Affordable Care Act in the United States

[A Nonny Moose 8,263]

So we are agreed that the ACA needs some serious repair?

[hym 358]

I would prefer to see it repealed in its entirety.  The bill could be as simple as:

 

The act is hereby repealed and all changes to US code in connection to the act shall be returned to their status prior to passage of the act.

 

It would make an excellent lesson about why politicians should be careful with their ability to write laws.

 

Health care reform needs to happen but the ACA adopts many incorrect approaches to the issue.

[A Nonny Moose 8,263]

Well, if it is really that bad, why not?

 

However, what then?  There has been a lot of activity in response to this law and it might leave people very much  worse off than previously.  "The moving finger writes, and having writ moves on ...".  I don't think you can just repeal something that has been in force for any time that affects the public.  You must have a replacement ready to go without any wrangling, so it is probably better to amend the daylights out of the existing law which has been OK'd by the SCOTUS.

 

When I was working on a bid up here in the frozen north for one of the provincial health outfits, one of their exclusions was that a man couldn't have two hysterectomies.  With computer programs like this, it was clearly time for an overhaul.

 

Make no bones about it, the states have to step up to the bar and be the single payer in each jurisdiction and use the tax power to get the premiums.  The system should look like ours and only pay for major things like hospitalizations, ER visits, physician visits, and a few other things.  Prescription drugs are excluded from our plan as are paramedical services such as physiotherapy and chiropractic except when performed in a hospital.  The private insurers are welcome and do provide supplementary coverage for items, including prescription drugs, dentistry, etc. not covered by the provincial (state) plan. 

 

The private sector insurers need to be excluded from the basic health care system which is covered by the states with an umbrella from the feds.  This may mean that equalization payments through the feds to "have-not" states will happen, and the "have" states kick-in to the pool.  Wealth distribution on this basis would probably cause a lot of cardiac and cerebral events among the two political parties, but you have to understand that the social safety net is not a private sector thing.  The GOP will knee-jerk block this, I am sure.  It is time to give the jerks the gate.

[hym 358]

The problem with such a proposal is two-fold.  First, neither the states nor the federal government are equipped to handle the cost of the American health care system, nor do they have any practical means to raise the funds to do so.  Second, it still has the government involved, and it takes what should be an issue between the patient and the doctor, and turns it into a political issue.  Insurance companies are simply going to try to avoid paying for medical expenses wherever possible.  The government may well get the political inclination to turn its health care funding into a quasi-cleansing program.

[SimCoug 5,977]

I don't think you can just repeal something that has been in force for any time that affects the public.

 

Prohibition comes to mind...

 

The fact is, people write laws.  People make mistakes.  Just because something becomes a law doesn't mean it's a good idea.  

[Linoa06 1,374]

Seven pages.... and not ONE ACA opponent has given me a good, valid reason for denying basic health care to sixty million people. (Not the ACA, the general principle of basic, universal healthcare coverage).

 

The ACA does have flaws. And I'm no one to discuss which flaws are good and which are just terrible. But one thing I understand is that sixty million people don't have basic healthcare because people are being selfish, the same people who are like "I don't go to school, stop funding them". 

 

How can anyone be against basic healthcare, unless they are severely deluded, extremely short-sighted, or just plain selfish? Can't people just buy one or two hamburgers less a year to pay for their share of the ACA, can't they accept that in a society, everyone has to stick together to some point? Can't they just have some compassion for their neighbours and sacrifice just a little so that sixty million people don't have to worry about getting sick? Can't they put their political views aside in the name of the nation for once in their life? Is this what it all comes down to - big egos, generalized greed and indifference? 

[SimCoug 5,977]

Seven pages.... and not ONE ACA opponent has given me a good, valid reason for denying basic health care to sixty million people. (Not the ACA, the general principle of basic, universal healthcare coverage).

 

Nobody is denying 60 million people health care - in fact it's a safe bet that the majority of those who are uninsured don't have health insurance because they don't want it.

Insurance costs money.  I can't tell people how to spend their own money, and if I did I wouldn't have very many friends.  The same can be said for 'government'.  And when elected representatives lose their friends, they lose their jobs.  

