are contracted, are part time, are for small business and start-ups, and don't carry insurance. And more of our companies are increasing premiums, co-pays and deductibles to spread the cost out, as they have aging employees and hiring freezes that keep the pool from getting younger and forces premiums higher.
When the base realizes that the replacement plan doesn't help them, that private insurance will cost their family $15 or $20K, then what happens?
Will we tell the peasants they ought to eat cake?
6
Once you give people somethg (pre existing conditions, children staying on parents plan till age 26. No copays for birth control, no copays for mamagram or colonoscopy) You take this away from people and they will come back and vote you Out. The Republicans know this all too well. This is their Quagwire.
5
Surely there are parts of Obamacare that need mending (mostly the parts that originally had to be compromised to get any of the GOP to help it pass). While I am a supporter of Medicare for all, I sincerely hope that Obamacare (actually the ACA) survives. I have a feeling that among any changes that the GOP wants to implement will be the name that they first applied to the ACA -- Obamacare. They want to re-brand it as an innovative health care bill that THEY put together. Many of the issues the plan has could have been hammered out at its inception had Congress not had obstruction of the president as its overriding goal. After all, the plan actually was hatched in GOP think tanks, and worked relatively well in MA when implemented by Romney. It will be interesting to see what they have to offer...after all, they have had 9 years to put together their "plan". If they hadn't been sidetracked by the 60+ attempts to overthrow the ACA, they might have had something to offer the first day Trump took office.
4
Medical insurance like car insurance is a pay it forward program. Insurance premiums paid beginning in the cradle are the only thing that prevents bankruptcy as you head towards the grave. Medical Care requirements for all!
4
I recommend listening to New Yorker editor David Remnick's interview of Atul Gawande on how the repeal of the Affordable Care Act could lead to a decline in patients seeking primary care and his ideas for how the ACA could be changed. Go to The New Yorker's podcast of February 3, 2017 Episode 68: The New Yorker Radio Hour.
11
It looks as though Medicaid expansion will be changed to block grants and left to gradually fade away. State legislatures will be left with the nasty business of making the cuts. From a Republican point of view, this will do away with giveaways to "able-bodied" people who should be earning their own livings.
Plans to provide tax credits for health insurance rather than income-based subsidies will complement Medicaid cuts to ensure that most lower-income Americans will once again lack health insurance.
Perhaps the US could arrange with a country like Cuba to set up cheap health clinics and maybe basic, substandard but affordable hospitals.
Plans to provide tax credits for health insurance rather than income-based subsidies will complement Medicaid cuts to ensure that most lower-income Americans will once again lack health insurance.
Perhaps the US could arrange with a country like Cuba to set up cheap health clinics and maybe basic, substandard but affordable hospitals.
7
The dog has caught the car. Now what?
15
If the republican plan goes as proposed, it may be moire like a pit bull caught a child's big wheel scooter, child on board.
1
The Republican repeal and replace Obamacare document issued on Thursday February 16 includes the repeal of $1 trillion in new taxes under the ACA. The ACA established new sources of revenue dedicated to the Medicare program, including a 0.9 percentage point increase in the Medicare Part A payroll tax on earnings of higher-income workers (incomes more than $200,000/individual and $250,000/couple), and a fee on the manufacturers and importers of branded drugs, which has generated additional revenue for the Part B trust fund, including $3 billion in 2015 alone.
If these additional payroll taxes on high earners and fees on drugs are repealed it would accelerate the projected insolvency of the Medicare Hospital Insurance (HI) trust fund, out of which Part A benefits are paid.
As a result, Medicare would not be able to fulfill its obligation to pay for all Part A-covered benefits within a shorter period of time if the ACA is repealed than if the law and additional sources of revenue is retained.
If these additional payroll taxes on high earners and fees on drugs are repealed it would accelerate the projected insolvency of the Medicare Hospital Insurance (HI) trust fund, out of which Part A benefits are paid.
As a result, Medicare would not be able to fulfill its obligation to pay for all Part A-covered benefits within a shorter period of time if the ACA is repealed than if the law and additional sources of revenue is retained.
14
Some think that eliminating these taxes is the only thing the Repub House really wants to do. Why would that be? LOL
2
Why do Americans fervently wish for other Americans not to have affordable health care access? What kind of people are these? What kind of people want seriously mentally ill people to have guns? What kind of people want innocuous, hard-working people thrown out of the country? Why, why, why?
23
'Mericans don't want anyone telling them what they can or cannot do. Unless they are from the 'right' side of the aisle, which tells you the right way to live. ++ The real challenge is that simple minds can handle simple thoughts, and the reality is way more complicated than the simple mind can handle. I offer this knowing full well that conservatives will think I am attacking them - no, I am attacking anyone who can't handle a complicated issue and still demands that their opinion has worth. It is really easy to condemn and criticize, it is much harder to come up with a solution - to improve something. anyone who has led an effort that creates anything knows this. those who sit on the sidelines criticizing everything that they don't like don't get it - they really don't get it - they have no clue that they don't, either. See the Dunning-Kruger effect.
Thanks for this review of the ACA. I am using the info as an effort by a
Indivisible group in Venice, FL to keep the ACA and improve it.
Really well done!
Indivisible group in Venice, FL to keep the ACA and improve it.
Really well done!
6
Republican legislators need a bomb disposal expert to defuse Obamacare and a genius to invent a quality replacement.
They have neither.
As this article states, every existent healthcare lobby designed their own part of the ACA to benefit their interest and each one is dependent on another lobby's benefit.
Obamacare is loaded with trip wires causing major explosions when they are excised and not replaced with a benefit to a certain lobby that is at least equal or better.
Sorry, Paul Ryan but everyone knows that health savings accounts and tax credits are worthless to poor and working class people, many of whom voted for Trump.
I'm sure Trump can easily produce the "terrific" plan he promised his admirers. "They are going to get so tired of winning."
Not!
Sad!
They have neither.
As this article states, every existent healthcare lobby designed their own part of the ACA to benefit their interest and each one is dependent on another lobby's benefit.
Obamacare is loaded with trip wires causing major explosions when they are excised and not replaced with a benefit to a certain lobby that is at least equal or better.
Sorry, Paul Ryan but everyone knows that health savings accounts and tax credits are worthless to poor and working class people, many of whom voted for Trump.
I'm sure Trump can easily produce the "terrific" plan he promised his admirers. "They are going to get so tired of winning."
Not!
Sad!
20
Almost a perfect condense observation of the situation.
1
The compassion of Obama and the Democrats vs. self-serving Republicans makes clear who truly cares about the well-being of all citizens of the U.S.A.
It is good to hear that citizens are speaking out about the need to keep Obamacare undiluted by the Republicans.
It should be an embarrassment to current republican politicians that countries around the world ensure that their citizens have publicly funded medical care for all their citizens.
Leave Obama care in place with appropriate improvements added to budget it appropriately. Don't frighten citizens any longer with mean-spirited threats to remove it and spoil their peaceful confidence that their government will care for them and their children when fate sends them costly illnesses.
Have a heart!
It is good to hear that citizens are speaking out about the need to keep Obamacare undiluted by the Republicans.
It should be an embarrassment to current republican politicians that countries around the world ensure that their citizens have publicly funded medical care for all their citizens.
Leave Obama care in place with appropriate improvements added to budget it appropriately. Don't frighten citizens any longer with mean-spirited threats to remove it and spoil their peaceful confidence that their government will care for them and their children when fate sends them costly illnesses.
Have a heart!
13
I just want all legislators to get exactly the same healthcare policies that thy pass into law for Americans...no group rates, no subsideies unless they meet income requirements.This is the on,y way we will ever get to better healthcare plan . Then we need to find preventive care and collect data about the most effective treatments since doing away with the ACA wii destroy this .
14
The Affordable Care Act made members of Congress and some of their staff became ineligible for the Federal Employees Health Benefit Plan, so they sign up for Obamacare in the District of Columbia. I suppose they'll continue to sign up for Trumpcare, whatever it might be.
4
Trumpcare? Right now - that is you are on your own. Tell me where I got that wrong?
1
This has to be democratic party priority! No better, no worse than the regular citizen.
Lets get to the real solution. Single payer system. Controls over drug and medical prices. Thats it folks. Its simple. It works for most of the world. Its the only real solution. Do it and lets move on.
28
Your voice of reason against a trillion dollar plus cacophony of "no to socialism!". Good luck with that.
1
After 6 years and 50 votes to repeal it, the Republican must have a really well crafted plan all ready to go. No wonder Trump promised to have it running in the first week. What could possibly be holding them back?
At least they should shut down the Death Panels.
At least they should shut down the Death Panels.
10
Re: "At least they should shut down the Death Panels."
They ARE the death panels -- deciding who does and who doesn't get healthcare is often deciding who lives and who dies.
They ARE the death panels -- deciding who does and who doesn't get healthcare is often deciding who lives and who dies.
1
Yep. Gotta get rid of those death panels first thing!
1
"Now came the president whom Needham once accused of embracing socialized medicine. Maybe he would somehow turn out to be a more reliable friend to the conservative movement than Reagan had been. Or maybe Washington would prove, hardly for the first time, that even the best of friends will let you down."
Or, just maybe Heritage Action, Needham, et al. will realize that their Weltanschauung passed its expiration date 85 years ago...
Or, just maybe Heritage Action, Needham, et al. will realize that their Weltanschauung passed its expiration date 85 years ago...
5
64 paragraphs in this piece. In paragraph 24, there's one solitary, brief,, off-point mention of the secretary of HHS in charge of Obamacare's changes -- and no mention of his plan. That's it for Price and his critical role? Whatever your politics, something is dramatically wrong with this article.
2
These analysts don't understand how mean the republicans are capable of being. The republicans will happily throw 20 or 30 million people off their healthcare insurance if it means that rich people will get a tax cut.The main goal of the republicans is to make the rich, even richer. Everything else - the economy, the constitution, the environment, the well being of average citizens, the national interest - all are secondary.
14
The most certain way Trump can make himself a one-term president, and the Republicans can give the House and Senate away to the Democrats, is by failing to kill Obamacare dead, dead, dead. If they want to "replace" it with something relying on available-to-all tax credits--and not being some complicated income-redistribution welfare scheme, and not being an insane government bureaucracy with a million insane rules--fine.
Obamacare is going to go down in history as a spectacular failure, as a studied example of the inevitable destruction wrought by leftist policies. The architects of Obamacare were not only cynical fools and economic ignoramuses, they also wildly underestimated the common sense of a majority of Americans--and all of these are characteristics of so-called "Progressives."
Obamacare is going to go down in history as a spectacular failure, as a studied example of the inevitable destruction wrought by leftist policies. The architects of Obamacare were not only cynical fools and economic ignoramuses, they also wildly underestimated the common sense of a majority of Americans--and all of these are characteristics of so-called "Progressives."
3
Odd how the Republican plan from the conservative Heritage Foundation doesn't work.
Go Medicare for all and watch the economy blossom!
Go Medicare for all and watch the economy blossom!
1
How come every time the government help the poor and middle class it's "redistribution welfare scheme" but when it's taxing people to save high flying financiers on Wall Street after their catastrophic blunders , or for disastrous wars, or tax breaks to billionaires like Trump, and the corporations we now describe as "people", then it's our "patriotic duty"?
2
Obamacare appears to be exploding so insurance companies are deserting the market. Republicans would be smart to allow nature take its course so they can pick up the pieces. It seems to me we need a plan to finance pre-existing conditions. Otherwise, the old system was not as bad as this.
Probably won't work. Public will blame the people in power.
People should be happy with their Obama care plan they took out a second mortgage to pay for. The new doctor only has a 3 month waiting list and does not allow emergency same day appointments. You enjoy spending 25% to 80% more each year on monthly premiums. You love paying that $6,000 deductible every year, $12,000 for your family. This new 60/40 plan is much better than the old 80/20 plan you had before. Your medicine that is not on the approved list is only a couple hundred extra a month out of your pocket. The added gross income on your 1040 that comes from your employer paid share of your health care policy only add a thousand dollars to your income tax payment. The Independent Payment Advisory Board has not determined that you are just a useless eater and need to die to save the government money. Being laid off from your job or being converted to part time with less than 30 hours a week is still workable. People will be grinning happily to stay with Obamacare with an IRS gun to their head.
2
You are making an excellent argument for Medicare for all, which covers from dollar 1! Oh, and complaining about the costs of the ACA, I bet you are one who wants Americans to have "skin in the game" on medical care.
Well, there it is!
Well, there it is!
Have you priced Individual health insurance before Obamacare? Prices here have increased, but actually at a lower rate than before. Meahwhile drug prices have doubled(?).
Most of the rest of your fable is just that.
Most of the rest of your fable is just that.
1
Medicare does NOT cover from dollar 1. It covers 80% of part B expenses (doctor's visits) with a $187 per year deductible. There is also a large deductible (1000-2000 or so) for part A (hospital) expenses. To lower or eliminate these out of pocket expenses, you must purchase a medicare supplement ("medigap" policy. which typically costs $100-$300 per month, depending on how much of the out of pocket it covers.
Let me sumarize the conservative outlook: tax cuts for the wealthy during wartime. Just ask George W. Bush; who tried to privatize Social Security.
9
Its really not that hard , instead of imposing a individual mandate which is deeply unpopular entice people and employers with tax incentives.
Next craft a "core package" of services every plan must cover , this package
must be gender neutral which means it only includes coverage for services that apply to both male and females , services such as abortion , maternity care, birth control or male enhancement can be sold as option packages.
The next step is to cap deductibles and limit the $ awards in malpractice suits and suits against pharma companies !
The exchanges could remain but instead of having one exchange for each state one federal exchange will cover all 50 states and enable customers to shop for coverage accross state lines !
Next craft a "core package" of services every plan must cover , this package
must be gender neutral which means it only includes coverage for services that apply to both male and females , services such as abortion , maternity care, birth control or male enhancement can be sold as option packages.
The next step is to cap deductibles and limit the $ awards in malpractice suits and suits against pharma companies !
The exchanges could remain but instead of having one exchange for each state one federal exchange will cover all 50 states and enable customers to shop for coverage accross state lines !
4
Some very good thoughts here. Too bad the Repubs in the House are too lazy to do homework like you did.
It does sound like the first item (incentives in place of mandate) would cost more, so something would have to be done to save money. Fixing the drug cost problem would take care of that.
It does sound like the first item (incentives in place of mandate) would cost more, so something would have to be done to save money. Fixing the drug cost problem would take care of that.
One of the core problems with Obamacare is that it was done without due consideration and study of the several aspects of the medical industry to be impacted. Now, journalists act as if curative action should have been taken with the President's first 30 days in office.
3
Actually over a course of 15 months there were discussions and negotiations in Congress as well as hearings on all aspects of the medical-drug-insurance industry.
7
Until insurance company's can't make money more by cherry-picking thier customers at the expense of lowering costs, things won't change.
My guess is that the replacement will include elements like:
-- Requiring mandatory coverage to eliminate adverse selection (buying insurance only when you think that you're going to be sick)
-- Retaining insurance companies
-- Putting self employed and corporate employees on the same tax footing
-- Eliminating underwriting of employer groups to prevent cherry picking of younger and healthier customers, but still allowing employers to organize employee health insurance coverage
-- Allowing insurance companies to adjust individual premiums by things like body-fat ratios, but not by age or sex
-- Trimming back those items that insurance companies must cover
-- Allowing sale of policies across state lines and eliminating much of the state regulation that duplicates insurance and other bureaucracy
-- Rethinking medical malpractice
-- Rethinking "moral hazard"
Overall, what emerges will resemble the Swiss system with less government involvement on the price setting of medical services.
My guess is that the replacement will include elements like:
-- Requiring mandatory coverage to eliminate adverse selection (buying insurance only when you think that you're going to be sick)
-- Retaining insurance companies
-- Putting self employed and corporate employees on the same tax footing
-- Eliminating underwriting of employer groups to prevent cherry picking of younger and healthier customers, but still allowing employers to organize employee health insurance coverage
-- Allowing insurance companies to adjust individual premiums by things like body-fat ratios, but not by age or sex
-- Trimming back those items that insurance companies must cover
-- Allowing sale of policies across state lines and eliminating much of the state regulation that duplicates insurance and other bureaucracy
-- Rethinking medical malpractice
-- Rethinking "moral hazard"
Overall, what emerges will resemble the Swiss system with less government involvement on the price setting of medical services.
3
If Democrats don't cooperate on replacing Obamacare the Republicans should just let it continue into the next election. Obamacare is in a death spiral and by 2018 many people will not even be offered a plan because insurance companies are pulling out.
1
Insurance companies are pulling out because they claim inadequate profits in that particular market, but they make huge profits company wide.
Their actions show the failure of the "free market" health system, not the ACA.
Their actions show the failure of the "free market" health system, not the ACA.
1
What needs to be widely shared is that members of Congress and their staffs were required to participate in the ACA. As soon as they repeal it, they will all glide right back into the Federal Employee Benefits program with a plethora of health plans at different price points. Everyone else who loses coverage will be left in the cold. How unfair and unethical. But that's the GOP for you.
5
On one of the Conservatives opposing ACA, "After graduating from Williams College in 2004, Needham went straight to work for Heritage, where he was made its director of Asian studies, despite having never visited Asia."
Yes it to totally makes sense, take a guy who knows nothing about Asia and appoint him as their expert. Now I start to understand the Conservative mind.
