Affordable Care Act in the United States

[A Nonny Moose 8,263]

As expected, the road is bumpy.

 

Hardly surprising for new apps on the Internet.  They only had two or three years to get it going and probably overstaffed the work.  Computer programs are not a mob-work thing, but best done by a very small group (two or three at most).  Security must he tight, in fact, bullet proof.  Very hard to accomplish, especially on the net.

[Ocram's Razr 964]

The USA is so messed up right now. Politicians passed this bill (and many others) without any full read-though. Now that the House Republicans realize how bad it is, they decide to shut down the government instead of doing anything productive.


--Ocram

[A Nonny Moose 8,263]

The ACA was passed several years ago.  I don't buy the premise that people didn't know what was in it.  If that were the case, why are you re-electing them?  Passed, election fought over it (and won by the administration), approved by the SCOTUS.  The party is over, and it is time to fish or cut bait.  Claiming your teeth hurt after all this time is just invidious.

 

The TEA Partiers want to deny health insurance to 15% (according to Obama) of the population.  That's around sixty million people.  This idea is just plain stingy and very stupid.  That many people can surely be more productive if they don't have to worry about the high cost of getting sick.  People don't get sick on purpose, you know.

 

The current attitude by the prior poster is one of those "F.U. Jack, I'm inboard" things that you hear from self-satisfied parishioners in the comfortable pew.  That pew needs to be roughened a little.

[Ocram's Razr 964]

I would hope that the government officials know what was in the bill by now. In case you didn't know, I didn't support Hillary Clinton because she wanted to mandate private insurance so I supported Obama instead. I very much like most of the ACA except for the Exchange, mandating private insurance, and taxing those with fancy insurance and putting a fee that Obama promised would not be a tax but Supreme Court ruled unconstitutional unless called a tax on those with no insurance. You are lucky to live in Canada, which has a far better insurance system. The main reason why we don't have a better insurance system is because of Republicans opposed to the public option.

--Ocram

[SimGuy23 67]

Once there were two toddlers, one named House and one named Senate. They hated each other. When House didn't want his Lego brick anymore, he handed it to Senate. Senate, irritated, threw the Lego back at House. They kept doing this for days. The immature mother, Barack Obama, kept screaming at House and Senate to get along, and did not do anything to stop the bickering. The mother then pointed her finger at House, blaming everything on him. Senate chuckled and laughed, and then the mother slammed on him. They then had a time-out session in the same room together where they kept going at it.......

Ladies and gentlemen, I give you the United States government.

[blade2k5 1,523]

I lived all my life without health insurance and will continue to do so.  I'm not going to toss money down a bottomless pit that gives you next to nothing in return.

[Indiana Joe 1,752]

The ACA was passed several years ago.  I don't buy the premise that people didn't know what was in it.  If that were the case, why are you re-electing them?

 

Keep in mind that congressional elections in the U.S. are a joke.  Unless a senator or representative has been done something extraordinary (good or bad) to get recognized, most people just vote a straight ticket or re-elect the incumbents with hardly a passing thought.  The presidency is the only election that gets any attention from the majority of voters.

 

But everyone certainly knew what the bill contained.  The right wing definitely hasn't given in to it yet; they hope to stall the full enactment of the bill until they have enough leverage to modify or repeal it.  On the other hand you could call Obama irresponsible for advocating such a liberal piece of legislation; it's like chucking a wrench into the political machine.  The gears have managed to keep turning until now, but the wrench has shifted and everything's stuck.

 

On the bright side, the government's accumulation of debt is temporarily slowed.

[A Nonny Moose 8,263]

The founding fathers could never have foreseen this kind of stalemate.  I don't believe the two current parties were mandated by the constitution but somehow, like Topsy, they jes' growed.

 

Now, you have what amounts to an undeclared third party wearing the wrong coat.  Radical right wing TEA Party members should properly resign from the Republican Caucus and form their own party.  Failing that, the Republican Party should pass the baby out of the birth canal and cut the cord.

 

It would be interesting to see how many of them could get re-elected without the umbrella of the GOP, and since they are making all this fuss, this is really what should be done.  If you want a new colour for the maps, let the TEA party states be coloured purple.  Goes with their complexion.

