GOP Repealing ObamaCare ---- WHY?

realitykeeper

InTheTrees wrote: »

So you have experience of the US system before the ACA do you?

It was a mess, premiums were rising substantially every year. The old system mean individuals were completely tied to their jobs because individual plans were unaffordable unless you had an employer contributing.

Fascinating times ahead as the republicans roll back all the reforms. There WILL be trump voters in the east that will die because of this.

Government should have no part in insurance schemes. It is for the greater good that the private sector take care of that.

FreudianSlippers

realitykeeper wrote: »

Then I shall simplify it for you. Obamacare is a bad idea. Some people may not want to pay for health insurance. Instead, they may wish to save cash to cover health costs in the future. Also, it is better to leave health care and insurance exclusively to the private sector and give people the freedom to decide whether or not they wish to avail of such things.

You telling me you can save up $50k+ frequently for a basic operation?

The problem with this "savings" argument is that people weren't doing that in the past and there is little evidence that they would start to do this in the future. Instead, people were forced to declare bankruptcy and not pay their bills, resulting in hospitals and insurance companies eating these costs - which they then passed on to customers.

There is no valid legitimate argument against the fundamental concept of the ACA in terms of requiring universal insurance and subsidising it for people who can't afford it.

FreudianSlippers

Inquitus wrote: »

What happens to you in the US if you have no health insurance and get diagnosed with something that requires hospitalisation and/or surgery? I assume you get treatment got get hit with an unpayable bill for same that will attempt to be collected via the full force of the law?

Depends on the hospital and its ethos tbh; there are certainly some hospitals that do not accept uninsured patients (even some that require you hold their insurance specifically - Kaiser Permanente is an example of this I believe), but many hospitals will do as you say and send the bill to a collection agency.

A colleague's child had a minor surgery in LA and the bill was $50k - insurance co-pay was $400.

FreudianSlippers

realitykeeper wrote: »

Government should have no part in insurance schemes. It is for the greater good that the private sector take care of that.

So you're against federal/state requirements for car insurance then?

Permabear

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InTheTrees

Permabear wrote: »

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You have shown no evidence of 25% premium increases.

You posted a link to a conservative opinion piece from last october that claimed there may be increases.

Permabear

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Inquitus

Permabear wrote: »

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Obamacare is still better than repeal and no replacement, it's not perfect, but it's the best stab at universal coverage the US has tried yet.

Permabear

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InTheTrees

Permabear wrote: »

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You still havent shown 25% increases. And you said you were having to pay 40% extra for your nanny. Presumably you can document that increase?

And how much is it going to increase once the new (amazing!) trump plan comes into existence?

Permabear

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jimmycrackcorm

Permabear wrote:

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I think it will be interesting to see what t the GOP will replace it with. I suspect that the outcome will be worse for millions of people.

vetinari

Health care is a need though, not a want.
Free market economics don't work with them.
Similar to a utility company that collects rent for the use of an essential product, competition is meaningless for these companies.
Without government regulations, people will choose to buy ultra cheap healthcare plans with minimal coverage.
Then when something serious happens, they won't have proper coverage and will have to file for personal bankruptcy.
Pre obamacare, health care bills was the leading cause of personal bankruptcy.

You're going to need some form of single payer system or subsidised health insurance plans to avoid this.
The likes of Aetna have no economic desire to insure some high risk patient unless they can charge them an exorbitant premium.
And even in the case of someone having say cancer, the best free market approach would be to not offer them insurance at all.
There is no way you could collect enough money in premiums to pay for someone's cancer treatment.

ancapailldorcha

InTheTrees wrote: »

You still havent shown 25% increases. And you said you were having to pay 40% extra for your nanny. Presumably you can document that increase?

And how much is it going to increase once the new (amazing!) trump plan comes into existence?

Yes he has. It's in the first page of this thread. Any more of this and you will be sanctioned.

Amerika

jimmycrackcorm wrote: »

I think it will be interesting to see what t the GOP will replace it with. I suspect that the outcome will be worse for millions of people.

I’m pretty sure the final GOP plan will look a lot like this plan, with some tweaking over the next 2-3 months, that was put out in June of 2016.

https://abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-PolicyPaper.pdf

Cartouche

ECO_Mental wrote: »

Well the first thing the GOP are at with their complete majority in congress, senate and and Trumpski is repealing Obamacare (apart from trying to not have any eithics :rolleyes:)

What is the GOP's problem with it?

For starters they hate poor people. Most Obamacare folks would fall into that category

Permabear

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Manic Moran

Obamacare was well-intentioned, but was a very loose band-aid which is starting to unravel. The problem with the healthcare system in the US isn't the root cause that some people can't afford it, but that the whole system costs way too much to begin with. With prices being ridiculously high, those rates are being passed down to premiums, and some can't afford those premiums. ACA didn't, as far as I know, cut any prices, or reduce the costs of healthcare, it merely juggled who paid for it by a combination of the mandate and subsidies. If the costs of healthcare itself were to be reduced, it would become feasible for those who cannot currently afford 'private' premiums to afford reduced premiums.