Needham (on the ACA): “It’s one-sixth of our economy!”
Please indulge me. Lets say that Trump in his fervor to fix the infrastructure, rebuild dams, waterworks, roads etc. Then finding there's not enough gives it off to the highest bidder. A significant amount of damns and reservoirs are fixed, built. But now, privatized. The new owners charge for the water. Americans are up in arms. What was once affordable is now prohibitive. There is a move in the Government to borrow money to pay off the owner and make it a public good. Heritage and Needham would be front and center, "But, but, but, its One-Tenth of the economy!"
Healthcare should be affordable and all Americans must pay into it for it to be affordable. No exclusions. It need not be socialized. All the European versions have private medicine for those that can afford to pay for them It will still thrive here. But the extra bureaucracy and the outsize profits have to go. If the GOP persists in this foolish venture the false claims of Death Panels they said will come with Obamacare will come true under their model.
Yes it to totally makes sense, take a guy who knows nothing about Asia and appoint him as their expert. Now I start to understand the Conservative mind.
Needham (on the ACA): “It’s one-sixth of our economy!”
Please indulge me. Lets say that Trump in his fervor to fix the infrastructure, rebuild dams, waterworks, roads etc. Then finding there's not enough gives it off to the highest bidder. A significant amount of damns and reservoirs are fixed, built. But now, privatized. The new owners charge for the water. Americans are up in arms. What was once affordable is now prohibitive. There is a move in the Government to borrow money to pay off the owner and make it a public good. Heritage and Needham would be front and center, "But, but, but, its One-Tenth of the economy!"
Healthcare should be affordable and all Americans must pay into it for it to be affordable. No exclusions. It need not be socialized. All the European versions have private medicine for those that can afford to pay for them It will still thrive here. But the extra bureaucracy and the outsize profits have to go. If the GOP persists in this foolish venture the false claims of Death Panels they said will come with Obamacare will come true under their model.
7
I have been a practicing physician since 1995, working in underserved areas for 10 years and currently both in clinical practice and healthcare information technology with a focus on population health. If there is any legislative issue I understand, it is this. Price is not the person you want at the HHS helm.
If you are serious about healthcare, why support a nominee who believes "what's good for doctors and healthcare industries is good for patients"? His track record in Congress speaks for itself, That is letting the fox rule the hen house.
The Affordable Care Act has compelled insular hospital systems to think about caring for the needs of the patients in their communities NOW to reduce the cost of expensive and frequently futile (but lucrative) care LATER, and to work toward the free flow of standardized patient information that can "follow" the patient wherever they go next.
This did not happen by accident. The ACA mandated it, in large part by leveraging the foundational technology implementations required in the HITECH act.
Of course, all the technology does little good if people are not enrolled and receiving care. The current "replace" options put forward by the GOP will do little to encourage patients to pursue preventive care today, but will do a lot to place the burden for coverage of expensive "high risk" patients squarely on the backs of the taxpayer tomorrow.
If you are serious about healthcare, why support a nominee who believes "what's good for doctors and healthcare industries is good for patients"? His track record in Congress speaks for itself, That is letting the fox rule the hen house.
The Affordable Care Act has compelled insular hospital systems to think about caring for the needs of the patients in their communities NOW to reduce the cost of expensive and frequently futile (but lucrative) care LATER, and to work toward the free flow of standardized patient information that can "follow" the patient wherever they go next.
This did not happen by accident. The ACA mandated it, in large part by leveraging the foundational technology implementations required in the HITECH act.
Of course, all the technology does little good if people are not enrolled and receiving care. The current "replace" options put forward by the GOP will do little to encourage patients to pursue preventive care today, but will do a lot to place the burden for coverage of expensive "high risk" patients squarely on the backs of the taxpayer tomorrow.
37
Humana just pulled out. Obamacare will collapse of its own weight. Dems don't want it fixed, it was designed to fail and usher in socialist medical care
6
Fingers crossed!
3
We already have "socialized medical care". It's called Medicare. You should tell everybody we need to eliminate it. Start by telling your parents.
8
Yes!
Medicare and insurance costs are spiraling out of control, faster than they were before Pelosi sold us out. Repealing it will be better than nothing.
4
So the best solution is to let the old folks (like me, at 70) try to fund their own insurance, even though I have worked since I was 16, putting money into Medicare from the time of its conception, and just started using it in June of '15, at the age of 68. That sounds fair enough - NOT!!!!!!
5
Well - repealing it will be better than nothing ? At what cost do you think repealing is good - 100,000 lives ? More perhaps ? Obviously the lives are those of poor people so do you consider those lives worth less ? Just checking :)
2
This question of whether the life of the poor person is worth less than the life of the 68-year-old person that has legitimate issues funding his own insurance is the very reason a system that treats everyone the same is the only answer.
That system is some version of a single-payer system!
Consider this when you judge Mr. Benton's comment - he may have more income which enables him to pay a higher premium then the poor person but how do you expect him to come up with money to pay for unplanned increases in annual expenses due to increases in health insurance premiums and deductibles - particularly if his income is fixed. Using my personal increases as an example ( I am younger than Mr. Benton and self-employed) vs last year I have to come up with an additional $350 a month for health insurance. This is not easy to do when your income and expenses are basically fixed.
I would argue that the poor person is better off because the subsidies will be adjusted so that the insurance is "affordable".
That system is some version of a single-payer system!
Consider this when you judge Mr. Benton's comment - he may have more income which enables him to pay a higher premium then the poor person but how do you expect him to come up with money to pay for unplanned increases in annual expenses due to increases in health insurance premiums and deductibles - particularly if his income is fixed. Using my personal increases as an example ( I am younger than Mr. Benton and self-employed) vs last year I have to come up with an additional $350 a month for health insurance. This is not easy to do when your income and expenses are basically fixed.
I would argue that the poor person is better off because the subsidies will be adjusted so that the insurance is "affordable".
OK, I'll admit it: I'm a Democrat -- but I am stunned at how bad a job the Republicans are doing. I mean, they waited 8 years to get back in power, and they come across as rank amateurs when it comes to providing reasonable and mature governance. Or was this Keystone Cops routine what they planned from the beginning?
24
American Medical Association (AMA) tightly controls the number of doctors by limiting seats in medical colleges so that doctors' salaries remain high. Pharmaceutical industry successfully lobbies to increase patent duration so that they can continue to reap above normal profits from life saving medicines. Congress passes laws to prohibit Medicare payments for outsourcing of radiology interpretations and other services to cheaper countries.Insurance companies keep on acquiring each other to limit consumer choices and competition. Employers who are the buyers of insurance are not consumers, and employers can often pass on higher costs to employees. Therefore, consumers have little power vis-à-vis healthcare industry. No wonder premiums keep on rising.
25
Hey Robert, the AMA has zero control over the number of "seats" in medical "colleges."
1
Mr. Srivastava makes some correct points, but a few facts must be kept in mind. First, the AMA has no purview over the building of medical schools or the number of seats, but I will admit that this is a technical matter. More to the point, it turns out that more supply does not seem to decrease healthcare costs. Oddly, the opposite is true, and this has been very well documented by researchers like Elliot Fischer and Jack Wennberg at Dartmouth. The term is "supply- and preference-sensitive care." Locales in the US with more physicians, hospitals and operating rooms provide more care - per capita - so costs per patient dont go down, they go up. I do agree that the pharmaceutical and device industries have been immune from competitive bidding based on hard-to-understand provisions of federal law that pre-date and have nothing to do with the ACA.
3
"We're probably in an age where smaller, humbler pieces of legislation are easier to get consensus around." I.e., completely reject at effort to work with the left to improve legislation but then go ahead and do it once your guy is in power. People are dying due to their access to healthcare and these guys are more worried about political scores. How does any Christian vote republican?
43
People are dying due to their inability to access healthcare? The ADA is unchanged since Trump took office but sure, blame Republicans. What a joke.
1
In refusing, seven years ago, to work with Republicans in devising some sort of bipartisan version of Obamacare, the Democrats made it clear they weren't interested in working with the Right. The Democrats own Obamacare and are wholly responsible for its dying. And it was Democrats who devised a system that's so expensive and with such outrageous deductibles that for most "access to healthcare" is poorer now than it was seven years ago--if "people are dying," it's the doing of the Democrats.
1
How indeed, TM. One only has to read as far as The Beatitudes and "Do unto others...."
3
Obamacare is the first target for the GOP, then Medicare, then Social Security.
The GOP wants to hurt as many as possible.
The GOP wants to hurt as many as possible.
21
The most striking thing about the GOP is how ignorant it is. If I have a job I want to do, I start my preparations, I make my lists, I discuss options with co-workers and others, I float ideas to see how they work, and solicit comments, etc. Then, when the job is available, I am ready for it.
With the GOP, it's almost as though none of them read even a NYT article on Obamacare, and they certainly didn't collect information from their constituents or from other affected parties. They are caught flatfooted and looking dumb. Who can they blame this time? Apparently, the only healthcare that interests them is related to a woman's uterus.
With the GOP, it's almost as though none of them read even a NYT article on Obamacare, and they certainly didn't collect information from their constituents or from other affected parties. They are caught flatfooted and looking dumb. Who can they blame this time? Apparently, the only healthcare that interests them is related to a woman's uterus.
22
First repeall the mandate to treat [EMATLA]. Reagancare
Then repeal the mandate to purchase insurance [Obamacare]
and wait for something fabulous from the Russians.. I meant Trump
Then repeal the mandate to purchase insurance [Obamacare]
and wait for something fabulous from the Russians.. I meant Trump
4
How about an article that comprehensively addresses the unbelievable rates the drug companies are charging our "so called" Health Care system for the same drugs that are available elsewhere for less than a fraction of the cost. This is, of course, only one of the reasons our "so called" Health Insurance costs the average household more than the outrageous cost of housing and most certainly drags down our ability to compete in a global economy.
3
I feel sickened reading this. There is little that I didn't already know but to see the details of how these ... people were so focused on their own victory and had absolutely no regard for the well being of their fellow Americans. Discouraging any helpful changes because they only wanted full repeal. This is everything that is wrong with our system of government right now. Never mind thirty-somethings downscoring a Senator because he had the audacity to attend his father's funeral. Dispicable
25
You uncover the heart of the problem. Our system is broken. Consensus and cooperation is not encouraged, even allowed. Needs big changes. It only serves the Oligarchy now.
1
What a great new reality TV show: Donald Trump starring in "House of Shards"! And that great theme song: "When We Break It, We'll Blame Someone Else and They'd Better Fix It--Or Else"!
9
I sure hope that the Republicans cut out Obamacare. Please, every Democrat must do their part to make this happen. Call the Republican Congress and insist they destroy Obamacare just as they promised.
There's no other way to wake the Trumpsters up to the reality of fake news. So what if it hurts Democrats - we can take it. During war you sacrifice to win.
This is the One Big Chance to turn it around, let the Republicans own it, and watch the Trumpsters march on Washington. Maybe the Republicans will think twice about privatizing Medicare and Social Security.
There's no other way to wake the Trumpsters up to the reality of fake news. So what if it hurts Democrats - we can take it. During war you sacrifice to win.
This is the One Big Chance to turn it around, let the Republicans own it, and watch the Trumpsters march on Washington. Maybe the Republicans will think twice about privatizing Medicare and Social Security.
8
Quite an amazing compendium. Should be required reading for anyone who wants to have a serious discussion about the ACA.
4
Do Republicans in Congress have any credibility with the Affordable Care Act?
In a word, no.
In more words: Republican members of Congress have spent the last 6-plus years whingeing about ACA and the need to repeal and replace a law based on an idea their own think tanks first devised, an idea put into effect in Massachusetts by a Republican governor, who as a presidential candidate vowed to eliminate the US version of it because it was suddenly bad policy.
They spent all that time with their symbolic repeal votes in the House and later Senate, knowing they would never have to worry about a replacement, because their repeal bills would be vetoed. Just come up with a good screed/diatribe about the Obama administration that even the shallowest of intellects could latch onto and parrot.
But questions remain. Why did the Heritage Foundation ever cook up this loser of an idea in the first place, thinking it would be good for America? Aside from appeasing a far-right faction of the GOP, why did Mitt Romney enroll the Bay State into his version of Obamacare then turn around and disparage the ACA as would-be trouble for the other 49 states?
Republicans owe Americans some answers. Otherwise, it's fair to say Republicans have ulterior motives with ACA. Repeal matters to them; replacement? Ha! It's not part of their equation. They only care to the point that constituents may stick them with some blame they so richly deserve at this point.
In a word, no.
In more words: Republican members of Congress have spent the last 6-plus years whingeing about ACA and the need to repeal and replace a law based on an idea their own think tanks first devised, an idea put into effect in Massachusetts by a Republican governor, who as a presidential candidate vowed to eliminate the US version of it because it was suddenly bad policy.
They spent all that time with their symbolic repeal votes in the House and later Senate, knowing they would never have to worry about a replacement, because their repeal bills would be vetoed. Just come up with a good screed/diatribe about the Obama administration that even the shallowest of intellects could latch onto and parrot.
But questions remain. Why did the Heritage Foundation ever cook up this loser of an idea in the first place, thinking it would be good for America? Aside from appeasing a far-right faction of the GOP, why did Mitt Romney enroll the Bay State into his version of Obamacare then turn around and disparage the ACA as would-be trouble for the other 49 states?
Republicans owe Americans some answers. Otherwise, it's fair to say Republicans have ulterior motives with ACA. Repeal matters to them; replacement? Ha! It's not part of their equation. They only care to the point that constituents may stick them with some blame they so richly deserve at this point.
16
Most Americans are so myopic and brainwashed that they have no idea how healthcare works in the rest of the "civilized world". If they knew that the rest of the so-called "First World" provides more effective health care to 100% of their citizens (and visiting foreigners too) at roughly half the cost (and virtually none of the paperwork) - they'd be marching in the streets demanding that America adopt "whatever they have".
As this article amply illustrates, the ACA is a Rube Goldberg monstrosity cobbled together by a complex of interlocking service providers - all of which are dedicated primarily to making as much profit as possible while actual treatment of patients is merely deemed an "expense" to be minimized. THAT'S why health care costs twice as much in America as almost anywhere else in the world - while providing patient outcomes which rank 37th (on a par with Costa Rica and Slovenia).
As T. R. Reid stated so eloquently in his 2010 book "The Healing of America", the rest of the world starts from the premise that quality, affordable health care is a fundamental right of citizenship. They then go off and find dozens of different ways of accomplishing this goal, with each nation incorporating its own cultural traditions into their respective systems.
But they all revolve around some form of "single-payer" administration and all focus on providing cost-efficient health care for everyone, rather than "maximizing profits".
And it works (just like Medicare for all).
As this article amply illustrates, the ACA is a Rube Goldberg monstrosity cobbled together by a complex of interlocking service providers - all of which are dedicated primarily to making as much profit as possible while actual treatment of patients is merely deemed an "expense" to be minimized. THAT'S why health care costs twice as much in America as almost anywhere else in the world - while providing patient outcomes which rank 37th (on a par with Costa Rica and Slovenia).
As T. R. Reid stated so eloquently in his 2010 book "The Healing of America", the rest of the world starts from the premise that quality, affordable health care is a fundamental right of citizenship. They then go off and find dozens of different ways of accomplishing this goal, with each nation incorporating its own cultural traditions into their respective systems.
But they all revolve around some form of "single-payer" administration and all focus on providing cost-efficient health care for everyone, rather than "maximizing profits".
And it works (just like Medicare for all).
22
Gee why not forget about ACA and leave it as is. And start regulating the hospital/pharmaceutical industry.
Oh, no! Why would we everwant to do that? Free enterprise above all, including advanced kleptocracy!
Oh, no! Why would we everwant to do that? Free enterprise above all, including advanced kleptocracy!
13
Hi - is this number confirmed correct, seems like a very high percentage of the country to have chronic illnesses?
"a meaningful protection for the 133 million Americans with chronic illnesses. "
"a meaningful protection for the 133 million Americans with chronic illnesses. "
3
It is correct. You have to take into account what is considered to be a chronic illness by the insurance industry, let alone a pre-existing condition. I probably have six to eight myself, yet I only have one that you'd traditionally think of as a chronic illness (Crohn's Disease).
1
High quality affordable care, who wouldn't want it? Apparently the republicans, who take their healthcare insurance for granted, all the while obstructing the least among us from getting similar assurance for coverage at a reasonable cost (even if subsidies are needed, paid for by us, taxpayers). A mandate (all people, even the young and healthy), was essential, so the premium wouldn't become too much of a burden. I doubt very much the republican congress, so irresponsibly advocating for its repeal by choking off the funds necessary to make it work (so they can say, hypocrites as usual, "I told you so"). Clearly, no partial system, be it the ACA or "Oscar" (akin to the ACA, and really trying to care for the patient), may escape the gouging by the healthcare industry (the physicians being the least likely, with an annual income of ~200K, the CEO's the worse, with an assault of the coffers with some 2 to 3 million dollars a year). The answer, adopted by every other industrialized nation except the U.S.A., is a single payer universal health care system, to remove the shameful impulse of greed; and where the reason of the health industry, the caring for the patient, looks like an afterthought. Trouble is, dislodging the powerful lobby for the health industry may be near impossible. And all began during the IIWW, when the war labor board decided that the benefits of health insurance counted as wages (not allowed then); leaving employers as the providers of health insurance.
