The Way Forward: Repeal ObamaCare

[Seawytch]

Repeal it and replace it with Medicare for all.

You could "fix it" with a Public Option.

 

[CrusaderFrank]

The weaknesses of the anti-ACA arguments on full display.

Misinformation (union exemptions that don't exist in the actual legislation, a completely backwards understanding of what's happened to Medicare spending in the last three years, entirely mythical rises in the CBO projections) and wild speculation (the 2020 repeal vote that eliminates the law's Medicaid funding, active purchasing in exchanges someday run amok) anchor the most riveting conclusions for why it has to go.

I can't wait to hear about the death panels.

“We’re going to need more revenue, we’re going to need, and probably in the end, surely in the end it will require some sort of middle class taxes as well. So again, we won’t be able to pay for the kind of government, the society we want without some increase in taxes, not a huge one, but some increase on taxes on the middle class, maybe a value-added tax. We’re going to have to make decisions about health care, not pay for health care that has no demonstrated medical benefits. So you know the snarky version I use, which is, I shouldn’t even say because it will get me in trouble, is death panels and sales taxes is how we do this.” -- Paul Krugman

 

[CrusaderFrank]

yet the most efficient pricing mechanism in the US is medicare. I'm not arguing for, or against, govt insurance. However, your notion of low income workers footing their healthcare not only won't work here, but works nowhere in the developed world.

There are means to inject more competitiveness, and personal responsibiilty, but yours is not one of them. In fact the gop is also paralyzed into doing nothing positive.

Based on what, your fundamental lack of knowledge and experience with the program?

 

[LoneLaugher]

Idiot nutters just love the word "fundamental".

 

[CrusaderFrank]

Idiot nutters just love the word "fundamental".

^ adds so much to every conversation

Like clockwork

 

[g5000]

yet the most efficient pricing mechanism in the US is medicare.

If you were a market participant and were allowed to write the rules for your competitors, and could hogtie them, then OF COURSE you would have the best pricing mechanism! With that kind of tyrannical power, it goes without saying. Or it should. Apparently, it does need to be pointed out.

That in no way means Medicare is the optimal system. Level the playing field for all the market players, and see what happens.

 

[Bfgrn]

I have solutions. See post 13.

That wasn't really a solution, and it points out the vapidity of the gop position (no personal offense intended). You proposed people should buy health insurance like other insurance. The workers not insured are lower income workers.

The government has driven up the cost of insurance through its policies and through its participation in the market. You don't see the cost of auto, home, or life insurance skyrocketing at the same rate as health insurance.

ObamaCare does nothing to bend the cost curve down, and actually more deeply entrenches things which bend it up.

If you were able to buy your health insurance in a truly competitive market, the cost of insurance would drop. Under the current situation, the government does not allow you to buy from any insurance company you wish. And most people are hostage to whatever plan their company offers. This means your company is a tiny pool of customers up against the insurance company. You're totally fucked on cost. In turn, the insurance company is geographically limited, making it hostage to the healthcare industry on cost. All because as an active participant in that market, the government gets to write the rules for its private sector competitors! You don't see the government tying its hands the way it ties the hands of its competitors. How fucked up is that?

And raising the retirement age would have a tremendous impact on the federal budget. If you work five years longer, that is five years more you pay into Medicare and Social Security, and five years LESS you draw out from them. We have had more than a literal doubling of the entitlement load since Social Security was enacted because we are living decades longer than our ancestors.

There is a HUGE fatal flaw in your thinking, and I mean FATAL, that is unless the 'invisible hand' is so magical, it can even heal...

The whole basis of a 'free market' is the buyer has leverage, i.e. he/she can take his/her business elsewhere. That works perfectly fine when the stakes are 'things' (cars or TV sets etc). But a person's health is not a 'thing', and the consumer's stake is their very life. An unhappy consumer can go buys a different car or TV. If a person has a life threatening illness and is denied coverage for treatment, WHAT leverage does that person have...take their business elsewhere IN ANOTHER LIFE?

 

[Bfgrn]

Is Medicare Cost Effective?

Here is a market-driven entrepreneur.

Bill Brody, M.D. President, Salk Institute for Biomedical Research

Dr. William R. Brody, an acclaimed physician-scientist, entrepreneur and university leader, joined the Salk Institute for Biological Studies on March 2, 2009 after 12 years as president of The Johns Hopkins University.

June 13, 2003

Is Medicare Cost Effective?

I recently spent a half-day in a meeting discussing a number of issues regarding Medicare. Most of us on the provider side of the street view Medicare as this multiheaded bureaucracy with more pages of regulations than the Internal Revenue Service's tax code. However, I came away from the meeting with some (to me at least) shocking revelations:

Medicare beneficiaries are overwhelmingly satisfied with their Medicare coverage, except for the absence of prescription drug benefits;

The administrative costs of Medicare are lower than any other large health plan.

