Politics Obamacare

No, you are. Medicare is single payer. Medicaid is single payer. In some respects SCHIP programs are single payer. Single payer is in effect in other modernized countries. Single payer works in other areas of the economy...the argument is legitimate. Problem is that many lack the courage to make the case. I simply state what my preference is.

There is healthcare and there is healthcare insurance. Simplified, you do not insure known costs, you pay for them. And if you do, the premiums have to be set to address those costs. So, a pool of 50+ men with known conditions including known cost, will cost more to insure 20 year-old men with less known costs. As 20 year old men age known costs increase - actuarial science can project those costs to death. The costs have to be paid for, one way or another. With this as a basis, it becomes clear that year to year policies are as close to gambling as we can get but still call it insurance. Under Obamacare the fix is to give insurance companies pricing power - the power to cover costs with virtually no risk and guaranteed profit. This in trade for what you call patient protection. Patient protection has a cost - a cost you/Obama/others don't discuss. This is cost shifting nothing more, nothing less. Real reform in the direction of competitive markets can address this. Why do other insurance markets function better than the healthcare insurance market?

I am an active insurance consumer. I do not need government's help. I agree some do.

We don't need convoluted legislation to incetivize prevention. I would argue we don't need government for this purpose at all and that in some cases the unintended consequences could be worse.

O.k., I like them all. However, I am not going to say there is only one solution or one way to accomplish a goal. I agree that goal can be accomplished even when not accomplished in an efficient manner - but we should always seek the most efficient solutions.

 

Ace...Medicare was enacted at a time when Republicans were not as extreme or obstructionist (despite Reagan at the time being a hired gun for the opposition and declaring Medicare would be the end of America as we know it). There is no public or political will for a single payers system....that is reality. You can think otherwise, but that wont change the political climate. I hope it changes sooner rather than later, but until such time, any improvement over the current system is a positive development.

The only failure of the ACA to-date has been the roll out of the Exchange website...a process issue not a policy issue. And to a much lesser extent, the fact that many on the individual market will lose their current insurance; an issue that does not impact 95% of the population and half of whom it does affect will get subsidies for better insurance at a lower price.

The provisions of the ACA that I have highlighted on numerous occasions now will improve both patient protections for all American immediately (in both the group and individual market) and will result in greater affordability for millions of low income uninsured immediately (in the form of subsidies) and likely to result in greater affordability (lowering the costs) over time as a result of the significant investments in improving the delivery system.

If these provisions dont work as envisioned, they can be tweaked or replaced, but the non-stop rhetoric of the ACA being a massive failure ignores the facts and is nothing more than ideological whining.

 

Red states (Republican governors) rejection of the ACA Medicaid expansion provision is near unanimous, even with the federal government paying 100% for the first two years and 90% in future years.

Five million working poor individuals and families in red states will remain uninsured because of Republicans unwillingness to expand Medicaid....but you want us to believe a single payer system is politically viable?

 

why should they have an alternative? this bill was supposed to fix things and it's worse than what we had before. the democrats are the ones hurting on this not the GOP. they got rid of the shelter with obamacare. more people are buying guns than obamacare and guns are a niche market. everyone has to have healthcare now...

 

1.6 million background checks as compared to:

• 5 million children with pre-existing conditions now covered and 50+ million adults with pre-existing conditions who will no longer be denied coverage starting in 2014.
• 20 million who received nearly $2 billion in rebates for premium overcharges.
• 6 million seniors saving more than $7 billion on Medicare prescriptions by closing the donut hole.

 

you say they are now covered, but are they actually covered yet? will they even be able to get coverage in 2014? the bill isn't working. sounds cool on paper i guess.

 

The 5 million children are now covered in group (employer) family plans for the first time. The 50+ million adults can no longer be denied in either group plans or the individual market starting in 2014. Millions of those adults work for employers that offer plans but were barred by the insurer from being covered until now.

The 20 million who received premium rebates were for 2011 and 2012. That number will decline as insurance companies come in compliance.

The 6+ million seniors on Medicare needing prescriptions will continue to save beyond the $7 billion to-date.
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These are not paper savings. These are real and have real impact on the lives of millions.

 

Drip, drip, drip...

Woman cited by President as Obamacare success story frustrated by sign up process – CNN Political Ticker - CNN.com Blogs

She is luck they found the error now rather than a year from now - imagine having to repay money you think is yours because of what you think is a subsidy.
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Why don't progressives try and understand the ACA, Obamacare.

Do progressives know that insurance company profits a gauranteed in the law? The insurance companies are taking virtually no risks. Would progressive supported the ACA if they knew this?