12
With the shamelessly entrepreneurial Dr. Tom Price as the Secretary of Health and Human Services, the current GOP politicians, in their drive to repeal and replace Obamacare, will merely revert to its regressive roots.
The laissez faire economic fatalism of Rev. Thomas Robert Malthus provides them with wise counsel:
"To act consistently [in accord with the laws of population increase, of scarcity and of the market], we should facilitate, instead of foolishly and vainly . . . impede, the operation of nature in producing . . . mortality . . . ." An Essay on the Principle of Population (New York: Dutton, 1960), vol. 2, pp. 179-80; originally published in 1803.
For the underclasses, death is a blessing.
Who needs death panels? The GOP's non-healthcare policies will result in a natural culling of the human herd.
For GOP politicians, as for Reverend Malthus, laissez faire capitalism is divinely preordained, as are the deaths of the non-affluent among the old, the halt and the infirm.
The prudent know it is best to turn a profit, stand back and let divinely inspired capitalism take its course. To do otherwise would be to compromise with sinful socialism!
Blessed be the shameless entrepreneurs for theirs' is the kingdom of Mammon.
The laissez faire economic fatalism of Rev. Thomas Robert Malthus provides them with wise counsel:
"To act consistently [in accord with the laws of population increase, of scarcity and of the market], we should facilitate, instead of foolishly and vainly . . . impede, the operation of nature in producing . . . mortality . . . ." An Essay on the Principle of Population (New York: Dutton, 1960), vol. 2, pp. 179-80; originally published in 1803.
For the underclasses, death is a blessing.
Who needs death panels? The GOP's non-healthcare policies will result in a natural culling of the human herd.
For GOP politicians, as for Reverend Malthus, laissez faire capitalism is divinely preordained, as are the deaths of the non-affluent among the old, the halt and the infirm.
The prudent know it is best to turn a profit, stand back and let divinely inspired capitalism take its course. To do otherwise would be to compromise with sinful socialism!
Blessed be the shameless entrepreneurs for theirs' is the kingdom of Mammon.
3
The first sentence in my earlier posting should read: "With the shamelessly entrepreneurial Dr. Tom Price as the Secretary of Health and Human Services, the current GOP politicians, in their drive to repeal and replace Obamacare, will merely revert to THEIR regressive roots."
3
All they wanted was to kill something the black president had done.
20
It's amazing how many reactionary, ill-informed, apathetic, angry people there are on this planet, who never ever, ever, ever take the time to question their sources, question their leaders, or question anything for that matter. Thinking is not only hard, it's downright terrifying. Much less difficult to accept the thinking of the masses—the comfort of the spiritually mediocre. That's why progress on our planet is so difficult; many of us instinctively fight against progress.
5
When they -- who by the way have a very good and, we might say, socialized healthcare program that WE provide for them -- take a healthcare program away from folks who have been protected in many ways but don't know it, I predict they've seen nothing in terms of protest and resistance and lost votes. For one thing, they never told people (who for some reason didn't know it) that the ACA they loved is actually Obamacare which they "hated." So they'll try to persuade folks that a plan with limits and caps and vouchers and pools that should scare them, in a world of lax regulation when pharma can take drug prices anywhere it wants, is so very good. When all it benefits are the wealthiest among us for whom Congress really works.
6
What happened to of, by for the people? I no longer believe our so-called representatives in Washington work for the citizenry. Rather, they work for themselves. Remember, their salaries once elected, last until death. One day we will go down as the Roman Empire did. Can no one think beyond the present moment?
4
Our rep is so non-representative that he has announced he will not will with his constituents. He says all who disagree with him are a bunch of paid agitators.
No, we are not. We are people stuck in a district so gerrymandered that we may never get representation. Oh, maybe that means no taxation, too???
No, we are not. We are people stuck in a district so gerrymandered that we may never get representation. Oh, maybe that means no taxation, too???
I work as a hospital physician and agree that the costs of medical tests, treatments, and procedures are astronomical. Many ask why are they so high. I do as well. Here some explanations which conspire to make our "system" in the world's most costly, while producing only middling results, do not cover everyone and is the leading cause a personal bankruptcy in our country.
1. Healthcare in the U.S. is socialized, but in the stupidest way possible. Emergency rooms are legally obligated to screen and treat all patients that walk through their doors without regard to ability to pay. Many patients therefore do not get preventive/timely care clinics and offices, and wait until their condition is serious and require expensive workups and treatments. Some just come in for routine care, which is provided in the most expensive way possible. Afterwards, when the hospital sends a bill that patients can't/won't pay, their costs gets shifted to the insured.
2. Our federal government mandated that Medicare, the biggest purchaser of medications, cannot negotiate drug prices with pharmaceutical companies. Guess who sets the price?
3. High technology cutting-edge procedures or handsomely rewarded, but those working to prevent disease or manage chronic conditions are poorly paid, so healthcare systems concentrate on costly esoteric procedures that benefit few.
More.....
1. Healthcare in the U.S. is socialized, but in the stupidest way possible. Emergency rooms are legally obligated to screen and treat all patients that walk through their doors without regard to ability to pay. Many patients therefore do not get preventive/timely care clinics and offices, and wait until their condition is serious and require expensive workups and treatments. Some just come in for routine care, which is provided in the most expensive way possible. Afterwards, when the hospital sends a bill that patients can't/won't pay, their costs gets shifted to the insured.
2. Our federal government mandated that Medicare, the biggest purchaser of medications, cannot negotiate drug prices with pharmaceutical companies. Guess who sets the price?
3. High technology cutting-edge procedures or handsomely rewarded, but those working to prevent disease or manage chronic conditions are poorly paid, so healthcare systems concentrate on costly esoteric procedures that benefit few.
More.....
23
These are only two of a score of fundamental reasons why "health care is socialized, but in the stupidest way possible. "
Public support ,even for the flawed ACA, per the polls, is creeping up, continually and significantly. beyond 50 percent.
But most people can't be bothered to understand the details or the issues in health care"insurance." Or that a "single payer"system for health care coverage of costs, is not, and would not be "socialism.".
This saga of how health care has been handled is a prime example of the oft-noted American tendency to try many flawed solutions before resigning ourselves to go for solutions that work.
Nowhere else has there been reporting of this depth and quality on the recent history of health care legislation in the Congress,' We have been trying to do something about this problem since the time of Teddy Roosevelt. The Amnerican Medical Assoiation was always, among others, opposed. Now The AMA is not opposed. But AMA members are a shrinking minority of physicians.
Public support ,even for the flawed ACA, per the polls, is creeping up, continually and significantly. beyond 50 percent.
But most people can't be bothered to understand the details or the issues in health care"insurance." Or that a "single payer"system for health care coverage of costs, is not, and would not be "socialism.".
This saga of how health care has been handled is a prime example of the oft-noted American tendency to try many flawed solutions before resigning ourselves to go for solutions that work.
Nowhere else has there been reporting of this depth and quality on the recent history of health care legislation in the Congress,' We have been trying to do something about this problem since the time of Teddy Roosevelt. The Amnerican Medical Assoiation was always, among others, opposed. Now The AMA is not opposed. But AMA members are a shrinking minority of physicians.
1
I meant to say all the three reasons given are only three of scores of other reasons. The only replace that would be an improvement would to pay for health care for all, with unversal coverage," something like "Medicare for all," paid for with public funds, like fire departments, police, highways. Services that most people do not need all the time but everyone needs sometimes in any livable community. -- paidfor with public funds. Such an arrangement would depend on taxation of personal incomes, corporate incomes, and other sources. But public financingt would eliminate the need for a for-profit, private sector "health "insurance" industry.
We are going to have to solve this. But at the moment we are between a rock and a hard place -- an inadequate, needlessly complicated "system" of"health insurance," 30 milion people without any coverage and more millions with inadequate, undependable coverage, often with high deductibles and co-pays, both unaffordable for many. In this "system" many cannot be provided with adequate health care. So many of those people, unable to pay ot ro pay enough for health care, will be chronically ill or will die before their time..
We are going to have to solve this. But at the moment we are between a rock and a hard place -- an inadequate, needlessly complicated "system" of"health insurance," 30 milion people without any coverage and more millions with inadequate, undependable coverage, often with high deductibles and co-pays, both unaffordable for many. In this "system" many cannot be provided with adequate health care. So many of those people, unable to pay ot ro pay enough for health care, will be chronically ill or will die before their time..
1
It was easy enough to vote for repeal when Obama was president. Say what you will about Obama, he was very reliable on this issue and vetoed every repeal bill.
Now the fun is over. Medical costs continue to be out of control, and they are so high that no scheme of payment will ever work. Insurance companies can't afford them, the government can't afford them, and individuals can't afford them.
Eventually, it will occur to the Republicans that they need to cut these costs. Congress, being a bunch status-quo bureaucrats, would never say that. However, President Trump tends to be very open about point out the obvious problem, and saying we should fix it.
I expect to see the tweet any day: "You know, gastroenterologists average $376K a year in income, and orthopedic surgeons $410K. Give me a break, how can the average guy ever afford this????"
Now the fun is over. Medical costs continue to be out of control, and they are so high that no scheme of payment will ever work. Insurance companies can't afford them, the government can't afford them, and individuals can't afford them.
Eventually, it will occur to the Republicans that they need to cut these costs. Congress, being a bunch status-quo bureaucrats, would never say that. However, President Trump tends to be very open about point out the obvious problem, and saying we should fix it.
I expect to see the tweet any day: "You know, gastroenterologists average $376K a year in income, and orthopedic surgeons $410K. Give me a break, how can the average guy ever afford this????"
15
Physicians spend between 11-15 years AFTER high school in training, and are often on average $250,000 in debt. The real costs aren't physician salaries, for which most doctors work anywhere from 60-80 hours per week and are increasingly burned out, retiring early or leaving medicine altogether.
The real costs of medical care are from the increasing number of CEOs, COO, and administrators, and insurance company administrators, which we just don't need. Their salaries are often $500,000 to several million dollars. This is a new expense in medicine, burgeoning in the past ten years or so. Many of them may have bachelors degrees only (4years past high school), maybe they went to business school (add three more years), much less debt, and work 40 hours per week, yet they earn as much or several times more than any physician. Look it up, it's all true.
The real costs of medical care are from the increasing number of CEOs, COO, and administrators, and insurance company administrators, which we just don't need. Their salaries are often $500,000 to several million dollars. This is a new expense in medicine, burgeoning in the past ten years or so. Many of them may have bachelors degrees only (4years past high school), maybe they went to business school (add three more years), much less debt, and work 40 hours per week, yet they earn as much or several times more than any physician. Look it up, it's all true.
1
We pay the paper pushers on Wall Street far more than the MDs and the MDs actually do something to help us.
2
The pricing of medical services and drugs has to do with one thing, rampant abuses by private corporations to jack up prices bc republicans love a free market where the government subsidizes them and the middle class gets eradicated
2
Lieberman sunk single payer as an option. Many of us will always remember him for this and this alone.
71
I remember his wife has a really odd name too.
The ACA or some substitute plan put forward, say TrumpedUpCare, is not the central problem facing American citizens. The monopolistic pricing of healthcare goods and services is the real problem that no one in Congress is willing to talk about let alone tackle. After all, they all have their investment portfolios to look after and the healthcare industry is one of the fastest growing, highest profit margin sectors on Wall Street. Congress has repeatedly tilted the playing field in favor of the major corporations providing goods and services and allowed regional hospitals and surrounding medical practices to be bought up by large corporations whose only interest is in higher profits. Furthermore, Wall Street drives publicly traded healthcare corporations to continually increase their profitability or see their share values decline. Until the contract between America and Big Healthcare/Big Pharma gets changed from "You get well/We get rich" to something more sustainable, no private or government run shared risk system like the ACA will provide satisfactory outcomes. Republicans are holding their breath hoping Americans won't figure out that their whole focus on Obamacare repeal is nothing more than a scam to distract them from the real issues at hand. They'll probably succeed.
46
Congressional Republicans are in a real bind. They hate the thought of government support for healthcare, and they have no credible replacement (or enough gullible constituents now willing to accept something far lesser). Their most likely strategy, as long as they're in control, will be to delay any replacement ('it's sooo complicated but we're working hard!'), continue to denounce the ACA's shortcomings and inevitable failure, and then handicap it any way they can while hoping it appears to die a natural death.
It's legislative malpractice but that's the government we elected (assuming you're fine with gerrymandered districts, voter suppression, and ample fake news about healthcare).
It's legislative malpractice but that's the government we elected (assuming you're fine with gerrymandered districts, voter suppression, and ample fake news about healthcare).
32
Dog finally catches car has no idea in the world what to do with it now.
Yelling from the podium is easy governing is hard and Trump has never worked a hard day in his life ! If people's lives were not literally at stake this would be funny.
Yelling from the podium is easy governing is hard and Trump has never worked a hard day in his life ! If people's lives were not literally at stake this would be funny.
68
In engineering, the fundamental rule is that the proper operation of a system depends on people’s acceptance of the system. If they don’t like it, for whatever reason, or will not utilize it as designed, then, despite what its creators think and data may show, it’s a bad idea. You may win a patent, but you’ll never sell it.
11
Very discouraging to read about the years wasted by Republicans when they could have been creating legislative revisions to ACA law that was a solution drafted to solve significant problems.
Insurance & Health industry’s expectation was "that the law would prove flawed in places, and that those shortcomings would be addressed legislatively. "
With a majority and so much lead time, should be easy for Republicans to fi what they were whining about.
We are stuck with a President who never gets into details, so he will likely sign anything.offered up.
Republicans must tread carefully in this china shop.
Insurance & Health industry’s expectation was "that the law would prove flawed in places, and that those shortcomings would be addressed legislatively. "
With a majority and so much lead time, should be easy for Republicans to fi what they were whining about.
We are stuck with a President who never gets into details, so he will likely sign anything.offered up.
Republicans must tread carefully in this china shop.
13
Secretary Price was confirmed four days ago and a replacement should be ready? Which is it, a rash administration or an over-cautious administration? This complex subject warrants careful consideration, whatever one's politics. Though you wouldn't know it from reading Mr. Draper's article, the outlines of a replacement are roughly clear if you compare Price's suggestions, Ryan's suggestions, and the president's suggestions during the campaign. What amazes me is that in a 64-paragraph article, the Secretary of HHS, who is the single most knowledgeable and empowered person with respect to this subject, is mentioned only once, briefly, in paragraph 24. There is something deeply odd about this piece.
8
Agree!
1
Why replacement
If things were great, repeal and go home!
If things were great, repeal and go home!
1
Price is not knowledgeable.
3
Heritage was created as a front organization to help the Oligarchs regain control of the country. Go back and read about the Lewis Powell memo to the wealthy oligarchs about how to pool their resources to compete with the Democrats and eventually control the federal government. Heritage was supposed to be a think tank. None of them counted on their inability to think, much less formulate policy, enact it and carry it out. All that requires work and the GOP doesn't really know how to work. They do know how to stop things from working.
29
As. Canadian citizen U.K. Born I and my partner live in Canada by Choice.
We considered several options 15 yrs ago Spain was up there and my wife was very keen on the US but I said no way were we exposing ourselves to the US Healthcare system, our age.
NAFTA gets in Canada, drug prices are outrageous by comparison to the U.K. Fixed price prescription the main element where the UK beats everyone for around $20 you can buy any approved drug on prescription.
Depending on who is in government you can get multi prescriptions during Labour government and the so called cost cuttings Tories usually ban the practice.
When we left the UK my sons Asthma stuff cost £12, monthly in Canada $CA140 or around $100 US on average.
The differences in Obamacare and how the NHS was born are really few the UK struggled with several realizations after WW1 the main one being a lack of fit men for cannon fodder, and a shortage of NCO,s with education as good as the Germans.
So both Healthcare and Edu need to be improved from the market based system the U.K. had.
WW2 proved Health simply wasn't good enough. Private Insurance based system was introduced, it wasn't working guess what the Tories were going to scrap it they won the election and eventually were forced to introduce single payer.
The Insurance companies proved themselves incapable of providing a solution as Government purchasing power is really the key to supply side healthcare.
We considered several options 15 yrs ago Spain was up there and my wife was very keen on the US but I said no way were we exposing ourselves to the US Healthcare system, our age.
NAFTA gets in Canada, drug prices are outrageous by comparison to the U.K. Fixed price prescription the main element where the UK beats everyone for around $20 you can buy any approved drug on prescription.
Depending on who is in government you can get multi prescriptions during Labour government and the so called cost cuttings Tories usually ban the practice.
When we left the UK my sons Asthma stuff cost £12, monthly in Canada $CA140 or around $100 US on average.
The differences in Obamacare and how the NHS was born are really few the UK struggled with several realizations after WW1 the main one being a lack of fit men for cannon fodder, and a shortage of NCO,s with education as good as the Germans.
So both Healthcare and Edu need to be improved from the market based system the U.K. had.
WW2 proved Health simply wasn't good enough. Private Insurance based system was introduced, it wasn't working guess what the Tories were going to scrap it they won the election and eventually were forced to introduce single payer.
The Insurance companies proved themselves incapable of providing a solution as Government purchasing power is really the key to supply side healthcare.
5
As you are both Canadian citizens, and entitled to Canadian single payer...you could have moved to the US, but lived near the border (Seattle, perhaps) and gone into Canada for anything expensive like surgery or to buy meds...but enjoyed a nicer, more affordable lifestyle in the USA.