[hym 358]

How can anyone be against basic healthcare, unless they are severely deluded, extremely short-sighted, or just plain selfish? Can't people just buy one or two hamburgers less a year to pay for their share of the ACA, can't they accept that in a society, everyone has to stick together to some point? Can't they just have some compassion for their neighbours and sacrifice just a little so that sixty million people don't have to worry about getting sick? Can't they put their political views aside in the name of the nation for once in their life? Is this what it all comes down to - big egos, generalized greed and indifference? 

 

Implementing a universal health care system in the US isn't just one or two hamburgers a year.  It's an estimated $8,000-$14,000 tax burden per household (in addition to what the household already pays).

[Ocram's Razr 964]

Denying health care is not the issue, Linoa06. Controlling costs for everyone is the issue. I believe that everyone should have access to basic preventative health care and essential medications. Unfortunately, the Unaffordable Health-Care Act does more harm then good.

--Ocram

[LexusInfernus 908]

Nobody is denying 60 million people health care - in fact it's a safe bet that the majority of those who are uninsured don't have health insurance because they don't want it.

Insurance costs money.  I can't tell people how to spend their own money, and if I did I wouldn't have very many friends.  The same can be said for 'government'.  And when elected representatives lose their friends, they lose their jobs.  

 

Oh yeah, because before the ACA insurance companies never denied anyone an insurance policy based on the fact that the person had been sick a while ago. What do they call it? Existing preconditions? 

 

Nor did they ever deny insured people coverage for some flimsy reason. Let alone have trained doctors sit at basically death panels with the sole job of denying as much people healthcare and rewarding them for doing so because they made the insurance companies a lot of money. 

 

And I'm sure I won't find out that of those 60 million people who were uninsured an extremely large group of people who are living either below the poverty line or just above it. No, in the US poor people can all afford insurance, just like they can afford to pay for food and don't require foodstamps at all. No but seriously, its rather callous to say that those people 'choose not to spend money on insurance'. You don't have much of a choice if your options are A) pay for food and rent or B) get health insurance. One might as well put a gun to people's head and say they have a choice to either do what the guy with the gun wants or ignore him and get shot. 

[A Nonny Moose 8,263]

The cost of health care is a major problem.  However, it is a "democracy" which is supposed to mean "the greatest good for the greatest number".  This means everybody into the pool, will they, nil they.  The ones that don't want it are being their usual selfish selves.

 

Getting the private insurance companies out of the act is a first step in lowering costs.  The states can employ the people let go by the insurance companies for openers, sorting out the bad apples over the next few years.  It will also be necessary to put the clamps on the drug companies and other medical suppliers.  A margin cap would help that.

 

The states don't have any mechanism?  Nonsense.  They can construct one if necessary, and there are lots of international examples around for them to choose from.  Not everything in America has to be home grown.  It is time for a taste of real freedom.  Freedom from fear that some illness will cause the whole family to be bankrupted.

[Fatherted 129]

The US has such a perverted "democracy" that is so far from its true meaning that it would better to go back to something that at least worked.

It's simple: UK style healthcare will never work in the US, because if you choose to live there, you choose to adhere to this system, and nothing will change because the "greatest majority" do not understand and immediately reject anything Socialist.

I do think it's disgusting a patient will not be treated if they can't afford it, on the contrary they should have access to good healthcare BECAUSE they can't afford it. But "if it ain't on fire with people screaming and money burning, don't fix it. Instead, spy on it" seems to be the mentality of Obama's party, and the Republicans. The only difference being one has a leader who can't speak without going "uuh" every five seconds, and the other's leader is looking increasingly authoritarian.

God Bless America. They'll need it.

[AcmeSigns 97]

When did this number of the uninsured jump from 48 to 60 million?