Who is taking the risks, you ask? The American public - tax payers, premium payers, the young... Why do we even need the insurance companies if they assume no risk and have guaranteed profits? We don't. In principle we need a system where the private sector assumes risks for their potential profits (free market stuff) or true single payer - since we are assuming all the risks anyway. The ACA is bad law, a mess. Destine to fail - in the context of not doing what they said it would do. Of course people will sign up, they have no choice or pay the tax/fine - and of course those with big subsidies or free care will sign up, those are not the measures of success.

 

"Unforced errors..." - Only if it was true! Link to another CNN article.

Private consulting firm warned of glitches before healthcare.gov launch – CNN Political Ticker - CNN.com Blogs

Seem like someone was telling a fib to Congress.
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So the progressives against the law are against it for principle and conservatives against the law are just wanting it to fail because....????

And those not aware of insurance companies getting a sweet deal, if they knew, would they care?

 

This whole thing can't possibly work. Any system that separates price signals from the user is going to end up generating huge waste and enormous expense, ultimately leading to centralized rationing (i.e. politicized access). And the efforts to overcome that problem end up building so much complexity into the system that it becomes a house of cards -- one thing balanced wrong and everything crashes. I'd rather get rid of third-party payment for routine and foreseeable expenses, provide savings accounts with incentives for intelligent usage, make sure we have a safety net for the poor, and get the govt the hell out of this business. The federal govt isn't good at this, and by giving the federal govt more to do than it can do well, it starts screwing up the things we really need the fedl govt for (and which it can do reasonably well), like infrastructure and defense.

 

Keeping the taxpayers healthy should rate up there as an important thing for a federal government to do. Every other 1st world country can handle doing it just fine. When you force cheap and poor people to spend money on health tests or preventative scans, they won't want to until it is a much bigger problem that they can't ignore.

The other things are the ones that a lot of money is being wasted on, yet the right doesn't want to cut.

 

loquitor...correct me if I'm wrong, but it sounds to me that you are proposing an expanded system of health savings accounts or vouchers.

How will that help the person with a pre-existing condition that insurance companies will refuse to cover? How will it help when an insurance company recinds a policy as soon as a person experiences a major illness? How will protect you from severe financial hardship or bankruptcy as a result of a major illness/accident. How will it guarantee that you as a consumer will have a right of appeal?

With the exception of administering the Exchange, the expanded government role is primarily regulating the insurance industry with national minimum standards as opposed to a weak, patchwork of state regulations and the federal government certainly has a role in regulating an industry that impacts the daily lives of all Americans as much as it does in providing defense and infrastructure.

As to administering the Exchange, it is really not that different than administering the sign-up for Social Security or Medicare....a process issue, not a policy issue, that we all agree was bungled but has been grossly mischaracterized as evidence of a failed policy.

 

those are transition and implementation issues, not conceptual ones. And that's why the question is senseless without quantifying the problem. If my proposal covers, say, 95% of the population well, then we have a 5% problem. That's not bad. We can figure out how to handle a 5% problem. It doesnt' require screwing around with the other 95%. But you have to quantify the problem. What portion of the population has to deal with the pre-existing condition problem, and what is the magnitude of the cost for each of them? Until you know the answer to those questions you don't know what the scope of the issue is. The existence of an issue doesn't dictate the solution -- the nature and scope of it dictates the solution (or whether a solution is even needed).
That was the problem with Obamacare - it was sold as a way of just covering the uninsured. But they chose to do it by micromanaging everything. Me, I'd make everyone uninsured (other than for genuine emergencies/catastrophes) and then tweak the edges to take care of the hard cases. But it makes ZERO sense to say that the existence of some relatively small percentage of the population with a problem (e.g., 15% without health insurance) means the govt has to dictate how everyone gets health insurance. That's exactly backwards. There's no evidence that the govt is good at it or possibly could be.
Obamacare dictates a whole bunch of stuff, far beyond just sending checks out (which is what Medicare and SS do). That's why it's over 2000 pages. I'm a 54 year old man - I don't need maternity care, addiction counseling, or any of a whole list of other special items that the President thinks have to be covered (no doubt because his cronies lobbied for them). But I have no choice. Under the new law I have to buy that stuff if I want any coverage. Why?
Anyway, the point is that centralized dictates is not the way to do things. It simply cannot be done right. Hayek got that exactly right. And it definitely isn't the way to solve a 5% problem, or even a 15% problem. And it's certainly not the way to deal with a problem you haven't even quantified.
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And no, BG, health care is not infrastructure. Even health insurance isn't infrastructure. By your definition everything can be made into infrastructure. It just ain't so.