[LexusInfernus 908]

The founding fathers could never have foreseen this kind of stalemate.  I don't believe the two current parties were mandated by the constitution but somehow, like Topsy, they jes' growed.

 

Now, you have what amounts to an undeclared third party wearing the wrong coat.  Radical right wing TEA Party members should properly resign from the Republican Caucus and form their own party.  Failing that, the Republican Party should pass the baby out of the birth canal and cut the cord.

 

It would be interesting to see how many of them could get re-elected without the umbrella of the GOP, and since they are making all this fuss, this is really what should be done.  If you want a new colour for the maps, let the TEA party states be coloured purple.  Goes with their complexion.

It doesn't actually matter anymore if the Tea Party forms a separate third party or not. At this point, by simply existing it is pushing the GOP into a more radical direction. The Tea Party and the Republicans are fishing in the same electoral pond, namely right wing conservatives. Now who do you think right wing conservatives react better to? A smart, moderate, well articulated, pragmatic politician or a loudmouthing windbag that promises completely unrealistic things but exactly the kind of things his voters want to hear? Right, so in order to gain votes, the moderate republicans have to become more extreme in their promises and rhetoric and effectively overshout the Tea Party people in order to win the votes. 

 

And of course, because they have to promise more and more extreme things in order to win, they also need to actually work to gain these promises when they are in Washington or else they will not get re-elected. Of course, all the promises are unrealistic and fail or they do not contribute to a solution to actual problems (the whole tax pledge for example, sure you can block every tax increase, but do you really think that is a solution?) but thats fine, that doesn't actually hurt your chances on being re-elected because you simply scapegoat the Democrats and yell really loudly that it is all the fault of those damned liberals and Obama and blame them for ruining America, which of course, the people that vote for you think is fantastic because well...come on, they thought that voting for someone promising all kinds of extreme nonsense was a good idea in the first place. 

[Meastro444 1]

Mandatory insurance is nothing new. For us in the Netherlands there are at least 2 mandatory insurance policies: 1. Health insurance, it covers every lifesaving treatment, and if you own a car you must have a liability insurance which basicly covers all the damage you do unto others, within limits. I don't get why some Americans are against it?

[blade2k5 1,523]

Mandatory insurance is nothing new. For us in the Netherlands there are at least 2 mandatory insurance policies: 1. Health insurance, it covers every lifesaving treatment, and if you own a car you must have a liability insurance which basicly covers all the damage you do unto others, within limits. I don't get why some Americans are against it?

 

First off, this ain't the Netherlands and secondly, there's a huge difference between car and health insurance.  A driver's license is not a right, [at least in this country] it's a privilege which is why you have to have car insurance.  And lastly, we make our own choices what's best for us, not the asinine, hypocritical and inept gov't in DC.  So when this asinine, hypocritical and inept gov't tells me I have to buy something, I tell them to go screw themselves.

[Themaroonday 40]

Mandatory insurance is nothing new. For us in the Netherlands there are at least 2 mandatory insurance policies: 1. Health insurance, it covers every lifesaving treatment, and if you own a car you must have a liability insurance which basicly covers all the damage you do unto others, within limits. I don't get why some Americans are against it?

Many Americans are against it because they believe in a pure free market kind of society, where everyone can manage their own wealth and not have to pay for others. ObamaCare is more of an altruistic plan that tries to incorporate everyone regardless of age, class, or wealth. Some people are against this because they don't want to have to pay for others who may need more care and therefore more funds. Personally, I am neutral, I will just wait and see how this turns out. 

 

--Themaroonday

[Indiana Joe 1,752]

Not only does it infringe upon the American capitalist ideal, but the projected rates are higher than many current private insurance providers.

 

The benefits of universal healthcare are apparent when implemented correctly...Canada, Norway, the Netherlands...but approximately half of all Americans are, and probably will remain opposed to centralization of any industry.

[Jasoncw 12,060]

The shut down doesn't actually have anything to do with ObamaCare.

 

Republicans know that what they're doing now isn't actually going to get rid of ObamaCare.  Everyone knows it. 

 

The purpose of this, and the 40+ times republicans have voted to repeal ObamaCare aside from this, isn't to get rid of ObamaCare, it's a purity test for Republican voters.

 

If a Republican doesn't go along with all of the crazy antics, then next time they're up for reelection they'll be labeled as a commie RINO who's soft of ObamaCare, and they'll lose in their primary.

