Author Topic: What comes after the ACA?  (Read 237093 times)

Metric Mouse

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Re: What comes after the ACA?
« Reply #1600 on: March 16, 2017, 05:12:30 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
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ZiziPB

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Re: What comes after the ACA?
« Reply #1601 on: March 16, 2017, 05:34:49 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.



Metric Mouse

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Re: What comes after the ACA?
« Reply #1602 on: March 16, 2017, 05:53:21 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.
I gladly pay the higher prices so that people can get lifesaving care regardless of ability to pay.
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Iplawyer

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Re: What comes after the ACA?
« Reply #1603 on: March 16, 2017, 06:11:38 AM »
"A 64-year-old making $26,500 a year would pay around $1,700 in premiums right now. Under the proposed changes, that person would pay $14,600, more than eight times more.

One big reason for that is that the new health care bill would change the gap between what young and old people will pay for their premiums. Currently, insurers can charge older enrollees three times what they charge someone younger. The Republican plan would up that from 3-to-1 to 5-to-1."

That's 14,600 for ONE 64yo. 64yo married couple? Double that. Early retired 64 yo with 57yo spouse and kids still in college? Oy.

Source:NPRhttp://www.npr.org/2017/03/15/520181569/5-charts-that-explain-the-cbo-report-on-the-republican-health-plan

Yes but at least the Government won't be telling said 64 year old he HAS to buy Health insurance.. So thats OK then!

We certainly can't have the Republicans living in a NANNY STATE!! I mean, my god. We should at least attempt SOME illusion of Wild West butchness.
Funny how all those blue states need the money from the red states to pay for all the programs they want to implement. :D

Metric Mouse - I'm going to call you on your lies again.  Why do you just make stuff up?  Please produce ANY evidence that Blue states are taker states.  What you will find is that Blue states are generally giver states.  It is the Red states that are generally  takers.    See:
https://wallethub.com/edu/states-most-least-dependent-on-the-federal-government/2700/#main-findings

Iplawyer

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Re: What comes after the ACA?
« Reply #1604 on: March 16, 2017, 06:26:27 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.
I gladly pay the higher prices so that people can get lifesaving care regardless of ability to pay.

Then why wouldn't you be willing to "pay more" for subsidizing health insurance so that these people can get regular care that is cheaper and means they won't need the very much more expensive "lifesaving care."  And by the way - it is only "emergency live saving care" that they can get.  They cannot get cancer treatments, blood pressure pills, insulin, etc.

And - are you even paying any taxes?

jim555

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Re: What comes after the ACA?
« Reply #1605 on: March 16, 2017, 06:30:10 AM »
They should get rid of EMTALA.  Damn moochers should die in skid row.  /sarcasm off

ZiziPB

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Re: What comes after the ACA?
« Reply #1606 on: March 16, 2017, 06:54:13 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.
I gladly pay the higher prices so that people can get lifesaving care regardless of ability to pay.
But you could pay less and ensure that people have normal health care regardless of ability to pay. 



Metric Mouse

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Re: What comes after the ACA?
« Reply #1607 on: March 16, 2017, 07:15:19 AM »
Metric Mouse - I'm going to call you on your lies again.  Why do you just make stuff up?  Please produce ANY evidence that Blue states are taker states.  What you will find is that Blue states are generally giver states.  It is the Red states that are generally  takers.    See:
https://wallethub.com/edu/states-most-least-dependent-on-the-federal-government/2700/#main-findings
I would imagine that a state that didn't need money from other states to pay for their own citizen's health insurance, and wished to supply that health insurance to its citizens, would not need an act of congress to do so? Massachusetts did so at one point, IIRC. I mean, one can't both argue that people in red states need to be taxed to provide healthcare for people in other states AND that those other states have enough money to do it all themselves.  It just seems illogical that all these blue states have the means and the desire to supply universal or greatly expanded healthcare, and yet they do not because the red states don't want to.
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Metric Mouse

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Re: What comes after the ACA?
« Reply #1608 on: March 16, 2017, 07:26:38 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.
I gladly pay the higher prices so that people can get lifesaving care regardless of ability to pay.

Then why wouldn't you be willing to "pay more" for subsidizing health insurance so that these people can get regular care that is cheaper and means they won't need the very much more expensive "lifesaving care."  And by the way - it is only "emergency live saving care" that they can get.  They cannot get cancer treatments, blood pressure pills, insulin, etc.

And - are you even paying any taxes?
Requiring people to have health insurance is a clearly sub-optimal way to get people healthcare. It would be much better to subsidize healthcare (which is what I just said) than the give massive subsidies to insurance companies so that they use a portion of that to pay for people's healthcare. Democrats clearly disagree, and so do Republicans, it seems, so I may be standing alone in this view.

I'm not sure tax liability is relevant; everyone in the country gets the same benefits from government services regardless if they pay taxes or not. If healthcare were a government service like defense or infrastructure, it could be available to everyone for far less money than we spend now. Health insurance is not a great proxy for healthcare and the country does not get equivalent benefits for replacing one with the other.
Give me one fine day of plain sailing weather and I can mess up anything.