In this, Trump is arguably looking in the right direction with his recent comments about the pharmaceutical industry. When the Epi-pen shot up in cost, or the HIV pill went from $13 to $500, that wasn't the health insurance companies doing it. But the health insurance companies have to pay them out, and their way of getting their money is through premiums. The root cost of healthcare in the US is out of control, that is what needs to be fixed, not the ACA solution. Now, if Trump's philosophy can be trickled down to the GOP lawmakers as to how this will be achieved, is another matter entirely.

FreudianSlippers

Permabear wrote: »

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Isn't there a bit of number trickery there though?

20 million people have gained health insurance due to the ACA; presumably that constitutes a number of "famil[ies] of four"?

So, the subsidisation has seriously benefited the poor insofar as they now have health insurance whereas previously they didn't.

I'm not arguing that there has been an increase on some groups, but surely the solution is to fix that issue rather than start over?

Permabear

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FreudianSlippers

Permabear wrote: »

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Accepted, but this is preferable to those people being uninsured which can cost the entire system more in write-offs (etc.)

As for the remaining 14 million, it's unclear how many became insured because of the subsidies, versus how many decided to get insurance because of the penalties.

I don't really see why that distinction matters if the result is the same?

It's well known, for instance, that many, especially young adults, in the pre-Obamacare era decided (fairly rationally) that they could take a gamble on not having health insurance at all, or taking out cheap "catastrophic injury or illness" policies that would have covered them only in the event of serious accidents, etc. The imposition of penalties may have changed that calculus.

It's a gamble that many couldn't afford, which passed on the cost to the insured.

We also have to remember that the population of the United States is around 320 million, so this touted number of 20 million is only about 6.25 percent of the population.

Agreed, but it's crazy to look at the decrease in uninsured since the ACA came in. 8.6% uninsured at the end Q12016

And for the average family of four, the difference between what Obama promised them would happen (a reduction of $2,500 a year in premiums) and what actually happened (an increase of over $3,600) is $6,100 annually. You're correct that this is offset by subsidies for some, but many are feeling the full brunt of the hikes.

That hike of 25% (approx) only effects less than 0.5% of people in the US, less than 2m people.
https://www.washingtonpost.com/blogs/plum-line/wp/2016/10/25/obamacare-has-some-problems-heres-how-we-can-fix-them/?utm_term=.eddf3a31f357

As many Americans see it, the Democrats grossly misrepresented the costs of Obamacare, and so we do have to question whether the benefits are actually worth it, rather than getting swayed by emotional appeals (what proponents of the law are now putting forward).

I think that the Obama administration underestimated the number of people with serious illnesses that would sign up to health insurance for the first time - which is a damning indictment for a first world country; let alone the most powerful country on Earth.

My point is that, there are plenty of people out there with ideas to fix the ACA, by bettering the exchanges, by expanding Medicare, by creating a true public option... not to mention by actually giving the insurance companies time to react to this new model.

The free market dictates that if premiums keep increasing, people will drop insurance levels or switch providers; this is bad for the individual company, so we have to let this market play out to find equilibrium OR force the hand to ensure that it find this.

I'd rather go for the prior given my (our) views on interference in the market and the fact that the premium hikes cause damage to a relatively small amount of the populous.

Permabear

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eire4

Cartouche wrote: »

For starters they hate poor people. Most Obamacare folks would fall into that category

Certainly the Republicans do seem to have a real lack of interest at best if not outright contempt for poor people. As for them mostly being Obama voters some sure but nowhere near the numbers you think. Roughly 47% of the US electorate did not bother to vote in the last election. The turnout rate in Obama's best year in 2008 still left 43% of Americans not voting. In midterm years the numbers are even higher with the numbers not voting in the last mid terms reaching 67%.

eire4

If the Democrats were smart here they would be not be pulling out all the stops to block the repeal of the ACA. It is not popular and really is just a patch with some good aspects on a still broken health care system with costs running out of control still.

Instead knowing that ultimately they do not have the votes to stop repeal they should be screaming from the rooftops that now is the time to expand medicare and make it medicare for all. Ask seniors what they think of medicare. They love it.

vetinari

Manic Moran wrote: »

Obamacare was well-intentioned, but was a very loose band-aid which is starting to unravel. The problem with the healthcare system in the US isn't the root cause that some people can't afford it, but that the whole system costs way too much to begin with. With prices being ridiculously high, those rates are being passed down to premiums, and some can't afford those premiums. ACA didn't, as far as I know, cut any prices, or reduce the costs of healthcare, it merely juggled who paid for it by a combination of the mandate and subsidies. If the costs of healthcare itself were to be reduced, it would become feasible for those who cannot currently afford 'private' premiums to afford reduced premiums.