Where does that number come from (I would like some sort of statistical proof, not just some talking head's 'fact').

http://www.nytimes.com/2013/09/18/us/percentage-of-americans-lacking-health-coverage-falls-again.html?_r=0

 

And to Linoa06...I have enough trouble taking care of me & mine (without any outside/Government assistance) so, in answer to your many & varied questions in post #186, my reply is a resounding NO!...I, for one, do not have, nor do I feel, any obligation to support/aid anyone else.I freely give to the charities that I believe in so that they can do the work they need to do. I most certainly do not need the government telling me what I must or must not purchase, all in the name of the 'greater good'. This is the United States...not an episode of Star Trek or some imagined utopia.

[krashspeed 40]

Our healthcare system is really messed up, but the ACA isn't the answer.

 

Government has proven time and time again that it can't run anything.

 

Insanity: doing the same thing over and over again and expecting different results.

 

Albert Einstein

 

[A Nonny Moose 8,263]

The worst thing about governments trying to do anything is that they are generally inept.  The true job of government is to keep the peace, keep order, and foreign affairs.  In a federation like the U.S. it is up to the states to provide anything else and stay out of the hair of the feds.  Looking at a hierarchical system, which we all have, the feds are responsible for the overall conduct of the nation in the world, the states for general things too large for municipalities to handle like interstate commerce and licensing, and the municipalities (counties and cities) look after the needs of the people.  This is, of course, theoretical.  Everybody fishes in everybody else's pond.

[LexusInfernus 908]

State level is also government. If you claim that the government is fundamentally inept at doing stuff, then it does not matter whether it gets organized at federal or state level. 

 

Though really, is it that inept? Sure, that is what classical liberals like Adam Smith claim, and its what every capitalist since has been mindlessly repeating, but one should examine such a claim critically. So why would the government be inept? Smith and other capitalists claim that its because there is no profit motive, hence no motivation to innovate or optimize because they get a free pass on spending stuff. But do they? Maybe that was true back in the day when a country was ruled by a unelected monarch or a bunch of unelected nobles (IE England in the time of Adam Smith) where the government did not have any accountability to the larger public. But that is simply no longer the case. We have accountability today and its called 'democracy'. A government that truly squanders the money of the people can expect to be kicked out of office during the next elections. 

 

Furthermore, the argument that the government is inherently wasteful ignores the fact that entire bureaucratic structures exist to keep government wastage to a minimum. Now that might seem contradictory given the bad reputation 'bureaucracy' has, but really, that is just there to ensure that tax payer money is allocated correctly and that the rules are upheld. In other words, bureaucracy is one of the most important checks on the government when it comes to a government properly executing its job. You might call that wastage, but history and practice show that the less advanced the bureaucratic structure of a state, the corrupter the government and the more money gets wasted. Of course, this slows things down, but that is the price one has to pay for keeping wastage to a minimum. 

 

Then there is the traditional argument also made by Smith that the government should focus on three things: National security, infrastructure that can't be maintained privately and the rule of law. Well okay, that is a nice argument, but it also fall flat on its face once you realize that those three things are exactly the things the government spends most of its time on. In fact, that are exactly the three things even todays Federal government does. Really, then what about welfare? Well, welfare actually falls under national security. You see, as the government in the 19th century discovered, letting poor people to fend for themselves tend to breed a lot of resentment, against the government and the overall system. And if you don't do anything about that, well, lets just say the Russian Tsar suddenly found himself at the wrong end of a firing squad. Welfare is simply a preventive measure against massive civil unrest. Of course, the policy areas in which the federal government now has to interfere did expand over the past few hundred years. But that is only natural, that as technology progresses and society changes, certain new policy areas are created. 

 

Finally, we must wonder whether 'the free market' does everything better. And I'd say the answer is a very clear 'no it does not'. The financial sector is a mess thanks to all the deregulation and cost the public billions of dollars. The healthcare sector had for the past few decades an active interest in not helping sick people as a direct result of the free market. The energy sector has been actively blocking attempts to get of our oil dependency because that would cut into their profits, even though it would have been much better for society as a whole. And the list goes on. 

 

Now, one can make a pretty decent point in saying that the ACA is bad legislation. But the whole 'its because the government is fundamentally incapable of doing it right' is just total nonsense. 

[hym 358]

It has been my experience that when a company makes a mistake, it will often apologize for that mistake. When the government makes a mistake, it won't apolgize. Rather, it may well threaten you with legal consequences for its mistake.