Of course, this only works if you are legal Canadian citizens.
Of course, this only works if you are legal Canadian citizens.
A nicer more affordable lifestyle in the US, i would disagree on the nicer and if its more affordable why don't you stay in the US for your surgery or meds.
The repeal of the Affordable Care Act, with or without a replacement plan that guarantees coverage without regard to pre-conditions and coverage for family members up to age 26 will not alter the public reaction. As with many of his bombastic, poorly thought out promises, many of the 20 million people who will be affected, some large percentage of whom voted for Donald, will turn against him and against the Republicans. He has put himself and the GOP in a difficult position: do nothing and the promise to repeal is broken; repeal and lose significant voter support next November. The actual need to repeal has been poorly articulated. Vast numbers of the public who felt the need to be against, yes, simply against, were willing to join the parade to repeal with little or no information about the underlying facts. Now that push has come to shove, there is little enthusiasm for doing something among the majority in Congress, but a fear of doing nothing.
9
I don't think Obamacare will go "under the knife", as in, have surgery done on it. Surgery implies a very careful procedure intended to cure a problem. I also think, call me crazy, that whatever happens to "Obamacare" will also happen to "the ACA". Trump voters need to have this pointed out firmly.
But in any case, I wouldn't worry about it. The ACA, or even Obamacare, is not going to get scrapped, or repealed and replaced, in the next two weeks. Right? I mean, we're all fairly certain that nothing is going to get done about it immediately.
Meanwhile, Flynn was told to resign after three weeks because the president felt that he could not trust him, after knowing about his duplicity for two weeks. Or at least, that's the current story coming out of the White House, going with Spicer's quotes rather than Conway's.
So we can't trust the president either at this point, due to the constant lies and ridiculous, calamitous stunts. I don't think he'll be in office long enough to do anything about the ACA, and I'd bet right now that he'll never get around to locking up Hillary.
But in any case, I wouldn't worry about it. The ACA, or even Obamacare, is not going to get scrapped, or repealed and replaced, in the next two weeks. Right? I mean, we're all fairly certain that nothing is going to get done about it immediately.
Meanwhile, Flynn was told to resign after three weeks because the president felt that he could not trust him, after knowing about his duplicity for two weeks. Or at least, that's the current story coming out of the White House, going with Spicer's quotes rather than Conway's.
So we can't trust the president either at this point, due to the constant lies and ridiculous, calamitous stunts. I don't think he'll be in office long enough to do anything about the ACA, and I'd bet right now that he'll never get around to locking up Hillary.
4
Just want to make sure that you understand that Obamacare and ACA are the same. You talk as if they are not.
18
Kind of like "keep the government away from my SS"!
That would be sad, Dan, but then President Pence will take care of the problem.
The ACA is going down. It is evil. It is destroying my family's financial future, by charging for health care I do not receive! in order to give OTHERS free Medicaid!
We are cutting it's head off, putting a stake in its heart and burying it so deep the sun will never reach it. The evil is going to die.
The ACA is going down. It is evil. It is destroying my family's financial future, by charging for health care I do not receive! in order to give OTHERS free Medicaid!
We are cutting it's head off, putting a stake in its heart and burying it so deep the sun will never reach it. The evil is going to die.
1
The fight over providing affordable health care to American citizens highlights the illegitimacy of the Republican's ideology.
Who supports a political party that does not believe in creating a health care system that is affordable to everyone?
Why would anyone think a for-profit health care system would be a) more affordable, and b) lead to better health outcomes? I know, the Republican argument is that a market based system would accomplish these goals but they neglect to explain how. For profit businesses only survive if they make profit. Profits are made by raising revenue higher than costs or cutting costs or both. The profit incentive opposes making something more affordable and improving the quality of goods and services. Republicans point out competition will lower costs and improve quality, yet fail to point out that prices on everything has increased and quality has diminished in most cases.
Republicans support privatization and deregulation. In short, they don't believe in government or maybe they don't believe that government can be more effective and efficient. What about Medicare? Is that not a clear example of what government can accomplish?
Who supports a political party that negatively seeks to undermine and weaken government instead of endeavoring to improve and strengthen government? Republicans go out of their way to make things worse than necessary just to make their point. That's really sad!
Who supports a political party that does not believe in creating a health care system that is affordable to everyone?
Why would anyone think a for-profit health care system would be a) more affordable, and b) lead to better health outcomes? I know, the Republican argument is that a market based system would accomplish these goals but they neglect to explain how. For profit businesses only survive if they make profit. Profits are made by raising revenue higher than costs or cutting costs or both. The profit incentive opposes making something more affordable and improving the quality of goods and services. Republicans point out competition will lower costs and improve quality, yet fail to point out that prices on everything has increased and quality has diminished in most cases.
Republicans support privatization and deregulation. In short, they don't believe in government or maybe they don't believe that government can be more effective and efficient. What about Medicare? Is that not a clear example of what government can accomplish?
Who supports a political party that negatively seeks to undermine and weaken government instead of endeavoring to improve and strengthen government? Republicans go out of their way to make things worse than necessary just to make their point. That's really sad!
24
It was going under the knife regardless of who won the presidency. It never really addressed COST! To quote Bill clinton-
"So you've got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It's the craziest thing in the world,"
"So you've got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It's the craziest thing in the world,"
4
What an incredible waste of time an resources by these lobby guys. Special interests, like the Heritage Foundation, throw millions of dollars out the window in an ideological fight - yet I seriously doubt a single one of them could satisfactorily explain why. None of the doomsday scenarios repeated by them ever came true. The economy didn't lose jobs. Healthcare costs didn't spiral out of control. Nobody got put on 'death panels' (remember those?). None of it happened. Instead, what did happen, is that now for millions upon millions of Americans, it will no longer mean starvation and debt to go visit the doctor if they have to. What a horrible outcome.
If Mr. Trump wants my respect (a dubious proposition, but hey he could try) then all he really needs to do is get rid of ALL these special interests - on both sides. Start by banning lobbying. Chase these guys out of town with pitchforks and write a few laws forbidding them from coming back, ever again. So-called 'special interests' are the slimy swamp between we, the people, and our elected representatives. How about we drain it?
If Mr. Trump wants my respect (a dubious proposition, but hey he could try) then all he really needs to do is get rid of ALL these special interests - on both sides. Start by banning lobbying. Chase these guys out of town with pitchforks and write a few laws forbidding them from coming back, ever again. So-called 'special interests' are the slimy swamp between we, the people, and our elected representatives. How about we drain it?
13
Wake up Polleyana and check out the list of people he has appointed to his cabinet. Remember he railed against Goldman Sachs? Okay then count how many former Goldman Sachs executives are in his inner circle right now.
I will clear the swamp, my foot.
I will clear the swamp, my foot.
24
I wonder if GOP seniors have realized yet that their Medicare drug costs will be thousands more when the dreaded donut hole (coverage gap) that Obamacare eliminated, is restored?
29
It will slip by them until they go to their local pharmacy and are shocked!
After that, look out Republicans for 2018 but the deed will have been done!
After that, look out Republicans for 2018 but the deed will have been done!
1
If the Republican Party is truly committed to fueling the engine of economic growth, they will enact Medicare for all. The economic freedom this plan would give tens of millions of Americans--to retire before 65, to change jobs, to start new companies, and to move to locations with more job opportunities, would be a powerful economic stimulus.
I'm not going to hold my breath, though.
I'm not going to hold my breath, though.
72
Great economic argument we simply do not hear enough. Thanks!
3
All the reasons stated are likely the reason they will never propose single payer. If they did that everyone would not be beholden to them for their livelihood.
1
"So you've got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It's the craziest thing in the world,"
Bill Clinton
Bill Clinton
12
Clinton was wrong. It isn't the first time. However, the congressional budget office has formally predicted that what Clinton described will happen in the first year if the ACA is repealed. That's what has the GOP so shook up. They know they would repeal the ACA at their own extreme peril.
9
We are already feeling the consequences of just the threat of repeal in my Florida coastal community. The local hospital has made large capital improvements based on required mammograms and colonoscopies. New medical facilities (doctors offices) have been built to meet the increased demand. The local self insured Fortune 500 employer and the hospital network have not come to terms on pricing. Employer paid deductibles have gone up 35% this year as well as emergency room charges. Costs are out of control. Everyone wants to make a buck. Less paperwork, outcome based procedures, preventive care and other cost saving controls are needed. The only thing that can begin to control costs is a single payer cradle to grave system for all!
I've got a toll road near Charlotte, NC I'd like to sell you, if you believe you'll see a new health care plan until after the elections in 2018 and quite possibly not until after the elections in 2020.
Years ago, when President Obama presented his health care plan, the Affordable Care Act, a fellow retiree very loudly complained about it. When I inquired if she was on Medicare, and then told her it was basically a form of socialized medicine and maybe if she objected so much to the ACA she should pay back all the benefits she had received. To which I got an adamant "NO WAY", telling me she was entitled to those benefits.
I will never see in return the amount of money my husband and I paid to Social Security. But I believe everyone is entitled to health care and not at a cost that drives families into debt forever or bankruptcy.
Years ago, when President Obama presented his health care plan, the Affordable Care Act, a fellow retiree very loudly complained about it. When I inquired if she was on Medicare, and then told her it was basically a form of socialized medicine and maybe if she objected so much to the ACA she should pay back all the benefits she had received. To which I got an adamant "NO WAY", telling me she was entitled to those benefits.
I will never see in return the amount of money my husband and I paid to Social Security. But I believe everyone is entitled to health care and not at a cost that drives families into debt forever or bankruptcy.
55
I was directly affected by the ACA. I was able to get much better healthcare and as a result, I am healthier and better able to deal with my disability. This isn't something a political party or other Americans should want to destroy. President Obama did a wonderful thing for the people of our country. While I know the ACA isn't perfect and could use some tweaks, to repeal it without replacing it with something comparable is unacceptable and unconscionable. As Americans, we should want our fellow countrymen and women to be well educated, happily employed or retired, and healthy, by all means, healthy. The GOP needs to think of people first, country second and party third. Get it right GOP, or face the wrath of the people in perpetuity.
18
And again the question is what will the GOP replace the ACA with? What will someone who we haven't elected to office, namely Needham, be allowed to do about it? He is not suffering because he cannot afford to pay the premiums, the copays, the deductibles, facility fees, etc. We are. Other countries consider health care, all of it, a right. America, or one should say at this point, the GOP side of America, acts as if the ability to receive the care one needs when needed is a gift or a privilege. It's the same way they treat people who are homeless through no fault of their own, people who cannot find work or cannot work. The GOP appears to want the public to worship them or, if they won't do that, to suffer and die.
A single payor universal access health care system would be better than returning to what we had. It would be an improvement on the ACA because the ACA does not control the costs of insurance, prescription drugs, co-pays, and so on enough for ordinary people. I'd prefer to pay more in taxes to cover the cost of medical care so that people don't have to worry about going bankrupt than continue with a system where the only affordable part is the premium. Having health insurance does not equal access to health care, not with narrow networks, changes in formularies, changes in approved providers, and the one size fits all no flexibility allowed medicine being foisted on us.
A single payor universal access health care system would be better than returning to what we had. It would be an improvement on the ACA because the ACA does not control the costs of insurance, prescription drugs, co-pays, and so on enough for ordinary people. I'd prefer to pay more in taxes to cover the cost of medical care so that people don't have to worry about going bankrupt than continue with a system where the only affordable part is the premium. Having health insurance does not equal access to health care, not with narrow networks, changes in formularies, changes in approved providers, and the one size fits all no flexibility allowed medicine being foisted on us.
19
It is easy to rail against the ACA, run on teh promise of "repeal and replace", and convince people that there is a better way via rhetoric. It is a great deal harder to come up with an alternative. The GOP, from President Trump, on down, have been eating a great deal of crow. It is pretty hard to dump something that the GOP advocated 20 or so years ago, and even up until President Obama got elected, their primary goal "buy insurance or pay a fine".
I have made my position clear, that I am for Medicare fro All. If that is not possible, then private insurance that are national in scope. The premise, the larger the group, the lower the risk. Throw in no networks, no life time caps and no denial for pre-existing conditions. All insurers would be required to have national policies that write in every state big and small. This will spread the premiums across a larger scope of the population, educing the cost of being insured. Couple that, with cost containment and maybe even set pricing. A system similar to Germany.
Medicare fro All would have been more easier, in a technical sense. But, the entrenched health care industry, and far right fiscal conservatives, have been against it. Even though it would be cheaper than our existing for profit, charge what the market will bear health care system.
The ACA needs significant repair; realistic cost containment, national policy and groups will be a great step in that direction. But, I still favor Medicare for All.
I have made my position clear, that I am for Medicare fro All. If that is not possible, then private insurance that are national in scope. The premise, the larger the group, the lower the risk. Throw in no networks, no life time caps and no denial for pre-existing conditions. All insurers would be required to have national policies that write in every state big and small. This will spread the premiums across a larger scope of the population, educing the cost of being insured. Couple that, with cost containment and maybe even set pricing. A system similar to Germany.
Medicare fro All would have been more easier, in a technical sense. But, the entrenched health care industry, and far right fiscal conservatives, have been against it. Even though it would be cheaper than our existing for profit, charge what the market will bear health care system.
The ACA needs significant repair; realistic cost containment, national policy and groups will be a great step in that direction. But, I still favor Medicare for All.
21
If Republicans repeal the ACA and replace it with the slipshod amalgam I have seen them describe where all the popular points are retained but the funding to support these programs stripped, the resulting mess will be incredible. If I didn't know people would die as a result during the ensuing chaos, I would be pulling for this because it might get enough voters infuriated enough to throw out the Republicans and get a single payer Medicare for All enacted that would insure millions while keep Medicare solvent and eliminating the Huge deductibles the Insurance industry has foisted on everyone. I would hope it would render many insurance company executives unemployed while transferring most of their employees into a system aimed at paying for necessary medical procedures instead of denying sick people necessary health care!
16
They are so seriously behind the 8 Ball with missile tests, botched Yemen maneuver and now Flynn that I seriously doubt they can beat their way out of a paper bag, let alone create a brand new health and human services outfit while revamping our entire international strategy complete with The Wall O'Trump that Mexico is paying for.
13
With all the time and money spent for the repealing of the Obama health Care program and nothing solid has come forth makes one wonder what the Republican party was doing all that time. To make it simple there should be health coverage for all Americans. Health care under social security is a wonderful program. Social Security health care is paid on a monthly basis from social security checks, it is just taken out, no choice. Therefore those people on social security, add health care coverage for medicaid, disability, and unemployment plus other government programs, many Americans would have fairly good coverage. For those who do not fall into any of the above programs. The remander of Americans will continue to pay for their coverage or will fined until they buy coverage. What would be left out are the many health care companies and their huge profits. Lastly if one has an additional drug program, they state that they have managed to lower drug costs with drug companies then why cannot other groups do the same?
4
There is legitimate concern among a broad spectrum of citizens--voters of all stripes--that the Republican-controlled congress will, in their zeal, do real damage to healthcare coverage now in place because of the ACA.
What is so ironic about all this, in my view, is that ALL the decision makers involved in slashing Obama's healthcare legacy enjoy the very best healthcare available anywhere in the world...and do not anticipate losing any facet of that healthcare because of their actions. The same is true of Governors who opted out of Medicaid expansion as part of Obamacare. The whole situation repulses me, the way both federal and state lawmakers lack real empathy regarding their fellow citizens.
What is so ironic about all this, in my view, is that ALL the decision makers involved in slashing Obama's healthcare legacy enjoy the very best healthcare available anywhere in the world...and do not anticipate losing any facet of that healthcare because of their actions. The same is true of Governors who opted out of Medicaid expansion as part of Obamacare. The whole situation repulses me, the way both federal and state lawmakers lack real empathy regarding their fellow citizens.
18
As the saying goes about Needham, "ah, the ignorance of youth".
2
We have a secretary in our office who voted for Trump because she was angry that her Medical Premiums (partly paid for by her, partly by our employer) had gone up. She blames Obamacare. Why, I don't know. If we now remove approx. 20 million people from the health insurance rolls, what does she think will happen to her premiums. I asked her. She doesn't know. All she knows is that she was angry about her premiums and that's why she voted for Trump. Never overestimate the average intelligence of your typical Trump voter.
27
I phoned Blue Cross yesterday with a ? About our monthly premium invoicing. I commented that the increase was 6% for 2017.
The BCBS rep on the phone was surprised that the annual rates were increased each year. I asked her if she had been paying attention to what the US has been talking about the last 10 years? Nervous fumbling was response..
I think some people expect everything to be cheap / cheap clothes, cheap food.
The BCBS rep on the phone was surprised that the annual rates were increased each year. I asked her if she had been paying attention to what the US has been talking about the last 10 years? Nervous fumbling was response..
I think some people expect everything to be cheap / cheap clothes, cheap food.
2
I don't follow the logic of your post. Ofcourse the woman is upset about her monthly health insurance going up! Can you find anyone out there who's happy about this mess? Like everything else healthcare has become politicized. The ACA did NOTHING to address cost. Pre-existing conditions yes but not cost. It exasperated cost. I think both sides of the political spectrum have some good ideas in how to improve the situation but politics and the Medical-Insurance lobby will fight it tooth and nail.
2
So have a couple of rich white guys who have never tasted struggle, scoring Congress as part of a game.
