ACA no repeal, no reform, just slow death

[william the wie]

In order to repeal prior to 2017 the following will be needed:

Veto-proof majorities in both houses, which is not possible because there are more than 145 safe D seats in the house whose occupants fear primary challenges from the left more than the failure of Obamacare.

Their will be no reform after 2017. The pre-ACA medical system is dying as we discuss its return and will be effectively dead prior to the 2014 election.

The workarounds for a less expensive medical system to replace the closed hospitals and the unemployed medical staff will be in place by election day.

The current Chinese real estate bubble is considerably larger than the US bubble 1993-2006.

The use of automated manufacture in the US is growing and is replacing Chinese labor. This process will bust the Chinese bubble and that will not be a one time event. The US is still dealing with the overhang of our own bubble bust in 2006 such as the recent JPM settlement.

Beyond defunding ACA no reform will be affordable. With the implied goal of eliminating roughly 10% of GDP (medical costs) the ACA is on target to do so before Obama leaves office.

That leaves slow death as a possible solution.

 

[JakeStarkey]

Nup.

 

[Katzndogz]

Then we will have government health insurance but no actual medical care.

 

[Stephanie]

 

[william the wie]

Then we will have government health insurance but no actual medical care.

Vice versa is far more likely. Compliant ACA private insurance for when concierge care is not sufficient to cover catastrophic bills and health clinics for the poor.

 

[william the wie]

About right this bill is more like the failed Washington state plan of 1991-9 than anything else, at least in execution.

 

[Katzndogz]

Hospitals are setting up their own concierge networks. Torrance Memorial did it a year ago. In Los Angeles, I just saw that Cedars Sinai was doing the same thing and they have already opted out of obamacare. That will provide excellent specialty and catastrophic care. Much of the specialty units are supported by charitable foundations now, along with concierge, those that can afford it will be just fine.

 

[Flopper]

In order to repeal prior to 2017 the following will be needed:

Veto-proof majorities in both houses, which is not possible because there are more than 145 safe D seats in the house whose occupants fear primary challenges from the left more than the failure of Obamacare.

Their will be no reform after 2017. The pre-ACA medical system is dying as we discuss its return and will be effectively dead prior to the 2014 election.

The workarounds for a less expensive medical system to replace the closed hospitals and the unemployed medical staff will be in place by election day.

The current Chinese real estate bubble is considerably larger than the US bubble 1993-2006.

The use of automated manufacture in the US is growing and is replacing Chinese labor. This process will bust the Chinese bubble and that will not be a one time event. The US is still dealing with the overhang of our own bubble bust in 2006 such as the recent JPM settlement.

Beyond defunding ACA no reform will be affordable. With the implied goal of eliminating roughly 10% of GDP (medical costs) the ACA is on target to do so before Obama leaves office.

That leaves slow death as a possible solution.

I don't see any repeal but there will have to be legislation that addresses some problems eventually . Obama opened Pandora's Box and nothing is going to close it.

 

[Flopper]

Hospitals are setting up their own concierge networks. Torrance Memorial did it a year ago. In Los Angeles, I just saw that Cedars Sinai was doing the same thing and they have already opted out of obamacare. That will provide excellent specialty and catastrophic care. Much of the specialty units are supported by charitable foundations now, along with concierge, those that can afford it will be just fine.

How does a hospital opt out of Obamacare?

 

[william the wie]

Hospitals are setting up their own concierge networks. Torrance Memorial did it a year ago. In Los Angeles, I just saw that Cedars Sinai was doing the same thing and they have already opted out of obamacare. That will provide excellent specialty and catastrophic care. Much of the specialty units are supported by charitable foundations now, along with concierge, those that can afford it will be just fine.

exactly. But lower cost concierge services are also available. The ER has to be renamed urgent care with trauma, ICU and perhaps other services as separate departments near the old ER but ERs are a target of Obamacare.

Some new form of non-hospital hospital chains will start spreading nationwide but Obama created a two and probably three or more tier medical service. Look at the growth in MediCal as a substitute for both Obamacare and concierge care.

 

[Dont Taz Me Bro]

I don't see any repeal but there will have to be legislation that addresses some problems eventually . Obama opened Pandora's Box and nothing is going to close it.

Repeal is a possibility once Obama is gone. By that time people will have suffered so much because of it even if he is succeeded by another Democrat repeal may very well be on the table.

 

[william the wie]

I don't see any repeal but there will have to be legislation that addresses some problems eventually. Obama opened Pandora's Box and nothing is going to close it.

True, but most of that will be done administratively by the next president. The way Pelosi and Reid handled this legislation poisoned the well for the administration.

 

[william the wie]

I don't see any repeal but there will have to be legislation that addresses some problems eventually . Obama opened Pandora's Box and nothing is going to close it.

Repeal is a possibility once Obama is gone. By that time people will have suffered so much because of it even if he is succeeded by another Democrat repeal may very well be on the table.

Too damned expensive. Run the numbers on all of the guarantees in the bill that can and will trigger takings clause lawsuits. Letting exchange coverage hit infinity to kill the program is the least cost exit.

