GOP Repealing ObamaCare ---- WHY?

jimmycrackcorm

Amerika wrote: »

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

Interesting proposal. What it suggests to me though is that the plan is to take out a lot of the ACA conditions so that insurers will have plans that everyone can buy. However it will be the equivalent of making a car purchase very affordable but the fuel tank won't hold enough to let you drive to the nearest petrol station.

Manic Moran

In defense of the defense budget, it is worth pointing out that the US Federal government spends less on defense than it does on either Healthcare or social security/unemployment. And national defense is something the federal government is specifically charged to do in the Constitution, the other things are not.

Amerika

Regarding that 20 million additional people now covered by Obamacare number ya'll love to throw out... Aren't nearly half of that number covered by Medicare/Medicaid and of whom will remain on those services if Obamacare simply goes away?

FreudianSlippers

Manic Moran wrote: »

In defense of the defense budget, it is worth pointing out that the US Federal government spends less on defense than it does on either Healthcare or social security/unemployment. And national defense is something the federal government is specifically charged to do in the Constitution, the other things are not.

I'm not disagreeing with you; however the US also wastes a **** load of money on defence spending. I'm thinking of those sweet deals to keep certain senators/congresspeople on side by keeping a vanity project going or spending on outdated tech (etc.). Granted it's not just defence, but it's a major waste of money.

FreudianSlippers

Amerika wrote: »

Regarding that 20 million additional people now covered by Obamacare number ya'll love to throw out... Aren't nearly half of that number covered by Medicare/Medicaid and of whom will remain on those services if Obamacare simply goes away?

7 million of the 20 million are covered by either Medicaid or CHIP according to HHS.gov. Politifact and CNBC both had articles recently which explained that repealing ACA has the economic impact of repealing the Medicaid expansion as well - State government spending is matched by the Federal government pursuant to the ACA which results in obviously half the money being available so less people covered.

I think the biggest disgrace is that over 26% of children covered by CHIP will lose their coverage if this happens.

InTheTrees

Amerika wrote: »

Aren't nearly half of that number covered by Medicare/Medicaid and of whom will remain on those services if Obamacare simply goes away?

Medicare/medicaid will be reduced.

Paul ryans goal is to use the ACA repeal to also starve the other government services so that scrapping them will be more politically acceptable.

Manic Moran

FreudianSlippers wrote: »

I'm not disagreeing with you; however the US also wastes a **** load of money on defence spending. I'm thinking of those sweet deals to keep certain senators/congresspeople on side by keeping a vanity project going or spending on outdated tech (etc.). Granted it's not just defence, but it's a major waste of money.

The US also wastes an assload of money on healthcare. Given how much we spend, per capita, we should have a damned better system than we do. ACA hasn't helped this fundamental dollars/head problem one bit that I'm aware of.

At least we can make -some- rational arguments in defense of the DoD waste, after all, the military is always a money-sink to begin with. Keeping the one tank manufacturing plant open even when the Army needs no more tanks means that we actually have a tank manufacturing plant when we need one in the future. All significant DoD products must be manufactured in the US, partially to make sure that we are self-sufficient in time of conflict, even if building in Germany might be cheaper. If Pfizer makes its drugs in Ireland instead of New Hampshire, that's an economics thing, not a national security thing. Keeping two shipbuilders building two classes of ship for the same job fosters some competition to encourage innovation and development, as well as keeping jobs open, and in all fairness, keeping a town's major economic driver open is probably good for the economy, even at a higher initial tax cost.

However, yes, it can go way too far. The military's pistol selection test was in the news again this week, they have finally, after a multiple-year, ten-million dollar selection process, decided upon a new pistol. That's ten million dollars just to decide which pistol to buy. As the head of the Army said last year, we're not talking about the next lunar landing. Just give him a credit card with a $10m limit, and he'll buy most of the pistols the Army needs at the local gun store. The problem here isn't the sweet deals, it's the ungodly amount of checks and balances that the legislature has put into the system in order to ensure that there is no favoritism, that the quality is what it needs to be, that the correct funds pools are used, and so on and so forth. All the measures in place to reduce fraud, corruption, and post-purchase costs probably cost more than the fraud, corruption and post-purchase costs would have amounted to if they had just let the Army go pick a gun using their own policies. I've had to study the US military's procurement process, it is absolutely god-awful in itself, nothing to do with favoritism/nepotism.

eire4

FreudianSlippers wrote: »

I'm not disagreeing with you; however the US also wastes a **** load of money on defence spending. I'm thinking of those sweet deals to keep certain senators/congresspeople on side by keeping a vanity project going or spending on outdated tech (etc.). Granted it's not just defence, but it's a major waste of money.