Maybe they need to see the Rust belt town and trailer parks folk I grew up with to see that. I tell my children all the time you don't know how scary it is during a storm as a child to live in a Trailer. It is scary!
I will tell them this if they Repeal and don't replace with a more affordable for that class of Folks that put Trump in office, they will see those high scoring members of Congress out in 2018.
Maybe they need to see the Rust belt town and trailer parks folk I grew up with to see that. I tell my children all the time you don't know how scary it is during a storm as a child to live in a Trailer. It is scary!
I will tell them this if they Repeal and don't replace with a more affordable for that class of Folks that put Trump in office, they will see those high scoring members of Congress out in 2018.
8
To all you "single payer" advocates: it's never gonna happen. Why? Because it's the worst kind of socialism. Move to Cuba if you want free healthcare.
1
Canada is closest for us in the northeast. many of our comedians hail from there.
1
whenever an argument ends with "move to ____" , you know the person does not really have much to discuss as far as solving a problem. Liking programs from other countries or trying to look at other solutions does not mean we need to move. We are just looking for improvements.
9
It is not going to happen not because it is worst kind of socialism but because of all heath care and insurance industry lobbyist spending millions of dollars to buy votes in Congress. Single payer system means no insurance company is needed. Single payer also gives negotiating power to keep prices low.
Medicare is single payer for eligible 65 years and older people. It has one of the most popular programs. Why not offer it to everyone? Take the lobbyists and fanatic ideologues, who themselves have the best health coverage, out of conversation and maybe and perhaps maybe, we can get more pragmatic solutions.
Medicare is single payer for eligible 65 years and older people. It has one of the most popular programs. Why not offer it to everyone? Take the lobbyists and fanatic ideologues, who themselves have the best health coverage, out of conversation and maybe and perhaps maybe, we can get more pragmatic solutions.
23
Trump's support is not conditioned on replacing ACA or even providing a credible replacement plan prior to repealing ACA. It is conditioned on repeal only: repealing a failed program and setting firmly on path to well-earned ignominious history. Bottom line: despite pleas suggesting otherwise, ACA is not too big to fail, and fail completely. So repeal must happen, with deliberation and in finite time.
That doesn't mean throwing everyone under the bus, but it does mean advance warning that the ignition is being turned on. Not perfect, very imperfect in fact, but hugely less imperfect than ACA. And that's the only bar Trump needs to take care off.
That doesn't mean throwing everyone under the bus, but it does mean advance warning that the ignition is being turned on. Not perfect, very imperfect in fact, but hugely less imperfect than ACA. And that's the only bar Trump needs to take care off.
1
Mr. Needham is an idealogue who has no interest in seeing that all Americans have access to health care. He, along with the Heritage Foundation, managed to drag the Republicans into this dead end. All their talk about "something better" is just cover for "tax cuts for the rich" as is every other Republican policy stance.
11
The Republicans don't want a well educated citizenry, so why should they want a healthy one.
Oh wait - to buy guns and man law enforcement and the military.
Oh wait - to buy guns and man law enforcement and the military.
11
2,700 pages? All that was ever necessary was to allow all Americans to buy into Medicare. The public option. Let the American people decide if they wish to purchase public or private insurance.
11
OK, you can buy into Medicare, $2000 a month. Or you can buy private insurance. Happy now?
1
Where did you get that number? Why would medicare cost twice as much as a good private policy?
1
They better be worried. Trump promised, better, cheaper and covers more people. That's impossible without single-payer. I think they'll make an unholy mess of this and send 20 million p*ssed-off, uninsured voters to the polls in the midterms.
6
People's health and death, decided by 'takers and parasites' like Needham is scary and sad. These so called 'grown up' Republican congressmen and senators are nothing but 'cowards' that are herded around and made to bray on command by this 30 year old 'punks'; what a sad state our country has fallen into. It is disgusting and disheartening.
9
I sincerely hope that the Republicans do repeal the ACA so that the mostly poor red state people who depend on it but voted for Trump anyway, thinking he wouldn't cross that line will finally maybe understand that 1) elections have consequences and 2) Republicans don't care about them or any of the working poor, never have, never will.
10
An extraordinarily good article, wish the people who needed to understand this would read it.
I believe that we'll eventually have universal health care, and that all of these past and impending failures will only make our need for that more clear. Too bad that so many people will have suffered in the meanwhile.
That an enormous portion of our population (never underestimate that again, Democrats) has been entirely swallowed up by the Republican/right wing propaganda machine and is not really having the same conversation or receiving the plain facts of the matter is dire indeed. We have some more cycles of misery and disrepair to go. I'm so angry and sad about what Republicans have done to my country.
I believe that we'll eventually have universal health care, and that all of these past and impending failures will only make our need for that more clear. Too bad that so many people will have suffered in the meanwhile.
That an enormous portion of our population (never underestimate that again, Democrats) has been entirely swallowed up by the Republican/right wing propaganda machine and is not really having the same conversation or receiving the plain facts of the matter is dire indeed. We have some more cycles of misery and disrepair to go. I'm so angry and sad about what Republicans have done to my country.
6
Ok so we all wanted a single payer for all. But in its absence Obamacare way better than nothing.
Repeal and reek havoc?
As for the party of NO now having to be the party of something!
As for the party who doesnt believe in government now having to find some half competent minds to come up with a replacement policy!
As for the party of anti-intellectuals and gut knee jerk extremism having to think in measured tones and write complex policy!
If it were not for how incredibly important this, for how many American lives Obamacare has saved, and for how much damage repeal and reek havoc will do, it would be worth to see them try.
Repeal and reek havoc?
As for the party of NO now having to be the party of something!
As for the party who doesnt believe in government now having to find some half competent minds to come up with a replacement policy!
As for the party of anti-intellectuals and gut knee jerk extremism having to think in measured tones and write complex policy!
If it were not for how incredibly important this, for how many American lives Obamacare has saved, and for how much damage repeal and reek havoc will do, it would be worth to see them try.
10
The problem with every plan is the math problem, the sickest 5% of patients use 50% of all healthcare spending. Someone has to pay for it, and as a society we won't accept people dying on the street for lack of medical care, Yet!
2
Please note that anyone can fall in the 5% You can't know ahead of time if it is you.
4
Absolutely, djt !
You never know when YOU are going to need the insurance money, what chronic illness or what awful accident you may have. You pay in your money to insure yourself in case misfortune befalls you or your family.
It is unbelievable that in the 21st Century,the United States of America,that vaunts itself for its superiority over all other nations does not yet have universal health care. It is also unbelievable that when a good system, ACA, is formulated it is reviled because
(a) its proposer is black,
(b was a Democrat and not a Republican.
You never know when YOU are going to need the insurance money, what chronic illness or what awful accident you may have. You pay in your money to insure yourself in case misfortune befalls you or your family.
It is unbelievable that in the 21st Century,the United States of America,that vaunts itself for its superiority over all other nations does not yet have universal health care. It is also unbelievable that when a good system, ACA, is formulated it is reviled because
(a) its proposer is black,
(b was a Democrat and not a Republican.
1
Thank you for pointing out one of the individuals that wish to repeal the ACA. Michael Needham is a 35 year old who probably has never been without health insurance and is happily employed with a hard core group that preys on the poor and needy.
Needham in my mind does not have a “soul”. He is just another leach that picks up the banner of so called conservatism to make as much money as he can in as short a time as he can off the less fortunate and those that cannot defend themselves.
Pope Francis said it best in his Apostolic Exhortation, where he decried what he called the "idolatry of money". That’s what this is all about. It has little to do with health care.
Needham in my mind does not have a “soul”. He is just another leach that picks up the banner of so called conservatism to make as much money as he can in as short a time as he can off the less fortunate and those that cannot defend themselves.
Pope Francis said it best in his Apostolic Exhortation, where he decried what he called the "idolatry of money". That’s what this is all about. It has little to do with health care.
10
I know a hardcore Republican/Tea Partier who spent years sharing anti-Obama and anti-Obamacare memes on Facebook. He was recently diagnosed with advanced prostate cancer and did not have health insurance at a time...but thanks to Obamacare, he was able to buy health insurance on the exchange and qualified for subsidiaries to help pay the premiums. Ironic that someone trained to loath Obama could have his life touched by Obama in such a profound and personal way. Still to be determined is whether this experience will temper his politics as he struggles to reconcile his political beliefs with the godsend that is Obamacare for people like him.
11
Shades of Rush Limbaugh who berated liberals and ACLU but sought their help when he was charged with using prescription medications of his housemaid. He used ACLU ARMY to help him and after that resumed his tirade. Sheet hypocrites.
3
deep breath:
who are insurance companies and why can they dictate everything about our Healthcare, starting with prices and working down to a single bandaid? why are insurance company profits more important than your kid's health?
is this the work of man or of God?
who are insurance companies and why can they dictate everything about our Healthcare, starting with prices and working down to a single bandaid? why are insurance company profits more important than your kid's health?
is this the work of man or of God?
9
Pottree - corporations are people too, according to the Supreme Court. People without a soul, or empathy, or compassion - solely made of greed. I don't think this is the work of God.....
3
The republicans in congress and the White House are now facing the contradiction between one of their most persistent lies, that the ACA is bad for Americans, and factual reality. They can't honor their their foolish campaign pledge to repeal without doing great harm to millions of Americans including much of their uninformed base. The republicans deserve this.
10
Another 30something guy with little knowledge of the struggles that most people face or apparent empathy for the misery that the uninsured and sick face - whose advocacy and fighting is less for people than for an ideological agenda, and doubtless, his own ego. It sickens me that it is men, young and old, who lead our government, and who care more about their territory, and amassing power and influence, than actually making policy that improves people's lives. I wouldn't expect the men profiled in this article to have the self-awareness, or wisdom, to appreciate any of this or see it in themselves.
15
Let every American have the opportunity to buy into the health insurance plans given to Congress. Let American's over 50 years of age buy into Medicare. Don't pretend that giving Americans a health savings plan is a solution when most Americans are living paycheck to paycheck. Don't say that Obamacare is failing based on the experiences in states that didn't actively try to use it. I prefer Obamacare to Republicansdon'tcare.
23
You know how the government pays to provide us with universal necessities like cops, education, fire departments, roads, snow removal, defense, garbage removal and the like? That's what we need to make sure that everyone in the country is covered for medical care. Not just this silly, convoluted ACA. Just like with the other services it should be paid for by the government using the taxes which we pay.
The ACA is deficient in that not everyone is covered because people are permitted to opt out by paying a fine. What sense does that make?
The ACA is deficient in that not everyone is covered because people are permitted to opt out by paying a fine. What sense does that make?
3
OK, how much should the government pay for medical care?
Let's suppose garbage men were allowed to buy their own garbage trucks and garages, and start picking up garbage from anyone who needed it collected, and send in what bill they like to the government. That's about how our medical system works. Doctors own practices, clinics, and hospitals, and hire skillful medical billers to get the last drop of money out of the government, the insurance companies, and the patients. They'd love to send all the bills directly to the government, and have them paid.
Let's suppose garbage men were allowed to buy their own garbage trucks and garages, and start picking up garbage from anyone who needed it collected, and send in what bill they like to the government. That's about how our medical system works. Doctors own practices, clinics, and hospitals, and hire skillful medical billers to get the last drop of money out of the government, the insurance companies, and the patients. They'd love to send all the bills directly to the government, and have them paid.
1
I am a senior citizen on Medicare. I am very concerned about my Medicare benefits that are part of the Affordable Care Act (Obamacare) and what will happen to them if the Affordable Care Act (ACA)/Obamacare is repealed.
I currently get basic preventive care for free, including cervical, colorectal and breast cancer screening; cholesterol and cardiovascular tests; diabetes screenings: flu shots and more. This will all go away if the ACA/Obamacare is repealed.
Worse is what it will do to my out-of-pocket drug costs. Before the ACA (Obamacare) once I hit the drug coverage limit, I entered the coverage gap (donut hole). Then I paid 100% out-of-pocket for my drugs until my costs reached $7,000 only then did my coverage began again.
Under the ACA (Obamacare), when I hit the donut hole this year, I only pay 40% (60% discount) for brand-name drugs and 51% (49% discount) for generic drugs. In 2020 the donut hole would be eliminated completely. But if the ACA/Obamacare is repealed, I am back to paying 100% out-of-pocket for my drugs until I reach the threshold of $7,000.
Like most seniors on Medicare, I am on a limited income with very limited resources. The repeal of the ACA/Obamacare will place undue financial hardship on me and millions of other seniors on Medicare.
I currently get basic preventive care for free, including cervical, colorectal and breast cancer screening; cholesterol and cardiovascular tests; diabetes screenings: flu shots and more. This will all go away if the ACA/Obamacare is repealed.
Worse is what it will do to my out-of-pocket drug costs. Before the ACA (Obamacare) once I hit the drug coverage limit, I entered the coverage gap (donut hole). Then I paid 100% out-of-pocket for my drugs until my costs reached $7,000 only then did my coverage began again.
Under the ACA (Obamacare), when I hit the donut hole this year, I only pay 40% (60% discount) for brand-name drugs and 51% (49% discount) for generic drugs. In 2020 the donut hole would be eliminated completely. But if the ACA/Obamacare is repealed, I am back to paying 100% out-of-pocket for my drugs until I reach the threshold of $7,000.
Like most seniors on Medicare, I am on a limited income with very limited resources. The repeal of the ACA/Obamacare will place undue financial hardship on me and millions of other seniors on Medicare.
25
Madam, PPACA is a Detroit bankruptcy-in-waiting.
The Democrats refuse to deal with reality and simple math, boosting the taxpayer debt to $20,000,000,000,000+.
Communism and Nazism grew out of bankruptcies. Not going to let that happen here.
The Democrats refuse to deal with reality and simple math, boosting the taxpayer debt to $20,000,000,000,000+.
Communism and Nazism grew out of bankruptcies. Not going to let that happen here.
I get it, that the intention motivating the implementation of the ACA, "ObamaCare", was laudable, health insurance coverage for all.
However, what's stupid about the ACA is that you should be able to shop around and buy health insurance coverage from any insurer in any state regardless of where you reside and you should be able to see the medical provider of your choice regardless of any so-called network or state requirements. Let the carriers compete. If there are no carriers who want to go into this business then the government will need to set up an insurance company, or set up a system like the Assigned Risk Pool where uninsureds can enroll and the government assigns the customer to a rotating list of carriers whether the carriers like it or not. Carriers who object can get out of the business.
I am in New York. My car insurance comes from an insurance company in Illinois. The company complies with New York law. When I need a covered repair I can take it to anyone I please. That's the way it should be with health insurance.
However, what's stupid about the ACA is that you should be able to shop around and buy health insurance coverage from any insurer in any state regardless of where you reside and you should be able to see the medical provider of your choice regardless of any so-called network or state requirements. Let the carriers compete. If there are no carriers who want to go into this business then the government will need to set up an insurance company, or set up a system like the Assigned Risk Pool where uninsureds can enroll and the government assigns the customer to a rotating list of carriers whether the carriers like it or not. Carriers who object can get out of the business.
I am in New York. My car insurance comes from an insurance company in Illinois. The company complies with New York law. When I need a covered repair I can take it to anyone I please. That's the way it should be with health insurance.
8
Mike - you do not understand. All the large health insurance companies offer policies in many different states. They offer different policies because the laws vary from state to state. It is just like car insurance. As you say, you car insurance complies with NY law. What the Republicans want is to make it possible for you to buy a policy that does not comply with NY law, but with SD (for example) law. To see what happens then, just look at credit cards.
CitiBank went to the (Republican) governor of SD and told him if SD would relax their laws, the bank would move its credit card operation to SD and thus provide some jobs. SD did, and the bank did.
Then all the other banks moved their CC operations to SD, and that is why we have cards with huge interest and pages of fine print gotchas.
CitiBank went to the (Republican) governor of SD and told him if SD would relax their laws, the bank would move its credit card operation to SD and thus provide some jobs. SD did, and the bank did.
Then all the other banks moved their CC operations to SD, and that is why we have cards with huge interest and pages of fine print gotchas.
2
This has been tried. Unfortunately, the insurance companies have been reluctant to take advantage of business opportunities to operate across state lines. In 2012, a study was done "of a number of states that passed laws to allow out-of-state insurance sales. Not a single out-of-state insurer had taken them up on the offer."
https://www.nytimes.com/2015/09/01/upshot/the-problem-with-gop-plans-to-...
It turns out that setting up the networks and contracts necessary to operate profitably in a specific state makes competing across state lines burdensome and costly.
The assigned risk pools (also has been done, without satisfactory results) resulted in huge and unaffordable premiums for people with chronic health conditions.
https://www.nytimes.com/2015/09/01/upshot/the-problem-with-gop-plans-to-...
It turns out that setting up the networks and contracts necessary to operate profitably in a specific state makes competing across state lines burdensome and costly.
The assigned risk pools (also has been done, without satisfactory results) resulted in huge and unaffordable premiums for people with chronic health conditions.
3
Medical insurance is the same as credit cards? Only on Bizarro World.
Interstate medical insurance CANNOT be offered today.
Credit cards can.
Interstate medical insurance CANNOT be offered today.
Credit cards can.
Just another horse-race story of "how we got here."
This article is almost worthless. Such a waste of resources, considering this "pickle" we are in.
Isn't everyone astonished how Americans misunderstand the ACA?
Civic journalism has a not to answer for.
