Obamacare

NedLowry

More than a decade on from being signed into law, and six years on from its major provisions coming into force, is it fair to say that this was a scandalous disaster?

Overheal

No it wouldn't be. Millions more people have access to insurance now, many of whom were previously ineligible because of pre-existing conditions. Most young people under 26, too, the vast majority of whom don't end up working for employers who offer it as a benefit, remained eligible through a parent or guardian, and this also made a realworld difference.

When Republicans finally mustered the majority to kill it, they lost the votes in the Senate because the larger public finally realized that rolling back to the pre-ACA state would throw tens of millions off of healthcare, most of whom needed it the most. You can find evidence out there of voters who thought "Obamacare was a disaster" but "The Affordable Care Act is okay" (they're the same law). Opposition to the bill was, primarily, fueled by disinformation, and in the 6-8 years of the GOP pledging to Repeal-and-Replace the bill, they never managed to generate the Replacement.

It's as unfair to call it a scandalous disaster as it would be to call it a flawless success.

Invidious

We can debate whether it is a "scandalous disaster," but it has certainly not made health insurance affordable, despite all the promises.

The New York Times recently estimated that a family of four would pay $1,520 per month for a benchmark "silver" Obamacare health plan. That's $18,240 per year, just for health insurance.

NedLowry

Could some of the negative reactions to Obamacare be attributed to the fact that - whatever his personal qualities - Obama was an atrocious Chief Executive, passive and disengaged?

Foxtrol

NedLowry wrote: »

Could some of the negative reactions to Obamacare be attributed to the fact that - whatever his personal qualities - Obama was an atrocious Chief Executive, passive and disengaged?

Are you talking about your own OP with this?

uptherebels

Invidious wrote: »

We can debate whether it is a "scandalous disaster," but it has certainly not made health insurance affordable, despite all the promises.

The New York Times recently estimated that a family of four would pay $1,520 per month for a benchmark "silver" Obamacare health plan. That's $18,240 per year, just for health insurance.

And what was the equivalent price for that family before Obamacare?

NedLowry

Foxtrol wrote: »

Are you talking about your own OP with this?

Not sure what you mean by this?

As I indicated I have some admiration for Obama as a human being, but it is hard to deny that his presidency was one long string of gaffes, domestic disasters and foreign policy blunders, strung together in a long, terrible line.

Overheal

uptherebels wrote: »

And what was the equivalent price for that family before Obamacare?

Affordabler, maybe? But also, doesn't work when you need it to.

PBS documentary back from 2009, the transcript of it:

https://www.pbs.org/now/shows/health-care-reform/transcript-now-segment.html

small excerpt:

HINOJOSA: The insurance plan through Natalie's work turned out to be too expensive, they say, so they decided to shop for a more affordable one on the independent market.

HINOJOSA: What was the mistake that you think you made from the time that you left your old insurance, and decided to get new insurance?

NATHALIE O'REILLY: We allowed for a gap between the policies. Our biggest mistake was setting that end date before we had something lined up. Solidly lined up.

HINOJOSA: During the gap between policies, Sophie who had recently had several bouts of pneumonia, got labeled by the insurance industry as having a "pre-existing condition;" two words that today are center stage in the debate over health care reform. Those two words also meant that Sophie's parents couldn't find a plan that would cover her for respiratory problems

STEPHEN O'REILY: Nat spent hours and hours looking for her, you know, looking at these—talk—talking to insurance companies, looking for possibilities. And we never found any. I thought it was just crass that—that she could be denied coverage. I mean, we're—we're willing to pay, you know?

HINOJOSA: But they were told if Sophie went a year without incident, she could get coverage. So her parents tried to keep her out of the doctor's office.

NATHALIE O'REILLY: So that there would be no paper trail for an insurance company to see that she had had this illness.

HINOJOSA: They were uninsured, still searching for a plan when Sophie woke up sick one day and began wheezing.

STEPHEN O'REILLY: The debate begins about, "well, what's the right thing to do here? Well, I mean, you know, we need to get her to the doctor. Is she doin' okay enough that we can not?"

NATHALIE O'REILLY: We just thought, "we've got the medication here. We're on the phone with the doctor. We just can't—we simply can't afford to have another strike against her by taking her to the doctor."