In fact, Medicare is very efficient by any objective means:

According to the Urban Institute's Marilyn Moon, who testified before the Senate Committee on Aging, Medicare expenditures between 1970 and 2000 grew more slowly than those of the private sector. Initially, from 1965 through the 1980s, Medicare and private insurance costs doubled in tandem. Then Medicare tightened up, and per capita expenditures grew more slowly than private insurance, creating a significant gap. In the 1990s, private insurers got more serious about controlling their costs, and the gap narrowed. But by 2000, Medicare per capita expenditures remained significantly lower than the private sector.

Moon argues somewhat convincingly that Medicare has been a success. While not necessarily denying that certain reforms might be needed, she stresses the importance of preserving three essential tenets of the program:

1. Its universal coverage nature creates the ability to redistribute benefits to those who are neediest.

2. It pools risk in order to share the burdens of health care among the healthy and the sick.

3. Through Medicare, the government protects the rights of all beneficiaries to essential health care.

It has been argued that, in part, Medicare's cost effectiveness arises from the fact that it does not need to expend funds on marketing and sales-functions that are obligatory for the success of competitive, private-sector health plans. Moreover, some argue that the competitive model for health insurance has not been successful. In a market-driven economy, the healthy can and will change health plans for savings of only a few dollars a month, while the sick must remain in their existing plan in order to retain their physicians. Such behaviors lead to asymmetric risk pools and cost inequities.

This was all sobering news to a market-driven entrepreneur such as yours truly. However, given the perverse incentives that frequently drive behavior in health care, my take-home lesson is that there are examples in the success of Medicare we can apply to other sectors of our population.

 

[Sallow]

The Way Forward: Repeal ObamaCare

Repeal away.

Provided you immediately replace the ACA with something that ensures all Americans have health insurance coverage.

Don’t just come with a complaint, come with a solution as well.

Replacing with Medicare for everyone is probably the way to go.

I don't have idea why HMOs are so protected. They aren't working...and haven't since their inception. Along side of almost every industrialized nation, the US has big medical costs and crappy outcomes.

 

[Dot Com]

Idiot nutters just love the word "fundamental".

Newt uses that word in every other sentence lol

Again , I go back to the fact that the Repubs had control of the Congress on numerous occassions and had the ability to do something about it and instead focused on coddling the wealthy as they always do.

 

[Greenbeard]

Their 2010 projection included the years 2010 through 2014, which is a period before the full implementation of Obamcare when the real costs start to kick in. That is about as disingenuous as it gets.

Their 2010 projection was that the net annual cost of full enrollment (achieved sometime around 2016) would be in roughly the $150-160 billion range. The only change since that time has been small revisions downward on a year-by-year basis.

There are no surprises here.

$1.363 trillion added to our national debt.

Here's an idea: read the footnotes you conveniently cropped out. Specifically, the first one, the one attached to the "Effects on the Federal Deficit" title of the table. That would be the one that says "Excludes effects on the deficit of other provisions of the act that are not related to coverage, which in the aggregate reduce deficits."

So no, that isn't added to the debt.

 

[dblack]

Now let's talk about the costs to the states....

in my view, all of the drawbacks pale in comparison to the loss of essential freedom inflicted on us by PPACA. Giving up control of our personal health care decisions to government (and its corporate sponsors) is sheer insanity.

Not sure where you get the idea you are giving up control of your personal health care decisions to the government. Are you moving to Canada?

We've given up control over how we finance our health care. Decisions don't get much more personal than that. We're being forced down the path of corporate insurance by the whores in Congress. If you control the money being spent in a given market, you control everything about that market - you control everyone who participates in that market. That's been the end game for the corporatists all along.

 

[dblack]

ObamaCare has to be repealed because shopping for insurance in the new marketplaces is too attractive an option?

Yes. That is a HUGE problem because the ‘attractive’ force is not because the marketplaces are better or because they offer something more to the customer. It is because the taxpayers are footing the damn bill for those plans. Essentially, this is a power grab by the government to ensure that the VAST majority of customers are purchasing their plans through the government giving them total control over the individual insurance companies that are able to operate and the plans that they offer. The real impact of forcing people to pay for those plane through taxation whether or not they actually want to purchase them. If the market were superior then the government would not need to force you to pay only a portion of those plans but allow you to apply that subsidy to the plan that you want.

Yes. Exactly. "An offer you can't refuse". Some 'market'.

 

[dblack]

Your 'personal health care decision', if that decision is to opt out of buying health insurance inflicts cost on every person whose 'personal health care decision' is to buy health insurance.

No, it doesn't. No more than my decision to 'opt-out' of fire insurance, or car insurance, or refusing to join any other kind of insurance pool. If your little insurance scheme won't work unless you force everyone else to play along - too bad.