If Journalism would devote the same resources they do to "political horse-racing" on explaining -- in simple language: (1) what ACA is and is not, (2) how it is weak, and (3) how it could be fixed, then ........
Democrats can't seem to do it.
Journalism can't seem to do it.
It's sad, really. You have forgotten your role in civic education.
Meanwhile, the school got taken over by bullies, anarchists, and kleptocrats.
This article is almost worthless. Such a waste of resources, considering this "pickle" we are in.
Isn't everyone astonished how Americans misunderstand the ACA?
Civic journalism has a not to answer for.
If Journalism would devote the same resources they do to "political horse-racing" on explaining -- in simple language: (1) what ACA is and is not, (2) how it is weak, and (3) how it could be fixed, then ........
Democrats can't seem to do it.
Journalism can't seem to do it.
It's sad, really. You have forgotten your role in civic education.
Meanwhile, the school got taken over by bullies, anarchists, and kleptocrats.
3
But people won't believe journalists : Trump yells "Fake News! Fake News! "at everything that's written in newspapers that are respected worldwide.
1
The struggle to replace Obamacare reveals the cold, hard truth about the Republicans governing in congress and in the White House: Unequivocally they care more about big business and the money that comes along with it than the health of the average American.
Period.
What constituents want is the quality healthcare offered by "Obamacare" at a reasonable rate. And what Republican leaders want is to pass off a sham of healthcare coverage for a reasonable price. But that ship has sailed. Americans, because of the horrible state of our health care system, are savvy consumers. They know what it means to have a health care plan that doesn't cover maternity or mental health. They know what it means to pay $50 co-pays and have a $5,000 or $10,000 deductible. They know HSA plans don't work for the working class poor or middle class.
It is starting to dawn on Republican leaders that they can no longer pull the wool over constituents' eyes like they could with other issues (gay people are evil, immigrants bad). And Republicans are terrified.
Ultimately, they will repackage Obamacare and sell it as their own. And declare victory.
Because that is what Republican leaders do these days.
Period.
What constituents want is the quality healthcare offered by "Obamacare" at a reasonable rate. And what Republican leaders want is to pass off a sham of healthcare coverage for a reasonable price. But that ship has sailed. Americans, because of the horrible state of our health care system, are savvy consumers. They know what it means to have a health care plan that doesn't cover maternity or mental health. They know what it means to pay $50 co-pays and have a $5,000 or $10,000 deductible. They know HSA plans don't work for the working class poor or middle class.
It is starting to dawn on Republican leaders that they can no longer pull the wool over constituents' eyes like they could with other issues (gay people are evil, immigrants bad). And Republicans are terrified.
Ultimately, they will repackage Obamacare and sell it as their own. And declare victory.
Because that is what Republican leaders do these days.
13
I hope ACA gets repealed. The resulting chaos and massive jump in insurance prices will lead us to what most of the developed world has already determined is the best way to provide health care services: Single payer
14
Yes it will be done, but the result will not be a single payer.
1
Health insurance in untenable unless it is heavily regulated by the government. Insurance works by covering low risk people and charging a lot for or denying high risk people. This works with driving a car and owning a home well enough, but when it comes to health care it's just cruel. People who aren't sick won't buy insurance, and people who are can't afford it.
The GOP is still pushing that free market, competition model as if it works for everything, even though they know it does not. So sick of this. Every other nation has already figured it out.
The GOP is still pushing that free market, competition model as if it works for everything, even though they know it does not. So sick of this. Every other nation has already figured it out.
16
A nephew with a pain in a molar went to his dentist and got a prescription for an antibiotic.
Over a long weekend the pain grew so he went to the ER and saw a very kind, capable doctor who said to wait a day or two and come back if his temperature went over 102. Five days later, another weekend, he went back to have the prescription renewed just to be safe. No treatment, just a script. Total time for both visits with doctors in the ER was less than 18 minutes. Cost: $2,800.
Just like our election process itself, there's no way to fix this system until we get the money out of it. The money poisons the entire process. The rest is mostly just words, and we've seen how much trouble those little things get us into.
Like government itself, health care must not be a profit center.
Over a long weekend the pain grew so he went to the ER and saw a very kind, capable doctor who said to wait a day or two and come back if his temperature went over 102. Five days later, another weekend, he went back to have the prescription renewed just to be safe. No treatment, just a script. Total time for both visits with doctors in the ER was less than 18 minutes. Cost: $2,800.
Just like our election process itself, there's no way to fix this system until we get the money out of it. The money poisons the entire process. The rest is mostly just words, and we've seen how much trouble those little things get us into.
Like government itself, health care must not be a profit center.
25
I'm sorry that your nephew received such a high bill but believe that it could have been avoided if he had been more savvy about his options and use of expensive emergency room facilities. Firstly, normally he should call his dentist's answering service about the pain over the weekend. (If the dentist does not have weekend coverage, consider switching to a different practice.) If the dentist was not available, he could go to a cheaper urgent care facility, which usually has weekend hours available. These facilities normally charge a few hundred dollars for a visit. The second ER visit could have been avoided by following up with the dentist instead of resorting to a full service emergency room for a prescription refill.
You state the full retail price billed by the ER was $2800. But that does not mean that your nephew will actually pay $2800 because there are normally discounts that come into play that can cut down the cost considerably, assuming your nephew has insurance. Many people don't realize that a major reason to have insurance, even if you have a high deductible, is that your care will be significantly discounted due to insurance company contracts.
You state the full retail price billed by the ER was $2800. But that does not mean that your nephew will actually pay $2800 because there are normally discounts that come into play that can cut down the cost considerably, assuming your nephew has insurance. Many people don't realize that a major reason to have insurance, even if you have a high deductible, is that your care will be significantly discounted due to insurance company contracts.
3
Absolutely agree!
I appreciate your advice, and I agree with you in retrospect, but of course he had no idea that anything like this was even possible. He hadn't seen a doctor in about twenty two years. The tooth was an anomaly. The dentist wrote out the script without charge, just to be nice, and he didn't want to impose. He expected maybe a two hundred dollar charge at the ER. In normal countries, that would have seemed high. The problem is that care is handled by doctors, but billed by investment bankers.
And no, he had no intention of paying this bill, as it stands.
Best wishes.
And no, he had no intention of paying this bill, as it stands.
Best wishes.
The GOP attack on Obamacare, if successful, is exactly what is needed to set the stage for implementation of a single payer system the next time around.
22
The hapless Dems didn't make a concerted argument for maintaining Obamacare. Pelosi has never been on the right side of that issue. The Dems provided no leadership at all, but are praying for the GOP to make errors and toss them some scraps under the table. Pelosi can't find a headline in Sacramento.
4
This is Pelosi's district:
http://pelosi.house.gov/our-district
Nowhere near Sacramento.
Why do you people insist on flaunting your ignorance for everyone to see?
http://pelosi.house.gov/our-district
Nowhere near Sacramento.
Why do you people insist on flaunting your ignorance for everyone to see?
6
You know, Sacramento being the capital and all. Point being she doesn't get noticed in her home state, she certainly doesn't do anything in D.C. of note. She's ineffective and a lousy leader.
Who is you people? Black folk like me?
Who is you people? Black folk like me?
I watched a very interesting segment about this issue on one of the national news broadcasts a few weeks ago. It focused on the coal country (I think in Virginia) and interviewed several different people who are helped by Obamacare. One retired miner who has black lung disease and voted for Trump is now having second thoughts if he did the right thing because now he doesn't believe that the GOP will be able to offer him the type of coverage he now has with the AHC. Another person interviewed was a women who lost her husband to black lung disease and because of AHC she now has the same type of coverage he had. While Obamacare is not perfect, it was a start to offer health coverage to millions of Americans that previously had none.
16
The dog (GOP and Heritage) finally caught the porcupine (US health care system). For all it's bark and bite, the dog never wins this match-up. See ya in 2018.
19
Now that Republicans control both the Senate and House, and the Presidency, there is no reason to delay the repeal of the A.C.A., and to role out their own well planned and comprehensive healthcare plan for all Americans. President Trump says they have one. The House and Senate say they have had a plan for half a decade, so let's get going. Why wait? Just push it through and be the heroes of the political century, making healthcare reform a reality for all of us.
36
While this article is a good history. it contains little data. Here are some:
All other industrialized countries have some form of universal government run health care, mostly single payor. They get better care as measured by all 16 of the bottom line public health statistics, and they do it at 40% of the cost per person. If our system were as efficient, we would save over $1.5 TRILLION each year.
www.pnhp.org & www.oecd.org, especially
http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequ...
Some more data:
Here are the per capita figures for health care costs in 2013 in PPP dollars (which take cost of living into consideration) from the OECD:
OECD average - 3463
US - 8713
UK - 3235
France - 4124
Australia (similar obesity) - 3966
Germany - 4919
Denmark - 4553
The Netherlands - 5131
Canada - 4361
Israel - 2128
Switzerland (Highly regulated private insurance) - 6325
Let;s compare some bottom line statistics between the US and the UK which has real socialized medicine.
Life expectancy at birth:
UK - 81.1
US - 78.8
Infant Mortality (Deaths per 1,000):
UK - 3.8
US - 6.0
Maternal Mortality (WHO):
UK - 9
US - 14
As Einstein said,
"The difference between genius and stupidity is that genius has its limits."
All other industrialized countries have some form of universal government run health care, mostly single payor. They get better care as measured by all 16 of the bottom line public health statistics, and they do it at 40% of the cost per person. If our system were as efficient, we would save over $1.5 TRILLION each year.
www.pnhp.org & www.oecd.org, especially
http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequ...
Some more data:
Here are the per capita figures for health care costs in 2013 in PPP dollars (which take cost of living into consideration) from the OECD:
OECD average - 3463
US - 8713
UK - 3235
France - 4124
Australia (similar obesity) - 3966
Germany - 4919
Denmark - 4553
The Netherlands - 5131
Canada - 4361
Israel - 2128
Switzerland (Highly regulated private insurance) - 6325
Let;s compare some bottom line statistics between the US and the UK which has real socialized medicine.
Life expectancy at birth:
UK - 81.1
US - 78.8
Infant Mortality (Deaths per 1,000):
UK - 3.8
US - 6.0
Maternal Mortality (WHO):
UK - 9
US - 14
As Einstein said,
"The difference between genius and stupidity is that genius has its limits."
6
Senior doctors in German public hospitals make 85,000 Euros or so. In the US, the average income of all doctors is $204K. It is not surprising they spend less per capita on health care than we do.
Studies have shown that there is little difference betwen the medical procedures per capita in the US and Europe. However, in the US, each medical procedure costs 2-3 times as much as it does in Europe.
How do the Europeans do it? That's how.
Studies have shown that there is little difference betwen the medical procedures per capita in the US and Europe. However, in the US, each medical procedure costs 2-3 times as much as it does in Europe.
How do the Europeans do it? That's how.
1
Doctor's income is only 10% of health care costs.
The reason that tests and procedures are so much cheaper in other countries is there is one entity to gather data, analyze, it, and make recommendations and regulations. That entity is part of the government and its goal is effective, efficient health care, not profit.
I would like a reference to those studies. It seems unlikely to me as we give many more tests (PSA, colonoscopies, mammograms, etc.) which probably leads to more procedures.
The reason that tests and procedures are so much cheaper in other countries is there is one entity to gather data, analyze, it, and make recommendations and regulations. That entity is part of the government and its goal is effective, efficient health care, not profit.
I would like a reference to those studies. It seems unlikely to me as we give many more tests (PSA, colonoscopies, mammograms, etc.) which probably leads to more procedures.
2
As they say, it is harder to take away something than not have it at all. In spite of the flaws, Obamacare has brought a new normal for number of people covered, which would be hard for republicans to match even if they had a cohesive plan which they don't. And they would pay a political price (as evidenced by the town halls) if they just listen to the conservatives. Some republicans have moved on from from Repeal and Replace to Repair. What's next Rename ? Retreat ?
3
We all know people like the GOP representatives. They complain about the status quo but have no answers, suggestions, or ideas. They look like fools because they are.
5
The cavalier and dismissive approach by the GOP to human life is seen in every one of their policies, every day.
Except, of course, the one that allows women control over their own bodies. They just can't resist on that one.
Except, of course, the one that allows women control over their own bodies. They just can't resist on that one.
6
The ACA has already been a smashing success in one area: putting health care for Americans on the national agenda to stay. The GOP fought tooth and nail to keep the ACA from being implemented because they realized that once America had a taste, they would want more of it. Repeal would become increasingly untenable as the years rolled on.
Now the Republicans are truly in a bind because not only did Trump promise to repeal the ACA, he promised to replace it with something better.
If only Nixon could go to China, perhaps only the GOP can propose a single payer health plan.
Now the Republicans are truly in a bind because not only did Trump promise to repeal the ACA, he promised to replace it with something better.
If only Nixon could go to China, perhaps only the GOP can propose a single payer health plan.
7
A dull knife or hammer at best.
Given that the Trump administration is a (fill in: train wreck, daily disaster...) how on earth could this bunch create or eliminate anything at all? This is a group who cannot even spell.
9
Just do away with the penalties for not having health insurance, the Obamacare tax surcharges, subsidies used to purchase insurance and funds used for Medicaid expansions and Obamacare will die on its own accord. In the meantime just come up with better ways to guarantee access to healthcare for all Americans and let everyone decide what type of coverage they want. And if someone decides not to carry insurance allow them to commit financial suicide by revoking the rule which forces Hospitals to care for someone regardless if they do not have insurance.
2
And then what? We step over the sick and dying in the streets on our way to work? Like they do in some third world countries?
8
If they should get the ACA repealed and come up with a replacement who is going to pay for the start up cost? Put another way re-registering all the people on ACA for the new plan. As a matter of record Teddy Roosevelt was the first to push this idea. He lost re-election because of it at the time on the Bull party ticket. Here is one more thing to consider. Have you heard or seen a lot of doctors saying get rid of ACA? You might want to look into what kind of tax break they on equipment because of ACA?
1
Proceed at your own risk, republicans. Looking at the participants in the red state town halls I don't see any radicals, paid or otherwise. Many of those folks are conservatives wanting to conserve their healthcare. If republicans would have helped Obama with this plan instead of their vicious, knee-jerk opposition, we would be enjoying a better plan at this point. Fixes, overhauls are in order, but I couldn't trust Ryan and company with a Pet Rock.
10
The ACA was enacted with one primary goal in mind: To improve access to health insurance, and thus health care, for the many Americans who did not have it. It has made great strides toward that goal, although many still do without.
We must challenge the Republicans with this question: What exactly is the goal of repealing and replacing the ACA, stated in terms of the benefits to American consumers of health care? The answer cannot be, "We hate Obamacare" or "Get the government out of health care." Those political talking points do not answer the question. What is the goal as seen by the consumer? I submit that if they can answer that question, they might make progress. They might even, heaven forbid, do nothing. But start with the goal, not some free-market or conservative ideology.
We must challenge the Republicans with this question: What exactly is the goal of repealing and replacing the ACA, stated in terms of the benefits to American consumers of health care? The answer cannot be, "We hate Obamacare" or "Get the government out of health care." Those political talking points do not answer the question. What is the goal as seen by the consumer? I submit that if they can answer that question, they might make progress. They might even, heaven forbid, do nothing. But start with the goal, not some free-market or conservative ideology.
7
Each additional non-white person in the US causes single payer to recede further in the rear view mirror. Stay tuned for whether the founding beliefs of the country can overcome skin color based tribalism. I don't think it can, and we will see all public services such as schools, Medicare, and Social Security disappear because of it. I think the country is really on the precipice of whether to choose "All men are created equal and are endowed...etc" or white nationalism. White nationalism seems to be on the upswing.
2
All this makes me think that, like they mentioned in the end, we'll just get something extremely similar to the ACA, it just has to be that way. Wouldn't it be easier and cheaper to just modify what exists???? At least one Republican, Lamar Alexander is a voice of reason and common sense.
1
Republican US Representative Jim Sensenbrenner has been reported to be having difficulty responding to his constituents regarding the "plan" to repeal the ACA:
(with apologies to Jerry Seinfeld)
CONSTITUENT: Mr. Sensenbrenner, can you tell us about your plan to replace the ACA?
SENSENBRENNER: I think I can sum up the plan we've got for you with one word: NOTHING.
CONSTITUENT: Nothing?
SENSENBRENNER: (Smiling) Nothing.
CONSTITUENT (Unimpressed) What does that mean?
SENSENBRENNER The plan is about nothing.
AIDE TO SENSENBRENNER: Well, it's not about nothing.
SENSENBRENNER: (To Aide and Constituent) No, it's about nothing!
AIDE TO SENSENBRENNER Well, maybe in philosophy. But, even nothing is something...
SENSENBRENNER: No, no, no! Nothing happens!!
AIDE TO SENSENBRENNER: Well, something happens.
CONSTITUENT: Well, why am I using your plan?
SENSENBRENNER: Because it's all you've got.
CONSTITUENT: Not yet!
http://www.remember-to-breathe.org/Breathing-Videos.html
(with apologies to Jerry Seinfeld)
CONSTITUENT: Mr. Sensenbrenner, can you tell us about your plan to replace the ACA?
SENSENBRENNER: I think I can sum up the plan we've got for you with one word: NOTHING.
CONSTITUENT: Nothing?
SENSENBRENNER: (Smiling) Nothing.
CONSTITUENT (Unimpressed) What does that mean?
SENSENBRENNER The plan is about nothing.
