GOP Repealing ObamaCare ---- WHY?

Mr.Micro

Amerika wrote: »

Funny, I find it ironic that a lot of people that complain about our defense spending are the first to call 911america when bad things happen.

Not sure what you mean there. Defence spending? To wage war or conflict in another country? It's big business and that is all it is. Nothing to do with defence. Weapons mean destruction and as such are counter productive to the advance of mankind. Spending money on health, education, social issues, public services would be far more effective in the advancement of mankind. I have never bought the phoney war on terror story.

eire4

Mr.Micro wrote: »

When people are poor in America, they are poor. It's a full time job stretching the dollar and virtually impossible to get out of it. Something that has always irked me in life, is the Money spent on arms, often for foreign wars and intervention, yet needy people, healthcare and all the other social issues are treated like the lowest of the low. If a fraction of the arms budgets was spent on bettering social situations for people it might make a massive difference for many, but no better to spend it on the likes of a dozens of smart bombs that cost $500 each. I cannot see that policy changing anytime soon, so the poor will stay poor.

When I read comments like that I am reminded again and again about President Eisenhower's famous farewell speech in 1961 when he said to bewary of:
"unwarranted influence, whether sought or unsought, by the military-industrial complex."

Sadly the idea that a permanent ruling class encompassing the Pentagon and its corporate suppliers could control much of the US government and its budget has come to pass just as Eisenhower warned against. What is worse still this has lead to much suffering around the world due to US military actions and much suffering in the US as the military budget sucks up so much of the US budget. The 2015 estimate of the US budget puts the military spending at 54% of the overall budget. Roughly 100 years prior to that as World War 1 began in 1914 the US military spending was only 1% of the overall budget. That is a stunning change in 100 years.

Valord

eire4 wrote: »

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.

Actually, several Republicans crossed over to vote for that one, even Ted Cruz, which is why the Democrats who voted against it are taking so much flack.

I'm reading that Obamacare has had premiums go up by 25% and I'm not contesting that, but (at least according to Obama himself) they had been going up at even higher rates prior to Obamacare being passed. Is that not true? I understand it's a far cry from the lofty goal of lowering costs for the consumers, but if it is true, it still seems like it's more appealing than the previous alternative.

Also, what are the possible alternatives Trump could have to Obamacare? Assuming the Republican Congress will reject any increased spending on subsidies or a public option. Even Obama himself is not incredibly happy with the current version of the law, but like many on the left, his solutions to the problem are the opposite of what the Republicans want. So what are the Republicans looking at doing?

rockonollie

I'd love to share some proof of the 25% increases in premiums.....but it did not take me long to crumple up and toss the letter that informed me that my premium was going from $327 per month in 2016 to $468 per month in 2017.
The major problem that is being ignored is the shameless over charging of hospitals, which kill the bottom lines of insurance companies, and in turn leads to the high premiums. Looking at an itemized US hospital bill is terrifying and infuriating.

mariaalice

The only solution is to make health insurance mandatory. Trump could spin it as personal responsibility, why should the insured have their premiums increased because of the unpaid bill of the uninsured bla bla, of course if Obama had made it mandatory it would be big government :pac:

Tony EH

Making something "mandatory" doesn't mean it becomes affordable. The problem remains price gouging by groups who consider only their bottom line.

Permabear

This post has been deleted.

eire4

Valord wrote: »

Actually, several Republicans crossed over to vote for that one, even Ted Cruz, which is why the Democrats who voted against it are taking so much flack.

I'm reading that Obamacare has had premiums go up by 25% and I'm not contesting that, but (at least according to Obama himself) they had been going up at even higher rates prior to Obamacare being passed. Is that not true? I understand it's a far cry from the lofty goal of lowering costs for the consumers, but if it is true, it still seems like it's more appealing than the previous alternative.

Also, what are the possible alternatives Trump could have to Obamacare? Assuming the Republican Congress will reject any increased spending on subsidies or a public option. Even Obama himself is not incredibly happy with the current version of the law, but like many on the left, his solutions to the problem are the opposite of what the Republicans want. So what are the Republicans looking at doing?

Thanks for the correction on that vote. I had the wrong info there. Who knows what the Republicans will do with health in the US. Other then making sure it remains very much a for profit industry who knows. They have been screaming about it for years but have never clearly articulated what they would do instead.

B0jangles

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

Authors:
David Himmelstein is a professor of public health at the City University of New York at Hunter College, a Lecturer in Medicine at Harvard Medical School, and a founder of Physicians for a National Health Program.
Steffie Woolhandler is a professor of public health at the City University of New York at Hunter College, a Lecturer in Medicine at Harvard Medical School, and a founder of Physicians for a National Health Program.

For more than 30 years, we have studied how death rates are affected by changes in health-care coverage, and we’re convinced that an ACA repeal could cause tens of thousands of deaths annually.

The story is in the data: The biggest and most definitive study of what happens to death rates when Medicaid coverage is expanded, published in the New England Journal of Medicine, found that for every 455 people who gained coverage across several states, one life was saved per year. Applying that figure to even a conservative estimate of 20 million losing coverage in the event of an ACA repeal yields an estimate of 43,956 deaths annually...

...

Although Aaron has a rosy view of a likely Republican plan, much of what they — notably House Speaker Paul D. Ryan (R-Wis.) and Rep. Tom Price (R-Ga.), who is Trump’s nominee to head the Department of Heath and Human Services, which will be in charge of dismantling the ACA — have advocated in place of the ACA would hollow out the coverage of many who were unaffected by the law, harming them and probably raising their death rates. Abolishing minimum coverage standards for insurance policies would leave insurers and employers free to cut coverage for preventive and reproduction-related care. Allowing interstate insurance sales probably would cause a race to the bottom, with skimpy plans that emanate from lightly regulated states becoming the norm. Block granting Medicaid would leave poor patients at the mercy of state officials, many of whom have shown little concern for the health of the poor. A Medicare voucher program (with the value of the voucher tied to overall inflation rather than more rapid medical inflation) would worsen the coverage of millions of seniors, a problem that would be exacerbated by the proposed ban on full coverage under Medicare supplement policies. In other words, even if Republicans replace the ACA, the plans they’ve put on the table would have devastating consequences.

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

Tony EH

B0jangles wrote: »

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

Would anybody be really surprised at that?

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."