Additionally, when companies screw things up, they make mistakes that shouldn't happen, but it is understandable why it did happen. The government, however, manages to make mistakes that defy all human reason and logic.

[Titanicbuff 1,262]

lucky for me I'm disabled- no problem there with medical.

[krashspeed 40]

Government is not held accountable for their actions! Most Americans just will not educate themselves about candidates much less vote and politicians know this.

 

As long as we have people walking into fountains, manholes and into traffic because they are more interested in a cellphone than life itself, we have a bleak future. Sadly it will probably take another great depression to wake people up and get them to vote.

 

For the record, I am not a conservative, liberal, libertarian, republican or democrat, I'm not even a independent, I refuse to be part of any group, I am just "me".

[Duke87 1,070]

Nobody is denying 60 million people health care - in fact it's a safe bet that the majority of those who are uninsured don't have health insurance because they don't want it.

 

Er, read your article again. What it's saying is that only 22% of people signing up for health insurance are using the Obamacare exchanges. When you consider the problems the website has been having, and the fact that a lot of states have been refusing to do anything to help implement the program, this number shouldn't be too shocking. But it speaks to the failings of the implementation, not to whether or not people want insurance.

 

People who could afford health insurance but don't want it do exist, for certain. There are plenty of healthy 20-somethings who don't think it's worth it to them and would rather spend their money on other things. Honestly, if I didn't have a condition that requires I take medication daily, I'd probably be one of them. But I doubt this makes up a majority of uninsured Americans. People who lack health insurance because they don't have a job that provides it and can't afford to purchase it on their own are certainly also numerous. Some of these people will still be unable to afford health insurance even with Obamacare subsidies.

 

Also, don't underestimate the ability of people living in poverty to act like they aren't in control of their lives and not be willing to lift a finger to change anything. Even if you offer free healthcare, that still requires people to get up off their ass and go sign up for it. Some people don't have the will to do that. Hell, even people who have insurance often put off going to the doctor because it's not something anyone enjoys doing, because it takes time and effort to set up and do, because they're afraid the doctor is going to tell them something they don't want to hear... so they procrastinate. I daresay at least some of America's health problems are caused by the fact that culturally we are far more likely to put our fingers in our ears and scream "la la la" instead of confronting and fixing problems compared to other developed nations. So of course things like public health suffer because people don't have the will to address their own dysfunctionality.

 

Access to healthcare is a far more complex problem than affordability. Obamacare attempts to tackle that aspect of it although it remains to be seen how successful it will be. Even if it's great at making care affordable, though, it still does nothing to address quality, availability, or desire/will of people to go to the doctor. Nor does it even really address cost, it just subsidizes it for poor people and passes the costs on to the taxpayer. So of course it's not going to be a magic pill that will solve all our problems, and acting like it is is wishful thinking. What it is is an attempt to create incremental improvement. It won't make healthcare in America not suck, but it might make it suck a little less.

[LexusInfernus 908]

It has been my experience that when a company makes a mistake, it will often apologize for that mistake. When the government makes a mistake, it won't apolgize. Rather, it may well threaten you with legal consequences for its mistake.

Additionally, when companies screw things up, they make mistakes that shouldn't happen, but it is understandable why it did happen. The government, however, manages to make mistakes that defy all human reason and logic.

I still haven't heard any apologies from bankers for costing the public billions, if not trillions of dollars. And no, I do not find how most major private sector screw ups are actually possible. I do not find that there is a logical reason for the financial crisis (greed is not a logical reason), I do not find there to be a logical reason behind that huge oil spill in the Gulf and I do not find there to be a logical reason behind a PMC going nuts and shooting a bunch of civilians in Iraq. 

 

That aside, if you don't like the way a government made a mistake and did not owned up to it, you should remember that during the next election and vote them out. 

 

And if people are to stupid or lazy to hold the government accountable for its mistakes, then really those mistakes or on them. I mean who is the bigger idiot, the guy making all the mistakes or the people who do not step in when he does and let him keep making those mistakes? 