AIDE TO SENSENBRENNER: Well, it's not about nothing.
SENSENBRENNER: (To Aide and Constituent) No, it's about nothing!
AIDE TO SENSENBRENNER Well, maybe in philosophy. But, even nothing is something...
SENSENBRENNER: No, no, no! Nothing happens!!
AIDE TO SENSENBRENNER: Well, something happens.
CONSTITUENT: Well, why am I using your plan?
SENSENBRENNER: Because it's all you've got.
CONSTITUENT: Not yet!
http://www.remember-to-breathe.org/Breathing-Videos.html
4
"Congress was blamed by the public for causing the shutdown, and its approval ratings plummeted."
And so what happens? The Republicans now control both houses of Congress, have the presidency, and are in the majority in terms of state governments. I don't get it.
And so what happens? The Republicans now control both houses of Congress, have the presidency, and are in the majority in terms of state governments. I don't get it.
11
Why isn't the press asking where in the industrialized world has "market based " health care worked ? We spend twice the amount of money and get the worst results for health care. Do we want to experiment with a "free market" Trumpcare for 1/5th of our economy?
Just copy the Canadian, French, German, English etc. system. They are very pleased with their health care and look with horror at ours.
Just copy the Canadian, French, German, English etc. system. They are very pleased with their health care and look with horror at ours.
13
Those countries have approximately 40-80 million citizens whereas the United States has approximately 330 million citizens, only 60 percent of whom are those working over the age of 16. As the ice cream man used to say - in a silly voice - to us kids in my blue collar neighborhood before making our orders, SHOW ME THE MONEY FIRST. Once we did, he would then make the milk shake, ice cream cone, Dixie cup, etc. Oh, and the Italians still have to buy their own insurance to get good healthcare.
So, what's your point?
Countries with 40 to 80 million people with quality, affordable health care is not a large enough sample to determine if their system is viable? Perhaps if you added together the population of the industrialized counties (minus the US), it would make you feel better.
Refusing to give you ice cream before showing the money is much different than refusing to give you life saving treatment for the lack of money. Morals are important.
Countries with 40 to 80 million people with quality, affordable health care is not a large enough sample to determine if their system is viable? Perhaps if you added together the population of the industrialized counties (minus the US), it would make you feel better.
Refusing to give you ice cream before showing the money is much different than refusing to give you life saving treatment for the lack of money. Morals are important.
The truth is, and it was strikingly clear from the moment that President Obama was administered the Oath of Office in January 2009, that what the white obstructionist and hateful republican party objected to was not the policy, but the man--the Black man.
They were driven by such rage and contempt that President Obama had the “audacity” to occupy the premier Public Housing complex--the White House, that developing any kind of coherent health care policy was the farthest thing from their minds.
"Any upheaval in the universe is terrifying because it so profoundly attacks one's sense of one's own reality. Well, the black man has functioned in the white man's world as a fixed star, as an immovable pillar; and when he moves out of place, heaven and earth are shaken to their foundations." James Baldwin
They were driven by such rage and contempt that President Obama had the “audacity” to occupy the premier Public Housing complex--the White House, that developing any kind of coherent health care policy was the farthest thing from their minds.
"Any upheaval in the universe is terrifying because it so profoundly attacks one's sense of one's own reality. Well, the black man has functioned in the white man's world as a fixed star, as an immovable pillar; and when he moves out of place, heaven and earth are shaken to their foundations." James Baldwin
15
Great quotation by James Baldwin.
And one could replace the words "the black man" by the words "the woman" ( of any colour).
And one could replace the words "the black man" by the words "the woman" ( of any colour).
Perhaps it is about time that the Heritage Foundation is "repealed".
11
The GOP national political platform since 1980: "I'm With Stupid"
'There is a cult of ignorance in the United States, and there always has been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "my ignorance is just as good as your knowledge."'
Isaac Asimov, Column in Newsweek (21 January 1980)
'There is a cult of ignorance in the United States, and there always has been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "my ignorance is just as good as your knowledge."'
Isaac Asimov, Column in Newsweek (21 January 1980)
27
Obamacare is the opposite of what the country needs, which is to rein in the exorbitant costs of medical tests and procedures in the US. The NYT, in a series of excellent articles, previously identified costs as our main problem, but costs have been widely ignored. Any health financing plan that fails to bring US health care costs into alignment with those in other developed countries will be just a shell game, and thus, like Obamacare, unsustainable.
9
What you say is true, but someone is receiving this money. It's nearly 20% of the GDP, after all, so cutting costs would be highly disruptive to many people's businesses and personal lives. We like to think of doctors as selfless people dedicated to making our lives better, rather than money-making 1%s with a summer cottage in the Hamptons. So no action, so far....
1
It's hard to believe how much money has been spent politicizing healthcare in this country. All that money, all that angst, could have been better directed to creating an expansion of Medicare for all.
I find it absolutely ludicrous in listening to Paul Ryan expound on those weary GOP saws of health care savings accounts and tax credits. For middle-class Americans not receiving subsidies, health care savings accounts do nothing because their benefit only rises with the amount of income one makes.
The people who most benefit from the ACA are those who don't aren't enough to be able to take advantage of a health care savings account. The other aspect of those accounts, which are used back in the 80s, is the limit of money that can be put away and the limit in what services can be covered.
Mr. Williams of heritage action hasn't been alive long enough to know the sordid history of healthcare in America. It is a damning history, one of neglect and greed by insurance companies. He only came into power around the time the ACA was created, and cut his teeth on opposing it for any number of highly idealogical reasons.
Insurance company should be abolished, they are expensive middleman who have carved out more money for themselves and they deserve. The only healthcare system that works is a national one.
So go ahead GOP, repeal Obamacare and replace it with survival of the richest. And watch your constituents flush you down the drain in the next 2 to 5 years.
I find it absolutely ludicrous in listening to Paul Ryan expound on those weary GOP saws of health care savings accounts and tax credits. For middle-class Americans not receiving subsidies, health care savings accounts do nothing because their benefit only rises with the amount of income one makes.
The people who most benefit from the ACA are those who don't aren't enough to be able to take advantage of a health care savings account. The other aspect of those accounts, which are used back in the 80s, is the limit of money that can be put away and the limit in what services can be covered.
Mr. Williams of heritage action hasn't been alive long enough to know the sordid history of healthcare in America. It is a damning history, one of neglect and greed by insurance companies. He only came into power around the time the ACA was created, and cut his teeth on opposing it for any number of highly idealogical reasons.
Insurance company should be abolished, they are expensive middleman who have carved out more money for themselves and they deserve. The only healthcare system that works is a national one.
So go ahead GOP, repeal Obamacare and replace it with survival of the richest. And watch your constituents flush you down the drain in the next 2 to 5 years.
116
Whoops: it's Michael Needham (who attended Williams college), not Mr. Williams.
I can only imagine the conversations between Needham and his Democratic wife at the dinner table when the subject of healthcare comes up. Would love to be a fly on the wall. Of course, like the healthcare "bureaucrats" he despises, Needham and his family are, I'm sure covered by good health benefits at Heritage Action.
I love all these policy wonks, covered by generous benefits, working so hard to take healthcare away from ordinary Americans. Such a charming picture: the Pope would approve.
I can only imagine the conversations between Needham and his Democratic wife at the dinner table when the subject of healthcare comes up. Would love to be a fly on the wall. Of course, like the healthcare "bureaucrats" he despises, Needham and his family are, I'm sure covered by good health benefits at Heritage Action.
I love all these policy wonks, covered by generous benefits, working so hard to take healthcare away from ordinary Americans. Such a charming picture: the Pope would approve.
17
Make USA medical care just like V.A.?
Ridiculous. Will never happen, ever. Riots will break out, first.
Ridiculous. Will never happen, ever. Riots will break out, first.
3
And Medicare for all would cost....how much? If you are making $50,000, are you prepared to pay $12,000 in additional tax? That's assuming that actual medical spending won't rise when medical care becomes 'free', which seems highly unlikely.
2
Ah, let's just admit that unlike France, Germany, Canada, Britain, Austria, etc., Americans are simply not worthy of accessible and affordable health care. Let's just admit that our politicians are not clever enough to make it possible in our poor little nation. Let's just agree that corporate profitability is the engine that drives our nation, and that new employees are still being born every day even if they may not have great care when they age and get sick. Let's just revel in our inferiority...
228
we already do: look at the results of the election and the fine mess it has gotten us into now.
3
" .. France, Germany, Canada, Britain, Austria, etc. .."
All much-whiter, higher taxes, longer waiting lists, less tolerant of homeless and junkies, doctor strikes, cutting back now.
Horse apples about "over there" is still horse apples, when hit with reality.
All much-whiter, higher taxes, longer waiting lists, less tolerant of homeless and junkies, doctor strikes, cutting back now.
Horse apples about "over there" is still horse apples, when hit with reality.
1
You forget that America is exceptional, and Americans need to dance to the beat of a different drummer. The drummers this year seems to be big pharmaceutical companies, healthcare companies, and healthcare insurance companies. Same old drummers, I guess.
2
This is a terrific piece, well-researched and providing amazing insight without falling into nauseating partisanship. This is journalism at its best. Keep this up, please. It explains the unexplainable.
Indirectly, it shows how deleterious ideology can be. Indirectly, it shows how money distorts the political process. Why should someone like Needham have so much power/influence on our system? He is to Obamacare what Nordqvist is to taxation. These guys are destroying our country - no more no less.
Public funding of elections, please! Let people decide not money or ideology. That's real democracy...
Indirectly, it shows how deleterious ideology can be. Indirectly, it shows how money distorts the political process. Why should someone like Needham have so much power/influence on our system? He is to Obamacare what Nordqvist is to taxation. These guys are destroying our country - no more no less.
Public funding of elections, please! Let people decide not money or ideology. That's real democracy...
70
I disagree. This is an opinion piece.
Referring to someone as a "feral cur" actually does indicate a certain amount of partisanship.
Referring to someone as a "feral cur" actually does indicate a certain amount of partisanship.
4
I agree. I only wish that the press had inundated the public with such excellent, unambiguous fare when all of this was happening. Red States might as well be behind an Iron Curtain - it's appalling. When people from those locales, where Medicaid expansion was blocked and every effort was made to make medical horrible in order to 'prove' the awfulness of Obamacare. For them, it was. Obama would have revolutionized health care.
2
@Margo: It isn't a news article, and it isn't an opinion piece. It's a feature story. Those are three valid journalistic categories that have been around for a very long time.
1
The insatiable arrogance shown by politicians who made ACA/Obamacare its whipping boy have done actual physical, emotional and financial harm to millions of innocent Americans.
Rather than revise the ACA and close gaping loopholes to improve it, they played games that put patients' lives in needless jeopardy. I own a national consumer healthcare advocacy. We don't have a political dog in the fight and my comments are not spin. We see these tragedies every day.
Knowing that Congress was blinded by maniacal power lust, the healthcare industry has run roughshod over patients' lives. Pharmaceutical companies gouge us on drug prices, knowing Capital Hill couldn't tie its shoes let alone stop them. Insurance companies jacked up premiums and deductibles, buried more patient costs in the fine print and strangled networks to deny patient access to quality care. Countless insurers resorted to computer algorithms to arbitrarily deny patient claims that should have been paid.
Healthcare providers overcharged more patients, made even more "billing errors", already at 50% - 80% average. They destroyed the patient's credit who didn't have $572 more to pay for a $10 splint on top of thousands in medical bills.
So while we dissect who did what when, let's keep this in mind: Actions speak louder than words. Patients and their families are furious, and we deserve far more than the toxic gruel of false promises served up by our civil "servants."
Rather than revise the ACA and close gaping loopholes to improve it, they played games that put patients' lives in needless jeopardy. I own a national consumer healthcare advocacy. We don't have a political dog in the fight and my comments are not spin. We see these tragedies every day.
Knowing that Congress was blinded by maniacal power lust, the healthcare industry has run roughshod over patients' lives. Pharmaceutical companies gouge us on drug prices, knowing Capital Hill couldn't tie its shoes let alone stop them. Insurance companies jacked up premiums and deductibles, buried more patient costs in the fine print and strangled networks to deny patient access to quality care. Countless insurers resorted to computer algorithms to arbitrarily deny patient claims that should have been paid.
Healthcare providers overcharged more patients, made even more "billing errors", already at 50% - 80% average. They destroyed the patient's credit who didn't have $572 more to pay for a $10 splint on top of thousands in medical bills.
So while we dissect who did what when, let's keep this in mind: Actions speak louder than words. Patients and their families are furious, and we deserve far more than the toxic gruel of false promises served up by our civil "servants."
132
Republican non-lawmakers have got that deer-in-the-headlights look. They haven't a clue as what to do about fixing the ACA, never did. They actually believed they could simply repeal it and America would celebrate! Can anyone name one thing—anything—that the GOP has gotten right?
4
The false promises were served up by Republicans who are unwilling to have their wealthy clients pay any taxes to help their poorer "undeserving" fellow citizens.
2
If patients and their families were so darn furious, why did they vote for Trump and why did they not vote to expel the Republican swamp creatures that caused all the problems in the first place?
TLDR -- Republicans used the ACA as a great source of political red meat, never expecting to be put in the position of delivering on their promises. Now the tide has gone out and we can all see who's been swimming naked.
160
TLDR - the signature of someone who can't be bothered to pay attention. This, as much as anything, is at the root of our declining nation.
Why didn't Reagan eliminate Medicare? Democratic Congress plus Medicare is very popular with those 65 and over. How many times among my peers have I heard expressions of delight upon reaching the age of 65? That's because they are now eligible for Medicare and are very relieved that they now have good health insurance.
150
Long winded article that ends with a sigh. The public outcry against repeal of ACA may be the key. It is difficult for people in DC ivory towers to see that.
18
It would not be so insurmountable a task if the legislators were not so intent on catering to the 'special' interests which have been dominating the entire U.S. health care system with their influence over the past 50 years.
There needs to be competition across the board; but the lobbies of the Medical Industrial Complex (headed by the American Medical Association) have done EVERYTHING in their power to assure that ALL markets operate on as much of a monopolistic basis as possible. This is why NO one knows what their medical care costs until WELL after it has been delivered. This is also the reason why PPO networks were created. To assure that such costs remain cloaked from, not only the public, but also other insurers. (Unless ALL insurers were playing on the same field by the same rules having them sell 'over State lines' is a complete act of futility because the PPO networks, which are run by the hospital industry conglomerates, do not treat all insurance companies equally.) The first step should be a predictable pricing methodology beginning with a base level for medical service pricing which insurers can build their policy pricing around. Pricing for hospital based services have averaged over 30% increases EVERY year for the past 7 years; but since the public only realizes this as increases in their health insurance premiums the media and the press vilify the insurers and NOT the culprits!!!
There needs to be competition across the board; but the lobbies of the Medical Industrial Complex (headed by the American Medical Association) have done EVERYTHING in their power to assure that ALL markets operate on as much of a monopolistic basis as possible. This is why NO one knows what their medical care costs until WELL after it has been delivered. This is also the reason why PPO networks were created. To assure that such costs remain cloaked from, not only the public, but also other insurers. (Unless ALL insurers were playing on the same field by the same rules having them sell 'over State lines' is a complete act of futility because the PPO networks, which are run by the hospital industry conglomerates, do not treat all insurance companies equally.) The first step should be a predictable pricing methodology beginning with a base level for medical service pricing which insurers can build their policy pricing around. Pricing for hospital based services have averaged over 30% increases EVERY year for the past 7 years; but since the public only realizes this as increases in their health insurance premiums the media and the press vilify the insurers and NOT the culprits!!!
39
Too bad this appears in the NYT. It should be presented in some venue targeting the masses who "like ACA but hate Obamacare." And for those who believe that Republicans will deliver an alternative to a health care plan that already bears their imprint.
63
Unfortunately, even if this article were to appear in some venue targeting the people who "like ACA but hate Obamacare" I doubt it would do much good. First, I doubt those people are inclined to read (if they are capable of reading, which capacity or lack thereof they share with their elected commander in chief). Secondly, they have been brainwashed by the Republicans and their propaganda cable 'Faux' news channel for the past 40 years to distrust the Federal government or the mainstream press, such that I doubt this would change many minds.
4
Reply to Misterbianco,
Unfortunately, the majority of "the masses who like ACA but hate Obamacare" would never make it through an article this long and comprehensive, regardless of how widely disseminated it might be.
Like their messiah Mr. Trump, they typically don't read much beyond menus and the occasional issue of "People" magazine. However, they do watch lots of TV.
And when they vote, it shows.
Unfortunately, the majority of "the masses who like ACA but hate Obamacare" would never make it through an article this long and comprehensive, regardless of how widely disseminated it might be.
Like their messiah Mr. Trump, they typically don't read much beyond menus and the occasional issue of "People" magazine. However, they do watch lots of TV.
And when they vote, it shows.
2
How's that chest thumping working out for you now Donald? Paul? Mitch?
So let's see, you've got a health care plan that is invisible to just us nonbelievers.
So let's see, you've got a health care plan that is invisible to just us nonbelievers.
106
They have it in the drawer with the secret plan to destroy ISIS.
3
How does one develop such hatred of others? The time and energy and brainpower that is being wasted on an attempt to deny others the opportunity to have health. What a shame.
28
Medicare for ALL. Stop this nonsense, please.
62
What is Art-of-the-Deal president Trump is smarter than all of us?
