What happened to all that "Obamacare is FINALLY working" drivel I heard from the Lib Media just a few months ago

Just saying!

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After they get done abusing their power and using it as a political weapon. It was sickening how the Dems apologized and babied the arrogant commissioner at the hearings.

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Just another Obama flunky with no clue and no desire to get to the truth.

mouth on this topic during the upcoming mid-terms. First, I'm a hard core free market capitalist. Republicans have nothing to crow about. They don't have a plan. And tort reform and selling insurance across state lines is NOT a plan. At best, they may impact costs at the edges. They haven't offered shit in I don't know how many years. So if there plan is just to bash Obamacare, I'm not buying it.  

Even hard core liberals don't like Obamacare. They want a single payer system, or universal health care system, or some combination of both. Some want a British version where everything is operated by the government, and where all providers are on the govt payroll, kinda like our VA system. Others just want an expansion of Medicare for all. But at least I give liberals credit for "generally" articulating what they want. Not so with the Republicans.  

 

Read on McDuff.

I looked at your article, and what were the first 3 bullets? And this plan is going to dramatically alter the cost of health care as we know it? You still have the same players. You still have the same system. Where in the Republican plan is the word "CONSUMER" or "CUSTOMER"?  

Let me give a small example. I went to my doctor for a simple visit and standard blood work. The blood work was done by Quest Diagnostics, probably the largest lab provider in the country. Blood work included shit like metabolic panel, cholesterol, vitamin D, PSA, and 2 other standard tests. The total retail price was $1,058.20. I have a high deductible plan, but nevertheless I get the benefit of my insurance company's negotiated rate, aka, "the allowed amount". Instead of $1,058.20, I only paid $98.76.  

I assume 99% of Quest's customers have insurance. I assume each insurance company has basically negotiated the same allowed amount rates. I'm paying about 10% of Quest's retail price, and I assume everybody is paying about 10%. Quest is a publicly held company, so I assume they are still making money on my payment of $98.76. This significant spread between the retail price and the allowed amount is fairly consistent with all providers. So how does malpractice reform, selling insurance across state lines, enhancing health savings accounts drive down costs like the one I just mentioned, when $98.76 appears to be an acceptable profitable amount for Quest?  

Name me any other product or service on planet Earth where I can't find a price, or at least a close estimate within 2 minutes of accessing the internet? It's the only this industry where customers are held hostage by an archaic system. Until the consumer is in control as in other industries, no tweaking of the existing system as noted in your thread will dramatically transform the industry.  
 -- Modified on 6/24/2014 2:26:49 PM

St Croix is correct- the Republicans do not have a health care plan

 
What you are calling a “plan” Jack is a attempt to cobble together five ideas floated by Bush, McCain and Romney and then to present that as an alternative to the comprehensive Affordable Care Act. St Croix mentioned two of them – tort reform and selling insurance across state lines. And this from a guy who hates Obamacare.  But he does not let his dislike for ACA cloud his analytical ability.

The Republicans have no idea whether these 5 ideas would actually work any better than the ACA, or the pre-existing system.  There is not a single peer reviewed study that has even attempted to make a comparison, or has concluded that the plan will work.

But I can do it for you, Jack. Let’s look at the 5 components of the RSC plan.

1. Tax deductions for qualified health care? Why do you think the ACA went the subsidy route, Jack? Bc the odds of the poor using the deduction for health insurance are slim and none.  They will use it to pay their credit card bill first and go out drinking later. Bush floated this idea years ago and was immediately annihilated by critics.

2. Selling insurance across state lines? Google “race to the bottom” Jack and report back to me.

3. Tort reform? Please…we already have tort reform in the majority of states and damage caps in many. They have not worked. At best, they reduce health care costs 1 to 3 %. I dispute that by the way on a cost benefit basis.

4. Government payments for high risk pools? If you think the delays at the VA are a scandal, you should do a little reading at how well these state plans have worked for those with pre-existing conditions. Yeah let’s flood these plans with tax dollars and see how well they work.  Under the ACA, you can get that policy tomorrow, even if you need a heart transplant.

5. Expanded health savings accounts? Ok I like this idea but it is hardly a substitute for the comprehensive ACA provisions.

We still do not know whether Obamacare will work or not. But the ACA is the work of the most PHDs since the space program. The RSC plan is just something thrown together by the REpubs in an attempt to show they have a plan. No independent experts have vetted it.

 I’ll go with the academics as a matter of policy and certainly, as far as individuals are concerned Obamacare is far, far superior solely bc it eliminates the annual and lifetime caps.