STEPHEN O'REILY: She's becoming more lethargic, then it's like, "okay, we need to get her to the doctor." Screw the insurance. Let's go.

HINOJOSA: They made it to the doctor's office but then Sophie took a turn for the worse.

NATHALIE O'REILLY: Sophie—started shaking violently, and she threw up, and she turned blue and limp. And the nurse said—"should I call 9-1-1, should I call an ambulance." And the doctor said, "there's not time to get one over here." We threw her in her car seat. Didn't strap her in. Just threw her in. And I drove around the corner to the hospital. And—it was just the most sickening feeling. I—I just—you know, the most sickening feeling. On the drive over there, she was not—talking. She wasn't alert. And I'm just yelling, "baby, please talk to me, please cry, please, please, please talk to me." And—they got her stabilized pretty quickly. But having to make that call to my husband and say, "this kid, who we tried to keep home today, we're in ICU right now."

STEPHEN O'REILY: I remember just going, "oh my God, I can't believe that I just pushed—that I just suggested that we—you know, that we keep her from the doctor over insurance."

NATHALIE O'REILLY: The guilt and the shame, you're terrified for your child. But the guilt and the shame was almost unbearable.

HINOJOSA: You almost didn't take her?

NATHALIE O'REILLY: We almost didn't take her. We almost tried to ride it out at home.

HINOJOSA: Because you didn't want the insurance companies to see that she was sick?

NATHALIE O'REILLY: Right. Right. The system as it stands is placing parents—and it's not just us. It's placing parents in a situation where you have to decide take her to the doctor and get that next strike against you, or keep her at home, and you're basically back against a wall to committing medical neglect.

HINOJOSA: But if you keep her at home, you might get—

NATHALIE O'REILLY: Insurance.

HINOJOSA: Health insurance?

NATHALIE O'REILLY: Right. Craziness. Craziness.

see also: https://abcnews.go.com/Business/Health/story?id=7911195&page=1

"[T]hey confuse their customers and dump the sick, all so they can satisfy their Wall Street investors," former Cigna senior executive Wendell Potter said during a hearing on health insurance today before the Senate Committee on Commerce, Science, and Transportation.

Potter, who has more than 20 years of experience working in public relations for insurance companies Cigna and Humana, said companies routinely drop seriously ill policyholders so they can meet "Wall Street's relentless profit expectations."

"They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment," Potter said. "…(D)umping a small number of enrollees can have a big effect on the bottom line."

Podge_irl

NedLowry wrote: »

Not sure what you mean by this?

As I indicated I have some admiration for Obama as a human being, but it is hard to deny that his presidency was one long string of gaffes, domestic disasters and foreign policy blunders, strung together in a long, terrible line.

It's really not that hard to deny that at all.


The ACA has also been utterly hamstrung from the get go by multiple Republican governors refusing to take advantage of it and congress attempting to gut important parts of it at every opportunity. But it still has increased the number of people with health insurance.

Carfacemandog

NedLowry wrote: »

More than a decade on from being signed into law, and six years on from its major provisions coming into force, is it fair to say that this was a scandalous disaster?

The opposite actually, it's become more popular more or less every year since it's been in existence and the majority of Americans approve of it.

The biggest issue with it was the scuppering by Republicans at the time, leading to a neutered version (one closer to a model developed by Mitt Romney in Utah than the one Obama originally proposed). Without that, Americans would probably enjoy something more akin to European healthcare, where we don't have to worry about losing half an entire year's pre-tax pay because of a broken limb, and pay a tiny fraction of the thousands dollars they are forced to churn out every month for medications.

Wanderer78

NedLowry wrote: »

More than a decade on from being signed into law, and six years on from its major provisions coming into force, is it fair to say that this was a scandalous disaster?

if you think obama was bad, wait till the other fella gets dragged outta the house and the mess he ll leave behind! they wont just be worrying about their health system, thats for sure

Overheal

NedLowry wrote: »

Could some of the negative reactions to Obamacare be attributed to the fact that - whatever his personal qualities - Obama was an atrocious Chief Executive, passive and disengaged?