[Easy Bakes 253]

Mandatory insurance is nothing new. For us in the Netherlands there are at least 2 mandatory insurance policies: 1. Health insurance, it covers every lifesaving treatment, and if you own a car you must have a liability insurance which basicly covers all the damage you do unto others, within limits. I don't get why some Americans are against it?

Because most people think we cannot afford to do this.

[Duke87 1,070]

The ACA was passed several years ago.  I don't buy the premise that people didn't know what was in it.

 

That idea comes primarily from a soundbyte from then-Speaker of the House Nancy Pelosi saying "we have to pass the bill so you can find out what is in it". Which she did actually say, but as is often the case with soundbytes, there was some clever editing that removed the context and thus significantly changed the apparent meaning. Here's the FULL clip:

http://www.youtube.com/watch?v=QV7dDSgbaQ0

 

Or if you prefer reading to listening:

You've heard about the controversies within the bill, the process about the bill, one or the other items. But I don't know if you have heard that it is a legislation for the future. Not just about healthcare for America, but about a healthier America, where preventive care is not something that you have to pay a deductible for, or out of pocket. That prevention, prevention, prevention is about diet, not diabetes. It's going to be very, very exciting. But we have to pass the bill so you can find out what is in it away from the fog of the controversy.

 

In other words, what she's actually saying is that people will have a better understanding and appreciation of the law when they see it in action than when they're caught up in arguing over it. But this got spun by conservative news outlets as "we don't know what the law says, and we're going to pass it without knowing what it says, and then later everyone will find out what's in it!", which was not what was meant at all.

[AcmeSigns 97]

Mandatory insurance is nothing new. For us in the Netherlands there are at least 2 mandatory insurance policies: 1. Health insurance, it covers every lifesaving treatment, and if you own a car you must have a liability insurance which basicly covers all the damage you do unto others, within limits. I don't get why some Americans are against it?

Once again I will point out...automobile liability insurance is only necessary when you've done something to warrant it. Until such time, if ever, who can say who on the road has insurance and who doesn't? They sell 'uninsured motorist' insurance for a reason. I wonder what that would be?

 

As for the ACA...

Let us not forget...no Republicans voted for the ACA. Not a one. Not in the House. Not in the Senate. This is purely a partisan, Democratic bill.

Let us not forget...it was none other than then-Speaker of the House, Nancy Pelosi, who famously said, 'We have to pass it so we can know what's in it'. That doesn't sound like they either read or understood it. Probably neither. Or both.

 

Me personally...I'm performing an act of civil disobedience by not signing up at all. If the ACA crashes in year or so under it's own weight (which, I'm thinking, it will) then it was all for naught. Just another footnote in history of yet another stupid government idea to tell you how to live your life (Prohibition comes to mind).

 

edit: Thanks for the link Duke87. I, for one, knew the whole quote. However, from Nancy's blathering she really doesn't say anything that sounds like she knows what is actually in the bill. That's just more political double-speak coming from a uninformed bubble head that should have been kicked out of office years ago. She also thinks that unemployment is good for the economy. And it is yet to be determined whether or not '...preventive care is not something that you have to pay a deductible for...' is the way it will be (I'll go out on a limb and guess 'not').

[Wiimeiser 452]

The US government is like putting nitroglycerin and plutonium in a bottle, dropping it in an earthquake simulator in a chemical plant, and expecting to not blow up the entire town.

[Jasoncw 12,060]

Let us not forget...no Republicans voted for the ACA. Not a one. Not in the House. Not in the Senate. This is purely a partisan, Democratic bill.

 

 

There were no Republican votes for purely partisan reasons.

 

In the early 90s the Clintons were shooting for socialized healthcare.  Republicans didn't want that and came up with their own healthcare solution, which is what obamacare is. 

 

Fast forward to a few years ago, democrats still want healthcare reform, but instead of shooting for the public option, they went with the republican solution because it was more realistic to get passed.

 

So yeah, it was voted according to party lines because for some reason republicans didn't want to vote for their own policy...

[LexusInfernus 908]

First off, this ain't the Netherlands and secondly, there's a huge difference between car and health insurance.  A driver's license is not a right, [at least in this country] it's a privilege which is why you have to have car insurance.  And lastly, we make our own choices what's best for us, not the asinine, hypocritical and inept gov't in DC.  So when this asinine, hypocritical and inept gov't tells me I have to buy something, I tell them to go screw themselves.