No matter what happens to us as we near the end of life, we will be covered by insurance.

 
When the Republicans can offer something like that, Jack, get back to me. Until then, St. Croix is right – the Republicans have no plan

Hint for Jack - many of the poor do not have telephones and some do not even know what the ACA is

Did you take an online Duke course in brevity?  

So what you are saying is that since they are poor, and they don't have a phone, and safe to assume they don't have a computer because they are poor, and they don't know what ACA is, it's safe to assume Obamacare is a failure.  

Mari, they have phones, maybe not caller ID, but they have phones (lol)
 

Including you. Repugnant swill not win a single seat without jerry mandering the districts and without voter suppression. You Repugnants lied about WMD and are lying about voter fraud. Every where else in the world of democracy they are getting more and more people to vote except in Repugnant controlled states.

You first ripped them for NOT having a plan but now you are ripping the plan itself? Fine to do mind you, but your beef has changed.

I would hope you aren't going to say you'd rather have Obamacare than the R plan OR the status quo.

Your point re: posting prices is DEAD ON accurate. John Stossel has done an excellent job pointing this out. As long as we have insurance paying, we dont give a fk what it cost. Doctors should have posted rates for services and consumers should be able to shop by price as well as quality, for their doctor and other services.

One of the biggest drivers of cost in any field is a lack of competition. Some states there are only 2 carriers. In NH, there is ONE!

Buying across state lines would have a dramatic effect in lowering insurance rates IF companies would be allowed to sell catastrophic coverage only policies. Then a "Geico" type company could come into any market and drag all the other pricing down with it.  

But Obamacare doesn't allow that and prices have spiked and will continue to do so until there is nation wide, multi-policy options from hundreds of carriers.

 

-- Modified on 6/24/2014 8:23:59 PM

People w/o phones aren't "poor" bro, they are destitute, and they are already covered by Medicaid.

But let me ask you this. Why has the approval rating of the U.S. HC system dropped from 75-80% pre-Obama to 35-40% post?  

Let's factor OUT R's and D's b/c they support/oppose for political reasons. (I dont actually think that, just saying it for the argument's sake.) Lets only focus on Indy's, who disapprove of O-care by about 55% or so. Why do you think that is Mari?  

And you didn't address my main point about why approval of the ACA has crashed even further since the 7.1 million enrollment figure was announced.  

Can't you realize/admit the possibility that the law is actually having an effect on the population and that that effect is mostly negative? What other reason(s) do you have for its recent and sudden, sharp downturn in approval if it the public ISNT seeing/feeling negative effects?

Thanks for replying.

-- Modified on 6/24/2014 8:43:38 PM

One which nobody ever seems to ask:

When did we, as a nation, decide that health care was a fundamental human right, so manifestly pre-political in nature, that it was axiomatically obvious that health care benefits be bestowed upon every citizen (or "undocumented immigrant") regardless of whether or not that person wants those benefits or wants to be "compelled to voluntarily comply" with paying his ACA tax in order to secure this piece of government largesse?

I missed this particular civics lesson, all the way from pre-school through elementary school, junior high, high school, college, and graduate school.  Maybe I slept through it all...

Many of the old people, who I know, can't hear their phone, don't know how to use it, forget to turn the ringer on, etc., etc. etc. In short, many of the people who want to talk to them can't get through to them.  

-- Modified on 6/24/2014 5:53:53 PM

Topic is Obamacare and the poor, not Medicare and the old and poor.

It was without question one of the most screwed up projects from conception to implementation that I've ever seen. Now that I said that, ACA has done one thing that various pundits didn't realize. It's causing discussion within companies, think IBM type companies, about getting out of the health care benefits business. It's a relic from WWII. Do companies really need to provide this benefit to attract the best employees? Companies are looking at providing a cash allowance that employees can use to offset the cost of buying insurance on their own, which will foster the creation of multiple private exchanges. How about using a eHealthInsurance.com type site? If you have 150 million shopping for individual insurance vs 7 million, would that potentially reduce cost? So yes, I will admit eliminating the "state line" issue can have a positive impact, but more so in an aggressive private exchange environment vs the status quo. In fact it's happening today with Trader Joes, Walgreen and a few other companies. But they are moving their part time employees to the public exchange.

Re Stossel's comments, when insurance is paying the first dollar out, and I use that term loosely, the consumer is taken out of the equation. Make health insurance more like auto and home insurance. You file a claim when really bad shit happens, generally speaking of course. If the 1st dollar is coming out of the consumers pocket, the consumer now has a vested financial interest, so logic says the consumer will demand better service and lower costs.