As well as waste the military budget is bloated on nasty activities the US should not be doing never mind paying for such as torture be it in Chile, Argentina, Brazil or more recently Iraqi or backing coups to get rid of governments the US does not like be it in the above countries or Indonesia or more recently in Honduras. Never mind the many CIA front organizations such as USAID and their activities.

Permabear

This post has been deleted.

Billy86

B0jangles wrote: »

Looks like repealing the ACA could leave large numbers of Americans with far worse coverage than before it was enacted.



https://www.washingtonpost.com/posteverything/wp/2017/01/23/repealing-the-affordable-care-act-will-kill-more-than-43000-people-annually/?utm_term=.0189a57dfbef

And that's without bringing up the elephant in the room: taxpayers wind up footing the bill for the uninsured, anyway.

Billy86

Manic Moran wrote: »

The US also wastes an assload of money on healthcare. Given how much we spend, per capita, we should have a damned better system than we do. ACA hasn't helped this fundamental dollars/head problem one bit that I'm aware of.

I know people are well aware of the joke that are US medical bills, but I read this the other day and was particularly startled. See this...?



The little cup you get your medicine in. Not the medicine itself, just the paper cup. You can buy them at a retail rate of $00.02c each on Amazon - https://www.amazon.com/Paper-Medicine-Cups-oz-Box/dp/B014JIURYM/ref=sr_1_3?ie=UTF8&qid=1485517623&sr=8-3&keywords=paper+medicine+cup -

In many US hospitals, do you know how much they bill you for them? Again, not the medicine... just the paper cup it comes in? $12.00. That's a 60,000% profit margin!! Until the US does something about the absolutely absurd medical prices, this problem is going absolutely nowhere.

rockonollie

When we had our son, the hospital charged $27 per diaper

BabyCheeses

Billy86 wrote: »

I know people are well aware of the joke that are US medical bills, but I read this the other day and was particularly startled. See this...?



The little cup you get your medicine in. Not the medicine itself, just the paper cup. You can buy them at a retail rate of $00.02c each on Amazon - https://www.amazon.com/Paper-Medicine-Cups-oz-Box/dp/B014JIURYM/ref=sr_1_3?ie=UTF8&qid=1485517623&sr=8-3&keywords=paper+medicine+cup -

In many US hospitals, do you know how much they bill you for them? Again, not the medicine... just the paper cup it comes in? $12.00. That's a 60,000% profit margin!! Until the US does something about the absolutely absurd medical prices, this problem is going absolutely nowhere.

But the free market can take care of that. You just choose a hospital that is in network and provides the care you need while being close that charges less for them.

FreudianSlippers

BabyCheeses wrote: »

But the free market can take care of that. You just choose a hospital that is in network and provides the care you need while being close that charges less for them.

Ah. I take it you do not live in the good ol' US of A!

The free market cannot control the items that are costing significant amounts; in fact the supply chain has so many hands in it that it actually distorts the free market significantly; Kenneth Arrow (Stanford professior / Nobel Prize winner) stated the least distorted aspect of the hospital supply chain is the service provider themself, i.e. the doctors and nurses.

In a paper titled "Uncertainty and the Welfare Economics of Medical Care," he listed a number of reasons why health care simply can't work like ordinary free enterprise, including totally unpredictable individual demand, lack of sure knowledge of what will work, the built-in gross imbalance of knowledge between seller and buyer, and an inevitable lack of transparent prices.

A typical consumer may need virtually no health care for decades and then suddenly be stricken with something that will cost hundreds of thousands of dollars to treat. At that point he is likely to be unconscious or severely disabled and unable to make free-market choices at all. Even in the best of circumstances he can't know how well a particular treatment will work or what further purchases may necessarily follow or how much it will all end up costing. Comparison shopping is usually out of the question. Meanwhile the market encourages doctors and hospitals to do as much as possible, and insurers to pay for as little as possible. The free market consumer is virtually helpless. He can do well in relatively low-cost elective matters like Lasik eye surgery or cosmetic dentistry, but not in the high-price emergency situations that cost so many times as much and that virtually all of us eventually face.