You are what the Heritage Foundation called a 'free rider' when they designed the individual mandate.

Fuck the Heritage Foundation. That have no clue what real freedom is all about.

 

[Bfgrn]

Your 'personal health care decision', if that decision is to opt out of buying health insurance inflicts cost on every person whose 'personal health care decision' is to buy health insurance.

No, it doesn't. No more than my decision to 'opt-out' of fire insurance, or car insurance, or refusing to join any other kind of insurance pool. If your little insurance scheme won't work unless you force everyone else to play along - too bad.

You are what the Heritage Foundation called a 'free rider' when they designed the individual mandate.

Fuck the Heritage Foundation. That have no clue what real freedom is all about.

Tell you what sonny boy. Get in an auto wreck, and see if anyone asks you if you have insurance before they extricate you, triage you, transport you to an ER, operate on you and save your life. And when you don't have insurance for the $100,000 medical bill, the rest of us PAY. Fuck YOU, you little self absorbed turd.

 

[sfcalifornia]

Well said, Mac.

People like me are not in love with Obamacare. We'd much rather have something simpler...as you have called for. But we know that it is far superior to doing nothing about the problem.

If you'd go a step further and call for the elimination of a profit motive in health care altogether....we might be on the same page.

I would like to see a much simpler system for health insurance. And why the onus of health insurance is put on employers is beyond me. Just one more layer of bureaucracy.

 

[dblack]

Your 'personal health care decision', if that decision is to opt out of buying health insurance inflicts cost on every person whose 'personal health care decision' is to buy health insurance.

No, it doesn't. No more than my decision to 'opt-out' of fire insurance, or car insurance, or refusing to join any other kind of insurance pool. If your little insurance scheme won't work unless you force everyone else to play along - too bad.

You are what the Heritage Foundation called a 'free rider' when they designed the individual mandate.

Fuck the Heritage Foundation. That have no clue what real freedom is all about.

Tell you what sonny boy. Get in an auto wreck, and see if anyone asks you if you have insurance before they extricate you, triage you, transport you to an ER, operate on you and save your life. And when you don't have insurance for the $100,000 medical bill, the rest of us PAY. Fuck YOU, you little self absorbed turd.

That's all you got. Suck corporate cock all you want. I won't play.

 

[Wacky Quacky]

Your 'personal health care decision', if that decision is to opt out of buying health insurance inflicts cost on every person whose 'personal health care decision' is to buy health insurance.

No, it doesn't. No more than my decision to 'opt-out' of fire insurance, or car insurance, or refusing to join any other kind of insurance pool. If your little insurance scheme won't work unless you force everyone else to play along - too bad.

You are what the Heritage Foundation called a 'free rider' when they designed the individual mandate.

Fuck the Heritage Foundation. That have no clue what real freedom is all about.

Tell you what sonny boy. Get in an auto wreck, and see if anyone asks you if you have insurance before they extricate you, triage you, transport you to an ER, operate on you and save your life. And when you don't have insurance for the $100,000 medical bill, the rest of us PAY. Fuck YOU, you little self absorbed turd.

You can opt out of auto insurance by using alternative modes of transportation. I'm sure dblack didn't mean driving illeaglly without insurance.

 

[dblack]

No, it doesn't. No more than my decision to 'opt-out' of fire insurance, or car insurance, or refusing to join any other kind of insurance pool. If your little insurance scheme won't work unless you force everyone else to play along - too bad.



Fuck the Heritage Foundation. That have no clue what real freedom is all about.

Tell you what sonny boy. Get in an auto wreck, and see if anyone asks you if you have insurance before they extricate you, triage you, transport you to an ER, operate on you and save your life. And when you don't have insurance for the $100,000 medical bill, the rest of us PAY. Fuck YOU, you little self absorbed turd.

You can opt out of auto insurance by using alternative modes of transportation. I'm sure dblack didn't mean driving illeaglly without insurance.

Not sure what you mean, but mandatory auto insurance is just as wrong as mandatory health insurance. Forcing people to tithe to corporate lobbyists is an abuse of government power.

 

[Wacky Quacky]

Tell you what sonny boy. Get in an auto wreck, and see if anyone asks you if you have insurance before they extricate you, triage you, transport you to an ER, operate on you and save your life. And when you don't have insurance for the $100,000 medical bill, the rest of us PAY. Fuck YOU, you little self absorbed turd.

You can opt out of auto insurance by using alternative modes of transportation. I'm sure dblack didn't mean driving illeaglly without insurance.

Not sure what you mean, but mandatory auto insurance is just as wrong as mandatory health insurance. Forcing people to tithe to corporate lobbyists is an abuse of government power.

If I take a bus to work, I'm no longer forced to buy auto insurance.

The ACA is much different. The only stipulation there is that I'm a living citizen.