You'd clearly have to be the one to tell us, if that's how you felt about him. Do you have negative reactions to the ACA because you didn't like Obama as a POTUS?

Timberrrrrrrr

NedLowry wrote: »

More than a decade on from being signed into law, and six years on from its major provisions coming into force, is it fair to say that this was a scandalous disaster?

A simple question for you,

Would you rather have a heart attack (and live) in America or Ireland?

NedLowry

Wanderer78 wrote: »

if you think obama was bad, wait till the other fella gets dragged outta the house and the mess he ll leave behind! they wont just be worrying about their health system, thats for sure

Agreed.

If the GOP do not insist that Trump resign from office-politically unlikely to be sure- they are liable to be withered and powerless in a matter of years.

Wanderer78

NedLowry wrote: »

Agreed.

If the GOP do not insist that Trump resigns from office-politically unlikely to be sure- they are liable to be withered and powerless in a matter of years.

the gop are bunch of scumbags anyway, many of the dems are the same, rotten country, politically

Wanderer78

Wanderer78 wrote: »

if you think obama was bad, wait till the other fella gets dragged outta the house and the mess he ll leave behind! they wont just be worrying about their health system, thats for sure

The same could be said about every American president of the last two decades. Measures of effectiveness have changed, along with the expectations of what a president should achieve. Trump, for all his many faults, had to take up the failures/inadequacies of past presidents, and he's actually been good for the economy (until covid happened anyway).

Bush Jnr. was a absolute ****. Obama was a dick. Trump is a dick. All three did/will generate some good, and a hell of a lot of bad... the rest is just spin.

Timberrrrrrrr

Timberrrrrrrr wrote: »

A simple question for you,

Would you rather have a heart attack (and live) in America or Ireland?

I'd certainly rather the diagnostic machines and pharmaceuticals created in the US than relay on Irish innovations.

Eric Cartman

salonfire wrote: »

I'd certainly rather the diagnostic machines and pharmaceuticals created in the US than relay on Irish innovations.

American medicine subsidises the R&D costs for most of the world. They do have the best medical services available to them , but at a cost.

Obamacare was terrible in that it raised prices for a lot of middle income earners, it was great in terms of allowing many more lower paid workers access to insurance, but overall I think the solution was as bad as the problem to start with.

I don't think US healthcare will ever be anything like our European systems , and in a way that benefits the world and encourages medical development and innovation , but hurts lower income earners in the states to benefit the rest of us worldwide.

Timberrrrrrrr

salonfire wrote: »

I'd certainly rather the diagnostic machines and pharmaceuticals created in the US than relay on Irish innovations.

That wasn't the question I asked.

Timberrrrrrrr

Timberrrrrrrr wrote: »

That wasn't the question I asked.

No, and you wouldn't ask it either because the answer would not suit your agenda.

But if you ever needed it, you can be sure it was US developed machines keeping you alive. Would your ideology be as important to you then?

Tony EH

There are those who just love trying to shoot down "Obamacare", which has more to do with their politics than anything else. But, at the very least, he tried something to fix that ridiculous farce over there re: healthcare.

If the Republicans could have their way, only the very rich would have healthcare and everyone else could rot.

It's a truly appalling situation.

Carfacemandog

salonfire wrote: »

No, and you wouldn't ask it either because the answer would not suit your agenda.

But if you ever needed it, you can be sure it was US developed machines keeping you alive. Would your ideology be as important to you then?

Are you sure about the bolded part? I can't see which countries lead on ventilators, but in terms of pharmaceuticals the US only makes up about 6% of the global export market - the same amount as Ireland, and less than the likes of Germany, France, Switzerland and Belgium.

At a glace, apparently only 3 of the 10 biggest developers of ventilators are based in the US - https://meticulousblog.org/top-10-companies-in-global-ventilators-market/

super_furry

NedLowry wrote: »

More than a decade on from being signed into law, and six years on from its major provisions coming into force, is it fair to say that this was a scandalous disaster?

Problem was it didn't go far enough. Nationalised health is the only way forward.

super_furry

salonfire wrote: »

No, and you wouldn't ask it either because the answer would not suit your agenda.

But if you ever needed it, you can be sure it was US developed machines keeping you alive. Would your ideology be as important to you then?

It's not a question of ideology though is it?