There is no balance between the buyer and seller at almost every stage of the healthcare supply chain until you get to the coalface; then it's distorted almost 180 degrees the other direction.

There is a good article in The Atlantic though that explains (at least in a bubble) how the free market could work in healthcare: http://www.theatlantic.com/business/archive/2012/03/liberals-are-wrong-free-market-health-care-is-possible/254648/

Tony EH

Billy86 wrote: »

The little cup you get your medicine in. Not the medicine itself, just the paper cup. You can buy them at a retail rate of $00.02c each on Amazon - https://www.amazon.com/Paper-Medicine-Cups-oz-Box/dp/B014JIURYM/ref=sr_1_3?ie=UTF8&qid=1485517623&sr=8-3&keywords=paper+medicine+cup -

In many US hospitals, do you know how much they bill you for them? Again, not the medicine... just the paper cup it comes in? $12.00. That's a 60,000% profit margin!! Until the US does something about the absolutely absurd medical prices, this problem is going absolutely nowhere.

And that's the real issue, not Obamacare. It's price gouging.

ECO_Mental

Well the new LONG awaited GOP replacement plan is out so I said I may as well resurrect this thread.

http://edition.cnn.com/2017/03/06/politics/republicans-public-obamacare-plan/index.html

Very early days and I haven't spent too much time going over the details but already Rand Paul (and a few other GOP'ers) has said that its just Obamacare Lite. So this goes back to very my original OP why bother repeal Obamacare when they have just replaced it with something worse giving tax breaks to the rich who can afford it etc but still having pre-existing coverage staying on parents policy until 26 etc.

I think they will find it difficult to get this over the line....

Zubeneschamali

ECO_Mental wrote: »

why bother repeal Obamacare when they have just replaced it with something worse giving tax breaks to the rich who can afford it etc

The Republican answer to every question is "Tax breaks for the rich".

How should we deal with a Depression? Tax breaks for the rich.
How do we tackle the deficit? Tax breaks for the rich.
What should we do with a surplus? tax breaks for the rich.
How do we create jobs? Tax breaks for the rich.

So it is no surprise to find that the answer to "How do we fix Health Care?" is tax breaks for the rich.

CMOTDibbler

Tony EH wrote: »

And that's the real issue, not Obamacare. It's price gouging.

Can't remember where I heard this and not bored enough to check. But part of the problem with hospital costs is the number of uninsured patients they have to treat and the lost income which has then to be recouped from insured patients.

Or patients who can pay.

That was the point of trying to get the number of insured people up through the ACA. Every extra insured person was a double negative whammy on hospital costs.

Overheal

CMOTDibbler wrote: »

Can't remember where I heard this and not bored enough to check. But part of the problem with hospital costs is the number of uninsured patients they have to treat and the lost income which has then to be recouped from insured patients.

Or patients who can pay.

That was the point of trying to get the number of insured people up through the ACA. Every extra insured person was a double negative whammy on hospital costs.

I think it's a lot simpler than that, a lot of the problem is how arbitrary medical billing is. There is no market price for a diaper or a cup or a band-aid. Here's an anecdote from a friend just this evening:

"This is why our healthcare system is so screwed up.
I call a local ENT to get a price on getting an ear cleaned out using suction as opposed to irrigation. The cost? They don't know. It depends on insurance and what they're allowed to bill. It also depends on what the doctor does. I JUST TOLD YOU WHAT THE DOCTOR WILL DO! I've had this done before, not my first rodeo. You expect payment up front, but you can't tell me what the cost is going to be ahead of time?
So, I ask what the cost of that would be without insurance. $200 up front and then the balance at checkout, based on what the doctor will do. Again, I told you what the doctor will do. Seriously? We need a freaking overhaul of our entire medical system in the worst way possible.
Almost two weeks ago I was able to "see" a doctor on my phone via Blue On Demand (for Blue Cross members). My cost? $59. I knew it ahead of time. $12 for the copay and the rest towards my deductible. Don't tell me this isn't possible at an office."