 

[oreo]

I don't see any repeal but there will have to be legislation that addresses some problems eventually . Obama opened Pandora's Box and nothing is going to close it.

Repeal is a possibility once Obama is gone. By that time people will have suffered so much because of it even if he is succeeded by another Democrat repeal may very well be on the table.

The only way democrats are going to save themselves is by repealing it themselves.
Obamacare is on track to do so much damage to millions in this country--that liberalism could lay down and die for the next 50 years.

 

[william the wie]

I don't see any repeal but there will have to be legislation that addresses some problems eventually . Obama opened Pandora's Box and nothing is going to close it.

Repeal is a possibility once Obama is gone. By that time people will have suffered so much because of it even if he is succeeded by another Democrat repeal may very well be on the table.

The only way democrats are going to save themselves is by repealing it themselves.
Obamacare is on track to do so much damage to millions in this country--that liberalism could lay down and die for the next 50 years.

See the OP again. The house Democrats will sustain the president's veto because in their district the Greens and Socialists poll higher than Republicans for more than 145 of them.

 

[Flopper]

I don't see any repeal but there will have to be legislation that addresses some problems eventually . Obama opened Pandora's Box and nothing is going to close it.

Repeal is a possibility once Obama is gone. By that time people will have suffered so much because of it even if he is succeeded by another Democrat repeal may very well be on the table.

No. By 2017, there will be no way to hit the reset button and turn the clock back to 2009. Even if Republicans controlled government today, I doubt it could be done. Republicans would have to come up with their own healthcare plan which would be ever bit as difficult to enact as the ACA because it would have to take into account:

• Medicaid will have expanded to cover between 10 and 17 million more people.
• 3 million young people under age 26 have already been added to their parents health insurance.
• The Medicare doughnut hole in drug coverage will be 80% eliminated by 2017.
• Without the ACA, million of people would not qualify for insurance because of preexisting conditions.
• Medical students would be receiving scholarships and loan repayment programs to increase the number of primary care physicians, nurses, physician assistants, and mental health providers.
• Almost every state has amended state insurance laws and there are number of additional changes pending.
• By 2017, almost half of the families in America will be receiving some type of health insurance subsidy due to the ACA.

I'm sure there will be changes in the law, but it's not going to go away.

How Health Reform?s Medicaid Expansion Will Impact State Budgets ? Center on Budget and Policy Priorities
Young Adult Coverage | HHS.gov/healthcare
Obamacare: Pre-existing conditions - POLITICO.com

 

[william the wie]

The much more likely outcome will be the result of unintended consequences not legislation but Obama destroyed the reset button for sure.

 

[Zoom-boing]

Hospitals are setting up their own concierge networks. Torrance Memorial did it a year ago. In Los Angeles, I just saw that Cedars Sinai was doing the same thing and they have already opted out of obamacare. That will provide excellent specialty and catastrophic care. Much of the specialty units are supported by charitable foundations now, along with concierge, those that can afford it will be just fine.

How does a hospital opt out of Obamacare?

Doctors can refuse insurance, including obamacare. Medicaid is often turned down, you have to go to whoever will take it. I imagine hospitals would be able to do the same?

 

[william the wie]

Hospitals are setting up their own concierge networks. Torrance Memorial did it a year ago. In Los Angeles, I just saw that Cedars Sinai was doing the same thing and they have already opted out of obamacare. That will provide excellent specialty and catastrophic care. Much of the specialty units are supported by charitable foundations now, along with concierge, those that can afford it will be just fine.

How does a hospital opt out of Obamacare?

Doctors can refuse insurance, including obamacare. Medicaid is often turned down, you have to go to whoever will take it. I imagine hospitals would be able to do the same?

Yes Mayo clinic does just that with medicare unless you are one of its retirees or volunteers.

 

[Flopper]

How does a hospital opt out of Obamacare?

Doctors can refuse insurance, including obamacare. Medicaid is often turned down, you have to go to whoever will take it. I imagine hospitals would be able to do the same?

Yes Mayo clinic does just that with medicare unless you are one of its retirees or volunteers.

Only a few hospitals in the US don't except Medicare, primarily VA hospitals and Shriners. The reason why is pretty simple.

60% of the hospitals are nonprofit hospitals, many of which depend on endowments and government grants. With approximate 1/3 of the hospital beds in the US being occupied by Medicare patients, turning down Medicare is simply not an option for most hospitals particular when you consider that about 40% of the people covered by Medicare have other insurance in addition to Medicare which will cover almost all of their hospital bill not paid by Medicare.

Many hospitals are faced with cuts in Medicare reimbursements if they don't improve their outcomes measured by readmission within 30 days and a number of other criteria. For hospitals that excel, their reimbursement rate will increase. Most hospitals will improve their patient outcomes rather drop Medicare.

BTW Mayo Clinic does accept Medicare. However, it doesn't accept Medicare-approved payment amount as full payment of physician services. On a $1150 bill, the patients responsibility is likely to be $150.

Medicare information for Mayo Clinic in Arizona