Have a less severe heart attack in Ireland, get treated, recover and pay nothing.

Have a less severe heart attack in America, get treated, recover and owe $175,000.

Timberrrrrrrr

salonfire wrote: »

No, and you wouldn't ask it either because the answer would not suit your agenda.

I did ask the question, no one has been willing to answer it honestly.

But if you ever needed it, you can be sure it was US developed machines keeping you alive. Would your ideology be as important to you then?

No really no, but regardless of who invented a machine 50/70/100 years ago, would you rather have a heart attack in the US or Ireland?

Eric Cartman

Timberrrrrrrr wrote: »

I did ask the question, no one has been willing to answer it honestly.




No really no, but regardless of who invented a machine 50/70/100 years ago, would you rather have a heart attack in the US or Ireland?

If I was a US citizen on over 75k a year with a decent company health plan and a low deductible , which isn't uncommon, the US, then the US.

super_furry

Eric Cartman wrote: »

If I was a US citizen on over 75k a year with a decent company health plan and a low deductible , which isn't uncommon, the US, then the US.

That's a lot of ifs you're talking about there and you're plain wrong when you say it's not uncommon.

84.29% of people in the US earn under $75k a year. https://en.wikipedia.org/wiki/Personal_income_in_the_United_States

People without adequate health insurance in Ireland can live in agony as well, failed by an over-funded, wasteful public system.

We don't have to look to the US to see how people can suffer without insurance.

It is not uncommon here for a family to pool together to have a parent's hip replaced privately, unable to get the care publicly

Overheal

Eric Cartman wrote: »

If I was a US citizen on over 75k a year with a decent company health plan and a low deductible , which isn't uncommon, the US, then the US.

You have some wild misconceptions of the pay rate and benefits afforded to most here. The median income in the US, overall, is $63k with many states lower than that. Only 69% of private employers provide healthcare plans.

Timberrrrrrrr

Eric Cartman wrote: »

If I was a US citizen on over 75k a year with a decent company health plan and a low deductible , which isn't uncommon, the US, then the US.

But if you were a US citizen on the average industrial wage with low/no private health insurance? You know, just your average joe six pack working in a factory/bar/farm/industrial plant?

Carfacemandog

It's even lower than you are asserting, Overheal. Your post refers to household income, not individual. The official average US income is $33,700, putting $75,000 at about 225% of the average income.

Ireland's official average income is €37,500, meaning if we had the US system you would want it be in €85,000+ to be able to avail of decent healthcare, and only if your employer thought you and your colleagues were worth giving the coverage to at that.

There's not really any arguing that Ireland has the better system - private if you can afford it, with public options there for those who cannot or who do not feel they want or need it. Hence why the rare person promoting the US system tends to shy away from (or plainly ignore) the fact that there is private coverage here too.

Carfacemandog

Carfacemandog wrote: »

It's even lower than you are asserting, Overheal. Your post refers to household income, not individual. The official average US income is $33,700, putting $75,000 at about 225% of the average income.

Ireland's official average income is €37,500, meaning if we had the US system you would want it be in €85,000+ to be able to avail of decent healthcare, and only if your employer thought you and your colleagues were worth giving the coverage to at that.

There's not really any arguing that Ireland has the better system - private if you can afford it, with public options there for those who cannot or who do not feel they want or need it. Hence why the rare person promoting the US system tends to shy away from (or plainly ignore) the fact that there is private coverage here too.

You call go ahead and tell the parent of a child bent over in two waiting on spinal surgery, the public system is right there for them.

Carfacemandog

salonfire wrote: »

You call go ahead and tell the parent of a child bent over in two waiting on spinal surgery, the public system is right there for them.

So waiting for one is worse than never getting one at all? In that case, they can 'skip' that queue by going private in Ireland if they can afford it, which lands them in the exact same situation as if they were in the US - though still at a significantly lower cost. Either way, it's preferable to be in Ireland than in the US in that scenario.

I'll ask again though where you got the impression that all ventilators are developed in the US as I did a few posts up, given that only 3 of the 10 largest producers are in the US and having looked a little further into it, while they are the world's largest exporter of medical devices, they only account for 18.5% of the global market and are actually a net importer of them?