 

So then what is access to healthcare? A right, or a privilege? ObamaCare seeks to turn it into a right for everyone, while apparently Republicans believe healthcare is a privilege only available to those who pay for it. 

 

 

 

You realize that the whole free market bit with healthcare has actually caused you to pay the most per citizen on health care while receiving healthcare that has the quality of a poor former Soviet State. Iran, America's supposed arch enemy ranks higher on the healthcare lists than the US. 

 

That aside, the idea that the free market will actually improve the quality of healthcare is fundamentally flawed. People have begun to believe that the free market equals lower prices and higher quality care, because competition. This is wrong. The free market, or actually, capitalism does one thing and one thing only, it introduces the profit incentive. It means that companies work for profit and they will behave in such a way in order to maximize profit. In some cases one makes a bigger profit by treating your customers as kings and lowering prices, and in the healthcare sector, profit comes from high prices and providing terrible service. 

 

Take a look at insurance companies. How do insurance companies maximize their profit? By having as many customers as possible though providing great service and having low insurance fees? Nope, they make money by having customers pay their fees, and they make a profit if they don't have to pay anyone out. Which means bad service, because good service means you pay out which eats at your profit. Really, an insurance company does not do itself any favors by healing people, that only costs them money and they get nothing for it in return. This is also why insurance companies used to turn down a lot of people, they deemed that those people were to likely to get sick in the near future forcing them to pay up. The perfect customer for the insurance company is a healthy twenty something with no history of any illness, because they are the least likely to get sick and thus pose the smallest risk for an insurance company to have as a customer.

 

And hospitals? Well, if they work for profit, you can be sure that it is in their best interest to make you pay through your nose for again bad service. Say you have a certain kind of illness, and there are two ways to help you. One is a relatively cheap bottle of pills, the other is expensive surgery. What do you think the doctor will recommend you? Pills? God no, that would be bad business. Why have you pay for a bottle of pills on which the hospital maybe makes 10-20 bucks if they can perform surgery, which means you have to stay in the hospital for two nights and have some specialist doctor take a look at you? They can charge you so much more money for that. The profit margin on that is a lot better for them. 

 

And what about the people that actually make your pills? The pharmaceutical sector? Well, the 'free market' is not that free over there, given how the patent system works. Which means that for so many years, after a new pill gets out on the market, those companies can charge ridiculous prices for it. Because you know, they are not a charity, they want to make as much profit as possible. Of course, actually opening up the market by getting rid of the patents will result in no one making any kind of new medicine anymore. I mean, it costs millions of dollars in R&D, trials and bureaucratic nonsense to get a new medicine out on the market. If other companies are immediately allowed to copy your work with far lower costs there is simply no profit to be made in developing medicine. 

[Ocram's Razr 964]

I don't care so much whether medical care is governed by the Free Market or by a socialist program but the ACA will cost the "ideal insured" people 2-5+ times what they would otherwise.

--Ocram

[ROFLyoshi 1,760]

What I don't get is how can the government be reduced to such a deadlock? From my understanding, bills are not being passed due to different parties in either house. If that happened here (it has), the entire government of both houses is thrown out and a new one is elected (as has been before).

[Easy Bakes 253]

What I don't get is how can the government be reduced to such a deadlock? From my understanding, bills are not being passed due to different parties in either house. If that happened here (it has), the entire government of both houses is thrown out and a new one is elected (as has been before).

good lord how we wish we could do that.

[ROFLyoshi 1,760]

What I don't get is how can the government be reduced to such a deadlock? From my understanding, bills are not being passed due to different parties in either house. If that happened here (it has), the entire government of both houses is thrown out and a new one is elected (as has been before).

good lord how we wish we could do that.

Double dissolution, check it.

We have the distinction of having a bicameral parliament where the senate is invested in significant power like the US, but there are rules in the constitution that resolve deadlocks. If the double dissolution passes, both parliaments merge into one and well the simple majority works for a joint sitting.

[A Nonny Moose 8,263]

 

What I don't get is how can the government be reduced to such a deadlock? From my understanding, bills are not being passed due to different parties in either house. If that happened here (it has), the entire government of both houses is thrown out and a new one is elected (as has been before).

good lord how we wish we could do that.