In this, Trump is arguably looking in the right direction with his recent comments about the pharmaceutical industry. When the Epi-pen shot up in cost, or the HIV pill went from $13 to $500, that wasn't the health insurance companies doing it. But the health insurance companies have to pay them out, and their way of getting their money is through premiums. The root cost of healthcare in the US is out of control, that is what needs to be fixed, not the ACA solution. Now, if Trump's philosophy can be trickled down to the GOP lawmakers as to how this will be achieved, is another matter entirely.

The issue regards costs is definitely true. However the likes of Aetna and co have been perfectly happy to go along with the continued price increases up to now. They just pass it on to their customers. Aetna makes over 2 billion dollars in profits a year. For doing what exactly? The free market approach is clearly not working regards the controlling of costs.

eire4

vetinari wrote: »

The issue regards costs is definitely true. However the likes of Aetna and co have been perfectly happy to go along with the continued price increases up to now. They just pass it on to their customers. Aetna makes over 2 billion dollars in profits a year. For doing what exactly? The free market approach is clearly not working regards the controlling of costs.

Not at all and congress in bipartisan fashion is not helping. During the recent health votes there was a vote on allowing Americans to buy the same medicines that are much cheaper in Canada. The vote was a no with 13 Democrats voting along with the 52 Republicans top vote no.

Inquitus

To quote Trump

https://www.washingtonpost.com/blogs/plum-line/wp/2017/01/16/donald-trump-may-have-just-destroyed-the-republican-effort-to-repeal-obamacare/?utm_term=.097a112a6f5d

“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.” …

“It’s not going to be their plan,” he said of people covered under the current law. “It’ll be another plan. But they’ll be beautifully covered. I don’t want single-payer. What I do want is to be able to take care of people,” he said Saturday.

B0jangles

Inquitus wrote: »

To quote Trump

https://www.washingtonpost.com/blogs/plum-line/wp/2017/01/16/donald-trump-may-have-just-destroyed-the-republican-effort-to-repeal-obamacare/?utm_term=.097a112a6f5d

His spokesman Sean Spicer has already 'clarified' Trump's pledge:

https://www.washingtonpost.com/news/post-politics/wp/2017/01/16/trump-spokesman-says-obamacare-replacement-will-harness-marketplace-competition/?utm_term=.6e17857a9a0b

A spokesman for Donald Trump sought Monday to elaborate on the president-elect’s plans to replace the Affordable Care Act, vowing that the new administration would lower health-care costs by infusing more competition into the marketplace, including by allowing insurers to sell health plans across state lines.
Trump’s goal is “to get insurance for everybody through marketplace solutions, through bringing costs down, through negotiating with pharmaceutical companies, allowing competition over state lines," Sean Spicer, the incoming White House press secretary, said during an interview on NBC’s “Today” show...


...Health insurance is regulated by states, and each state sets its own rules for health plans. Republicans have long favored the idea of selling insurance across state lines on the premise that this could lower prices. Opponents contend that it would deteriorate the quality of health plans, because insurance companies might choose to locate in the states with the weakest coverage requirements.

So classic weasel move; you'll be able to buy a cheap plan but it won't actually cover you for anything.

ECO_Mental

To quote Trump

https://www.washingtonpost.com/blogs...=.097a112a6f5d

Quote:
“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.” …

“It’s not going to be their plan,” he said of people covered under the current law. “It’ll be another plan. But they’ll be beautifully covered. I don’t want single-payer. What I do want is to be able to take care of people,” he said Saturday.





Just something I've noticed (noting to do with Obamacare) but I do think that Trump thinks of everything as a golf course or hotel.

I mean who describes a health insurance policy as beautiful? but he says it all the time for everything its like he cant get hotels and golf course out of his mind "oh its beautiful golf course" is ok but you will be "beautifully covered with your health insurance" I don't think so :rolleyes:

Anyway continue on.... there are other threads for this stuff :P

eire4

B0jangles wrote: »

His spokesman Sean Spicer has already 'clarified' Trump's pledge:

https://www.washingtonpost.com/news/post-politics/wp/2017/01/16/trump-spokesman-says-obamacare-replacement-will-harness-marketplace-competition/?utm_term=.6e17857a9a0b



So classic weasel move; you'll be able to buy a cheap plan but it won't actually cover you for anything.

Agreed. I was expecting that move. It sounds great competition in the market place. But this is peoples health and lives we are talking about not something which should be at the whim of how much money some CEO can make. There are all sorts of levels of regulations or lack thereof depending on the state in question and the kind of plans available say in a weak regulation state like Texas simply would not be allowed to be sold in somewhere like California. This will basically result in a race to the bottom which will not be good for Americans chances of actually getting good quality affordable health care.