But at the end of the day the consumer has to get smarter and take control.

P.S. If that's what the Republicans want to call it, so be it, but then maybe I'm not the audience for it. To me it's a bunch of bullet points/tactics that at best tweaks an existing system. It's not transformational, and I don't think it's going to dramatically lower costs.  

-- Modified on 6/24/2014 8:39:52 PM

-- Modified on 6/24/2014 8:42:56 PM

The real solution is a free market solution. Unfortunately, we do not have that, and the Liberals want to go in the opposite direction - Government paid.

When the consumer is insensitive to cost, then they will demand all the service they can get, regardless of the cost.

What, in healthcare, has declined in price? Laser Eye Surgery. Why? Because the individual has to pay for it. If the consumer had to pay for lab fees out of their own pocket, then lab costs would drop as labs competed against each other for cost sensitive consumers.

Unfortunately, you can't reintroduce free markets into healthcare overnight. One step towards that is free market competition at the insurance level (selling insurance across state lines).

I think high deductible plans are the way to go: Reintroduce competition where consumers have time to make choices (every day healthcare). Insurance then covers the low probability, high cost, events - what insurance is designed to do.

For the poor people, have government clinics to provide the basic health care. Just like housing, not everyone can live in the lakefront mansion.

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A policy issue is slamming into a political one for R's. Think about this. If the R's put out an actual bill, written in legal-ese, i.e. something that could actually get voted on, the Lib Media and Dems in Congress will go CRAZY in an effort to make R's look bad and put the R's on the defensive.

Imo, there is NO need to do that now, on the verge of taking back the senate. Politically speaking only, I think its best to paint broad strokes, have 6,7, 8 things in it that people will remember that will be VERY popular. E.g. keep your doctor, docs must list rates, tort reform, state lines, etc. similar to what they did in my link.

Now 2016 will be different, for any R running for Prez will need a full bill, available for CBO scoring and scrutiny, no doubt, but I think the country will be STARVING for a new plan/idea at that point and it will make it much more feasible to sell than it is now.

We are not going to solve the HC issue between now and the election anyway, so why let Libs bash the shit out of any detailed plan in an effort to try and neutralize the negative effect of Obamacare on the upcoming election.

-- Modified on 6/25/2014 8:54:27 AM

You are such a prince, Jack. Guess us “rich folks” are the only ones who should be queried.

         Here is why "the poor" most certainly do count if we are taking a poll on the “popularity” of Obamacare.  The Affordable Care Act makes substantial improvements to state Medicaid programs. Eligibility is expanded; enrollees receive the minimum benefits the ACA requires for insurance policies; prescription drug coverage is improve; more child health programs; improved medical records; get tough on Medicaid doctors provisions -the list goes on.

        I’d guess that nearly 100% of Medicaid enrollees who understand how the ACA improved Medicaid would vote “hell yes” in a poll.  Your telephone surveys don’t even reach the poor who lack phones – I’d guess the percentage of land lines in public housing is quite low (Rasmussen “corrects” for this by doing  an online survey but "the poor" don’t have computers either Jack) - and even if we assume the surveys reach a representative sampling, they are still invalid bc the average Medicaid enrollee –just like you Jack - is unaware of the improvements to Medicaid wrought by Obamacare.

       Indeed, if someone as educated, intelligent, and informed about health care as you are is clueless about this, how could you expect the average Medicad enrollee to have information sufficient to make an informed decision when contracted over the phone by a robocaller?

      Once you add in the knowledegable poor to your poll, Jack, that “55%” disapproval (Rasmussen says only 35% of voters  rate the system as poor)  figure starts sinking …about as fast as your post – well, maybe not that fast LOL.

 
     Finally, Jack, I could not help but notice you did not give us the poll figures for repealing Obamacare. Any particular reason for that? LOL

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But come on Mari, is that how you want to argue its popularity, or lack there of? On the margins like that? Liberals told us this law would be WILDLY popular like on the order of SS and Medicare popular i.e. 80-90% popular. The fact that you are lowering the bar THIS much, THIS soon is a tell tale sign of how bad this law is.

And you dodged my question about why it has sunk since the policies were written and the law actually went into affect. You're smart and I appreciate your opinion but you don't have one on this topic? LOL

You don't think the disapproval of the law is based somewhat on its negative effect on the insureds? Are you really arguing that point with me?

And yes, since I won't dodge your question, I would agree at this point that the majority of Americans do not want it repealed but again, isn't that an awfully low bar for what was billed as such a wonderful piece of legislation?