 

The fathers of the constitution set it up so that no one entity could get too much power.  You can see that this is a flop in many ways no matter how much propaganda has been pumped into the people.  A tripartite government is an experiment.  The U.S. is the only one that really has this.  You have no way to heave those fools because you can only have elections on schedule. 

 

Most working democracies -- and I use that term loosely -- have mechanisms to dismiss the government and call an election.  What a shame the U.S. does not.  The American experiment has run into the trouble expected by many people.  You have a deadlock and the only way to break it is to go to the people.  You have no such mechanism, so you are stuck with the fools, boodlers, and lobby clients that nobody cared enough to block at the last election. 

 

Government of the people, for the people and by the people.  What happened to Mr. Lincoln's vision?  The Republican Party is not the one he was a member of.

 

This law, the ACA, now in force is pretty much a permanent entitlement now.  About all that can be done with it would be amendments to make it better.  The idea of universal medical care as a right has been around for a long time now, nearly a century, and it is time to get on with the job.  Insurance companies in this area are a boil on the body public and it needs to be lanced.

[MandelSoft 2,775]

It seems that no-one in the American government has heard of the Three Vicious Circles of Poverty:

 

- The Circle of Hunger: No food > No energy > Bad health conditions > No work > No money > No food...

- The Circle of Sickness: You become sick > No work > No money > Can't afford healthcare > Bad health conditions > you become sick...

- The Circle of Education: No education > Little chance to get a good job > Low income (if any) > Can't afford education (to yourself and your children) > No education

 

The second circle is what's at stake here (and in lesser extend, the third one also plays quite a role in the USA). By not improving healthcare conditions for the poorest Americans rules them out of getting a better chance on the job market. So in brief, the poor remain poor, because there's no realistic opportunity to improve. Obamacare tries to break the circle, but from an outsiders perspective, American politics only cares about who can realise his ideology the best and not about the people they are governing. They never had to deal with the problems where poor Americans have to deal with every day...

 

The United States is not the land of opportunity anymore. The classic American Dream as we know it has died a long time ago...

 

Best,

Maarten

[Cobraroll 138]

Cracked.com linked this in one of their articles today. I found it an interesting read.

 

Sounds like a possible course of action could be regulating how much profits that can be made from hospitals. Americans spend a lot of money on healthcare because they accept spending lots of money on healthcare, and no laws prevent healthcare from costing a lot of money. Trying to make the hospitals more cost-efficient for the patients would be bad for business, so they remain expensive to use. Who could possibly benefit from such a system, except the very few at the very top?

[hym 358]

So we are going to take a system stressed by the lack of doctors and nurse necessary to cope with patient loads, add 40 million more patients to it, then pass laws further encouraging doctors and nurses to leave the profession. What could possibly go wrong?

Meanwhile we continue to pump out more lawyers than the system has open positions to fill and Congress continues be dominated by lawyers.

[A Nonny Moose 8,263]

It is clear that medicine in general in the U.S. has entered a positive feed-back loop.  Private enterprise will always try to maximize profit for the least amount of effort.  At the same time the legal profession is becoming a disgustingly large growth industry.

 

Instead of pouring money into the plant to support the legal system, why not take the funds for all those new court houses and jails and put it into the medical system.  Put a cap on admission to law schools.  There are too many lawyers per capita in the U.S.

 

At the same time, some serious incentives to enter medicine needs to be in-place.  That medical fraternity has had it as an old boys club for far too long.

 

In any case, becoming qualified in either profession should not be a license to print money based on the backs of the clients.  What do you suppose would happen if a new entitlement insisting that everyone was entitled to legal advice and support became law?  Suppose the idea of public defenders became standard and no-one was allowed to be his own lawyer?

 

At the same time, some kind of excess profits tax needs to be levied on any business deemed by the IRS to be overcharging their clientele?  And while you are at it, collect all that tax owed by defaulters.  If the various taxing authorities in the country were effective with their accounts receivable, especially on the big boys, the U.S. would not be short of cash.

[Ocram's Razr 964]

There should be more doctors and nurses in the USA. We need both female nurses and male nurses. A problem is that the education system does not teach and train enough.

--Ocram