What if newly inaugurated President Trump is actually smarter than everyone? What if, as he has said, he "has a really good brain?" Then his promises that seem so over-reaching and even-simple-minded, might actually be part of a long-range endgame that only he knows how to achieve.
Isn't it strange, after all, that he has appointed so many people to lead agencies that those people have spent their careers opposing, even trying to shut down?
I realize that there is a management technique that says "appoint the strongest critic to the department you want seriously reformed" but this is carrying that to extremes....or is it? Maybe Trump is practicing some sort of management Jujitsu, turning an opponent's strength against himself.
Taking health-care as an example, where his nominee, Tom Price, has suggested everything from repealing the Affordable Care Act to eliminating Medicare and Medicaid as we know it, perhaps replacing those with vouchers or block grants to states, respectively, as House leader Paul Ryan wants to do.
Trump has promised "Health Insurance for everyone" as recently as January 15th in an interview with the NY Times.
But, as usual, his promises are dramatically short on specifics, although he has said "I don't want single-payer."
Read the rest here: http://bit.ly/2lGp6r8
What if newly inaugurated President Trump is actually smarter than everyone? What if, as he has said, he "has a really good brain?" Then his promises that seem so over-reaching and even-simple-minded, might actually be part of a long-range endgame that only he knows how to achieve.
Isn't it strange, after all, that he has appointed so many people to lead agencies that those people have spent their careers opposing, even trying to shut down?
I realize that there is a management technique that says "appoint the strongest critic to the department you want seriously reformed" but this is carrying that to extremes....or is it? Maybe Trump is practicing some sort of management Jujitsu, turning an opponent's strength against himself.
Taking health-care as an example, where his nominee, Tom Price, has suggested everything from repealing the Affordable Care Act to eliminating Medicare and Medicaid as we know it, perhaps replacing those with vouchers or block grants to states, respectively, as House leader Paul Ryan wants to do.
Trump has promised "Health Insurance for everyone" as recently as January 15th in an interview with the NY Times.
But, as usual, his promises are dramatically short on specifics, although he has said "I don't want single-payer."
Read the rest here: http://bit.ly/2lGp6r8
3
These people have deluded themselves into thinking that they're leading a popular movement. They should check the vote totals. Half the American public, it seems, agree with me that the Affordable Care Act should not, repeat not, be repealed.
19
The Republicans proclaimed their intent to go after Obamacare with an axe in one hand and a sledgehammer in the other. But they were not streetwise nor tough in their bombastic bullying buffoonery. The real street toughs do not talk loud nor make threats. That is what punks do.
8
The heartlessness of some of these Heritage folks and our representatives (Pence, King, Ryan as examples) are truly disheartening. What Christian hypocrisy. I would as for only one thing and that would be to require all individuals voted into office have to find their own individual healthcare. I really get sick when I think that I am paying for their healthcare and they want others to suffer and die without the gold plated insurance that these spineless characters get. Disgusting.
98
Excellent history of the resistance to ACA. It should be re-titled "How a couple of young punks from your grandfather's think tank intimidated the GOP into repeatedly doing the wrong thing."
But then you'd have to move it to the opinion pages.
But then you'd have to move it to the opinion pages.
28
The thing about reading about some of these scary types like young Needham is that it actually takes one breath away. It is hardly possible to make reasoned arguments against such zealots for whom the vague concept of "socialised medicine" induces such abject fear. And yet socialised organisms surround you even in the USA starting with the huge military which functions as a kind of alt-welfare state. Primarily we see here a religious like faith (and a misanthropic one at that) trumping the desire to make life better for most people. SAD!
34
The military is 15% of the Federal budget, which is about $4 trillion. So we spend $600 billion on the military, and that includes pensions and the VA.
Total medical spending in the US is $3 trillion, which is five times the military budget. Having to pay taxes high enough to support this spending would instill fear in anyone. An additional tax on all salaries of 25-30% would be required.
Total medical spending in the US is $3 trillion, which is five times the military budget. Having to pay taxes high enough to support this spending would instill fear in anyone. An additional tax on all salaries of 25-30% would be required.
2
If the Canadians and Australians can achieve it why can't the USA?
3
It's not an "additional" tax if it replaces what you pay your medical insurance provider, only it will be missing the 20% profit margin, advertising, bonuses for executives, etc. that they so eagerly apply. Payment will be simpler than the IRS-like billing systems each insurance company maintains.
4
The joke around Washington,” the former Democratic congressman Jim McDermott told me, “is that the Republicans are going to repeal Obamacare — and they’ll replace it with the Affordable Care Act.”
This would work too since a large fraction of Trump's supporters don't know they're the same.
This would work too since a large fraction of Trump's supporters don't know they're the same.
108
The worm turns. During the Obama presidency all we heard from Republicans was how Obamacare would leave our healthcare system in ruins. The cost would bakrupt our nation. It seemed as if every other week they were taking a vote to repeal the law. Now that Republicans are in powerand can repeal it, I have noticed they do not speak about Obamacare, instead the debate is about the Affordable Care Act.
16
Will you, and everybody else stop calling the Affordable Healthcare Act, Obamacare. At least call it Affordable Healthcare Act, formally known as Obamacare. This will really help people to understand that they are one and the same. The media is to blame that so many americans do not know this.
29
First, thank you for this extremely informative piece with loads of background information.
Personally, I expect a "rebranding" of Obamacare. A complete repeal would bring up real and actual stories of premature deaths from treatable or manageable illnesses. Yes, the media would bring back Sarah Palin's "Death Panels" with a new twist, this time against the GOP.
Also, hospitals and pharmaceutical companies would not be happy if fewer people used their services and products. Hospitals especially would not care much for unreimbured care.
Healthcare professionals would not like full repeal on moral grounds. Their goals are to improve life and generally exxtend it, not to let people die because they can't afford treatment or medication.
With "rebranding", people currently covered under Obamacare could keep it, while the name change would fool enough of the undereducated "Keep your hand off my Medicare croowd" to believe it had been repealed.
One more plus for "rebranding": Republicans could actually improve Obamacare instead of constantly chipping away at it. They could then take credit for the so-called new and improved healthcare system!
It's not like their constiutents give a darn about extreme conservative principles.
Personally, I expect a "rebranding" of Obamacare. A complete repeal would bring up real and actual stories of premature deaths from treatable or manageable illnesses. Yes, the media would bring back Sarah Palin's "Death Panels" with a new twist, this time against the GOP.
Also, hospitals and pharmaceutical companies would not be happy if fewer people used their services and products. Hospitals especially would not care much for unreimbured care.
Healthcare professionals would not like full repeal on moral grounds. Their goals are to improve life and generally exxtend it, not to let people die because they can't afford treatment or medication.
With "rebranding", people currently covered under Obamacare could keep it, while the name change would fool enough of the undereducated "Keep your hand off my Medicare croowd" to believe it had been repealed.
One more plus for "rebranding": Republicans could actually improve Obamacare instead of constantly chipping away at it. They could then take credit for the so-called new and improved healthcare system!
It's not like their constiutents give a darn about extreme conservative principles.
15
Ah, but they want their tax cuts for their wealthy benefactors. Just watch what Price does under the radar. This whole Republican Congress is a sick joke.
5
Please stop calling it Obamacare.
It's the Affordable Care Act.
By continuing to do so unnecessarily, the NY Times and other media outlets continue to dangle a red flag in front of those who mindlessly want to eradicate any and all successes of President Obama's administration.
We need no more proof than the current Circus Trump and their lies, deceptions, and alternative facts and reality.
It's the Affordable Care Act.
By continuing to do so unnecessarily, the NY Times and other media outlets continue to dangle a red flag in front of those who mindlessly want to eradicate any and all successes of President Obama's administration.
We need no more proof than the current Circus Trump and their lies, deceptions, and alternative facts and reality.
153
After the Republicans mess around with it I think if should be called Trump care. How soon will the death panels start to save money.
Affordacare has a nice ring to it. We don't call Medicare and Medicaid The Big Johnsons, do we?
3
"Affordable Care Act" is the actually greater slander because as we have all learned the hard way, it sure isn't affordable!
4
A child of privilege, Mr. Deenham could use some time outside of his bubble. Are his wife and child covered by a health plan provided by Heritage Action for America? Did he reject that plan on principle, and get insurance on his own? If the latter, kudos. If the former, Mr. Deenham continues to be a child of privilege, unbothered by reality.
37
Obamacare is going to be "no care" in just a few months. Good luck to the Republicans keeping their jobs. I guess seven years of trying to repeal Obamacare was too short to think of alternatives. Goodbye Republican majority in Congress in 2018!
57
They are talking about stalling the repeal until after midterms for this reason.
3
It is so rich that a privileged scion from East Manhattan who has never held a real job nor has ever had to struggle in life, decided to become the ultimate arbiter of the fate of millions of hardworking and poor Americans. To Mr. Needham I would award him the Marie Antoinette "Let them eat cake" award. If there truly was a God or at least the Ghost of Christmas Past, they would come in and sweep up Needham take him out of his privilege and stick him in a minimum wage job at McDonald's. They would also take away any hope of health insurance, and then curse him with a chronic disease. However, there is no justice, and privileged fools like Needham are free to inflict their political ideology upon the rest of us. Of course, it was the Heritage Foundation which came up with the plan known as the Affordable Care Act, and now Needham an intellectual midget, has decided to become the enemy of his foundation's creation.
217
Great comment!!!!
1
Exactly. As I kept reading the accounts of Chapman and Needham getting "visibly red-faced" at members of Congress, I couldn't help thinking the same thing I often wonder about Grover Norquist: Who exactly do these guys think they are and when were they elected by anyone?
5
Wrong. "Not Hillary" spent more time with union laborers than HRC and BHO ever did, combined.
And that ridiculous claim about the Heritage Foundation has nothing to do with the financial mess known as "ObamaCare." That is as absurd as claiming that since Republicans call 9-1-1, they should support every police unions' pay demands.
And that ridiculous claim about the Heritage Foundation has nothing to do with the financial mess known as "ObamaCare." That is as absurd as claiming that since Republicans call 9-1-1, they should support every police unions' pay demands.
1
ACA has already succeeded. Any replacement put forward has to include coverage for pre-existing conditions, no lifetime caps and affordability.
The only way to fund these "table stakes" is to create a very large pool of enrollees, young, old, healthy & ill. That is how insurance works, and no amount of deceptive Conservative political slogans changes that.
Math is immune to politics, and has already won this for the Democrats (and American citizens).
The only way to fund these "table stakes" is to create a very large pool of enrollees, young, old, healthy & ill. That is how insurance works, and no amount of deceptive Conservative political slogans changes that.
Math is immune to politics, and has already won this for the Democrats (and American citizens).
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S, you've obviously never heard the Detroit bankruptcy or "TennCare."
Both ran out of tax-money, and services cut back. This has happened, all over the world. Canada has laid off government workers. Europe has long waiting lines for surgeries.
The Democrats have no idea what math is, IMHO.
Both ran out of tax-money, and services cut back. This has happened, all over the world. Canada has laid off government workers. Europe has long waiting lines for surgeries.
The Democrats have no idea what math is, IMHO.
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Math might be immune to politics, but Republicans can't do math. Exhibit #1 - trickle down economics.
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Math isn't immune. Republicans prove every day to their base that 2+2=3.
One little discussed consequence of repealing the ACA will be its effect on those who have availed themselves of it because it has created career opportunities which previously did not exist. These would include the 1.4 million ACA enrollees who are self-employed, many of whom have made that choice only because the law ensured them access to a vibrant individual market which, for the most part, provided affordable coverage. Vox.com has a useful piece which examines the new doubts which now cast a shadow over the lives of some who have made that choice and are now having to prepare for the worst if the ACA is repealed:
http://www.vox.com/a/obamacare-aca-repeal-trump.
http://www.vox.com/a/obamacare-aca-repeal-trump.
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The only thing "far better" that is lower cost is anathema to the GOP (single payer, that is).
Other countries have successfully done it. No successful country hasn't done it except the U.S.
Other countries have successfully done it. No successful country hasn't done it except the U.S.
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Who are these people? Do they act this way in other aspects of their lives? If I told my wife for seven straight years I was going to replace our car, how would I squirm out of it?
It beggars belief that anybody can be so easily fooled as the Republican voter. Where do I sign for this lucrative and apparently legal scam?
It beggars belief that anybody can be so easily fooled as the Republican voter. Where do I sign for this lucrative and apparently legal scam?
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Here is how it works (because sadly, I've been there): you promise your spouse a new car at the 7 year mark.
It comes around, and you are broke, owe money, have no savings. After looking around at dealers at cars you cannot remotely afford...you AND your spouse reluctantly admit that, no matter how much you WANT that new car....you are going to keep driving the clunker for another couple of years.
That is reality, my friends.
It comes around, and you are broke, owe money, have no savings. After looking around at dealers at cars you cannot remotely afford...you AND your spouse reluctantly admit that, no matter how much you WANT that new car....you are going to keep driving the clunker for another couple of years.
That is reality, my friends.
ACA A.K.A. ObamaCare is a failure caused by Obama, Republicans and Democrats. It is anything but affordable because it failed to address the source of the issue, which is the cost of healthcare. Hospitalizations and medications cost a fraction, of what it costs in the US, in Europe.
Government controls what can be charged and of course taxes contribute to make healthcare affordable for all.
For as long as campaign finance is the main motivation of our legislators, Hospital and Pharmaceutical companies will do what it takes to keep our healthcare expensive.
Government controls what can be charged and of course taxes contribute to make healthcare affordable for all.
For as long as campaign finance is the main motivation of our legislators, Hospital and Pharmaceutical companies will do what it takes to keep our healthcare expensive.
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I've been screaming at the top of my lungs about this for years -- NO HEALTH REFORM will ever work until we get a control on costs. And Obamacare did absolutely zero for that. Indeed, it merely locks down a customer base for Big Insurance, which it has done handily -- but look at the 42% a year increase!
The truth is that health care is 18% of our economy and for a reason -- the doctors, nurses, technicians, hospital administrators, CEOs and so on, all make the big bucks and at our expense. This is NOT true in other nations that have the universal health care we claim to admire so much -- for example, Germany has excellent universal coverage. But their doctors earn an average of $85K a year, vs. our doctors at $275K a year. That's a fantastically huge difference -- NO insurance could EVER compensate for that difference.
There is a segment of the economy that is doing very, very well because they rip the rest of us off. NO REFORMS will ever work -- not for Trump, not for Republicans, not for Democrats, not for Bernie Sanders or Elizabeth Warren -- without getting controls on COSTS.
The truth is that health care is 18% of our economy and for a reason -- the doctors, nurses, technicians, hospital administrators, CEOs and so on, all make the big bucks and at our expense. This is NOT true in other nations that have the universal health care we claim to admire so much -- for example, Germany has excellent universal coverage. But their doctors earn an average of $85K a year, vs. our doctors at $275K a year. That's a fantastically huge difference -- NO insurance could EVER compensate for that difference.
There is a segment of the economy that is doing very, very well because they rip the rest of us off. NO REFORMS will ever work -- not for Trump, not for Republicans, not for Democrats, not for Bernie Sanders or Elizabeth Warren -- without getting controls on COSTS.
The gold-plated, Cadillac health insurance coverage plan of Senators, Representatives and their families should be withdrawn the day and hour they scrap ACA/Obamacare.
Once they have worked out an alternative to ACA/Obamacare, they should all get enrolled in this new, fantastic coverage that they have been talking about for some years now.
Once they have worked out an alternative to ACA/Obamacare, they should all get enrolled in this new, fantastic coverage that they have been talking about for some years now.
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ALL members of Congress must, by law, purchase their health insurance on the exchanges.
They get good Federal benefits, but they do not get any "special" gold-plated nor Cadillac health coverage.
I used to believe that; it certain gins up rage but it is in fact NOT TRUE.
They get good Federal benefits, but they do not get any "special" gold-plated nor Cadillac health coverage.
I used to believe that; it certain gins up rage but it is in fact NOT TRUE.
Victory or disappointment. Sounds more like the outcome of a cheap board game than our lives are at stake. Look at the videos of Bush Sr. and Reagan talk about being compassionate and sensible about immigration and you'll see how far astray republicans are from their core principals.
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Reagan gave illegals the amnesty that caused their numbers to increase 10-fold in 30 years. So, while others may remember him fondly -- I do not!
Columbia University Press has just published "Health Care as a Right of Citizenship: The Continuing Evolution of Reform" by Gunnar Almgren. The publisher's blurb notes "The mainstream American public now views access to affordable health care to all citizens as a crucial function of just and effective governance—and any proposed alternative to the ACA must be reconciled with that expectation."
I wish that were the case. I live in Florida, where there's been no political support for Medicaid expansion, and where members of Congress whose districts have very high rates of Obamacare use, want the program abolished.
Still, a significant number of people who didn't have health insurance have gained it, and might be vocally upset to lose it.
I wish that were the case. I live in Florida, where there's been no political support for Medicaid expansion, and where members of Congress whose districts have very high rates of Obamacare use, want the program abolished.
Still, a significant number of people who didn't have health insurance have gained it, and might be vocally upset to lose it.
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"Columbia University Press has just published "Health Care as a Right of Citizenship: The Continuing Evolution of Reform" by Gunnar Almgren."
Quoting (D) about (D) issues is newsworthy?
Only to (D).
Quoting (D) about (D) issues is newsworthy?
Only to (D).
3