[hym 358]

You can't vote out a court clerk for losing jury duty paperwork and then getting you accused of willful violation of a court order. Nor can your vote out a postal worker who manages to lose a tracked package that is supposed to be impossible to lose. Nor can your vote out an IRS agent who somehow manages to mail a refund check without actually providing an address for it to be mailed to.

There is a reason that "good enough for government work" has a negative connotation.

[LexusInfernus 908]

Those kind of flaws you also find in private companies, and they happen just as often as when the government does that job. And in plenty of cases those companies also tell you to go f*** yourself if you complain to them about it. And what can you do about that? Stop being their customer? Okay and then what? All the competitors are no better. 

 

Of course, you could go to a consumer protection organization and start a class action lawsuit or something. But they should have similar organizations for people who are victim of government mistakes. I think they are called 'Ombudsman' or something, but that could just be the Dutch word for it. 

 

Also, just because people have a saying about it doesn't mean its true. Given what the government does on a daily basis, they are really not doing any worse than a privately run corporation. 

[A Nonny Moose 8,263]

{rant}

Some people would complain if they were being hung with a gold rope.  The dysfunction of some snivel serpents brings disrepute upon the whole class.  Similarly, in corporations, the serpent in the basket of good workers spoils the entire basket.  Once the work ethic went out the windows, I can assure you, trouble walked in the door.

 

The front-end of most corporations consists of two phases: the HR people who know nothing at all about either the business nor the qualifications necessary to support the company as a work place; and the receptionist/clerk who care more about their next date than the customers.  America and the rest of the world has become so personally self-centred that the word 'service' has lost its meaning.

{/rant}

[Fatherted 129]

Not to mention PR.

Sony has been taking a few hints off the US government with the lies and cover-ups surrounding the PS4 at the moment. It's pathetic that companies can get away with the bait-and-switch lies that Sony can get away with anyway, but the horrible part is it's standard practice in government.

[Hellken 1,658]

Obama on His 'If You Like It, You Keep It' Pledge

http://www.youtube.com/watch?v=A_Ict1O35xQ

American President Obama explained that a grandfather clause in the Affordable Care Act was insufficient, leading to the cancellation of some Americans' health plans

[A Nonny Moose 8,263]

Wonder how raw crow tastes?  Obama is a lawyer, I believe.  Didn't he read the act before it was finally passed?  Considering it is his 'talisman' piece of legislation, his presidency will not be rather marred by this failure to dot I’s and cross T's.

 

How they can possibly repair this is a good question.  You'll notice the private insurers jumped on the bandwagon and cancelled policies left and right without so much as a by your leave.  Enjoy the capitalist system.

[Duke87 1,070]

Well that was an interesting concession.

 

My take on all this is that what he meant in spirit was that for most people nothing much would change (which, as far as I can tell, is true so far). But saying there will be new regulations governing what plans can charge and offer is still inherently contradictory to saying that everyone can keep their existing plan. Obviously some existing plans must not meet the new regulations, or what is the point of them?

 

Nonetheless I think the matter is somewhat overblown. What people are being told isn't "we're cutting you off, bye, nice knowing ya", it's "we are no longer able to offer you the plan you currently have but we can offer you any one of these other plans instead". Bear in mind that this can happen to anyone at anytime even without new regulations if your provider decides they don't want to continue supporting the plan you're on because it isn't making them enough money or for whatever business reason.

Although it seems to me that it should in some cases be possible to modify an existing plan to comply rather than cancelling it. Methinks that some companies that don't like Obama and/or Obamacare are just finding ways to needlessly stir up drama about it.

[A Nonny Moose 8,263]

That is a very good point.  I wonder how many of them contribute to the Republican party?  They may very well be in a zugzwang situation.  This is where they have to make a move but will be checkmated if they do.  Sounds like some creativity is lacking.

[Easy Bakes 253]

That is a very good point.  I wonder how many of them contribute to the Republican party?  They may very well be in a zugzwang situation.  This is where they have to make a move but will be checkmated if they do.  Sounds like some creativity is lacking.

Do you really believe  they only donate to one party?