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protostache

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Re: What comes after the ACA?
« Reply #1609 on: March 16, 2017, 07:33:28 AM »
Requiring people to have health insurance is a clearly sub-optimal way to get people healthcare. It would be much better to subsidize healthcare (which is what I just said) than the give massive subsidies to insurance companies so that they use a portion of that to pay for people's healthcare. Democrats clearly disagree, and so do Republicans, it seems, so I may be standing alone in this view.

I'm not sure tax liability is relevant; everyone in the country gets the same benefits from government services regardless if they pay taxes or not. If healthcare were a government service like defense or infrastructure, it could be available to everyone for far less money than we spend now. Health insurance is not a great proxy for healthcare and the country does not get equivalent benefits for replacing one with the other.

The Democrats are a big tent. That said, we are, were, and will continue to be almost completely united behind the idea of universal health care, with the notable exception of the unions that negotiated big health care benefits in lieu of cash compensation. If we hadn't tried for a year to compromise with an intractable GOP in 2009 we probably would have universal Medicare today.

Political reality as it stands means that "market based solutions" are the only thing on the table. This isn't what anyone who actually understands the problem we're trying to solve actually wants, including yourself.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1610 on: March 16, 2017, 07:46:50 AM »
Requiring people to have health insurance is a clearly sub-optimal way to get people healthcare. It would be much better to subsidize healthcare (which is what I just said) than the give massive subsidies to insurance companies so that they use a portion of that to pay for people's healthcare. Democrats clearly disagree, and so do Republicans, it seems, so I may be standing alone in this view.

I'm not sure tax liability is relevant; everyone in the country gets the same benefits from government services regardless if they pay taxes or not. If healthcare were a government service like defense or infrastructure, it could be available to everyone for far less money than we spend now. Health insurance is not a great proxy for healthcare and the country does not get equivalent benefits for replacing one with the other.

The Democrats are a big tent. That said, we are, were, and will continue to be almost completely united behind the idea of universal health care, with the notable exception of the unions that negotiated big health care benefits in lieu of cash compensation. If we hadn't tried for a year to compromise with an intractable GOP in 2009 we probably would have universal Medicare today.

Political reality as it stands means that "market based solutions" are the only thing on the table. This isn't what anyone who actually understands the problem we're trying to solve actually wants, including yourself.
I would have believed that before the ACA. The Dems had the votes, they had the opportunity, they had the presidency, they were even focused on healthcare reform - where is this universal healthcare they kept championing? Prior to that, where was it at their state level?  Democrats bowed to the insurance lobby and the union lobby interests, pandering to them with huge subsidies rather than advancing on the universal healthcare front; so I guess all three groups are to blame for the mess we have, and for the missed opportunity. Republicans have never claimed to want universal healthcare; in fact they've even championed getting rid of the programs that are the closest thing to it; terrible, but at least they're consistent. I just can't wrap my mind around how Democrats can keep blaming their own failings on Republicans who didn't, and didn't need to, vote for the program that Democrats never brought to the table anyway.
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ZiziPB

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Re: What comes after the ACA?
« Reply #1611 on: March 16, 2017, 08:59:11 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.
I gladly pay the higher prices so that people can get lifesaving care regardless of ability to pay.

Then why wouldn't you be willing to "pay more" for subsidizing health insurance so that these people can get regular care that is cheaper and means they won't need the very much more expensive "lifesaving care."  And by the way - it is only "emergency live saving care" that they can get.  They cannot get cancer treatments, blood pressure pills, insulin, etc.

And - are you even paying any taxes?
Requiring people to have health insurance is a clearly sub-optimal way to get people healthcare. It would be much better to subsidize healthcare (which is what I just said) than the give massive subsidies to insurance companies so that they use a portion of that to pay for people's healthcare. Democrats clearly disagree, and so do Republicans, it seems, so I may be standing alone in this view.

I'm not sure tax liability is relevant; everyone in the country gets the same benefits from government services regardless if they pay taxes or not. If healthcare were a government service like defense or infrastructure, it could be available to everyone for far less money than we spend now. Health insurance is not a great proxy for healthcare and the country does not get equivalent benefits for replacing one with the other.

There are some countries that provide universal care through an insurance mandate.  And it's working pretty well.  I'm not sure on what basis you assume that it's not optimal. There are definitely ways to do it, it's just that the ACA did not go far enough in that respect.  Some examples are Germany, Australia, Japan, Switzerland, etc.  It requires insurance companies to be more regulated but it definitely can be done successfully.



jim555

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Re: What comes after the ACA?
« Reply #1612 on: March 16, 2017, 09:02:15 AM »
Japan has a mandated price list for every procedure and they seem to do ok.

Schaefer Light

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Re: What comes after the ACA?
« Reply #1613 on: March 16, 2017, 09:10:08 AM »
I wasn't talking about things the government provides.  I was talking about goods and services that buyers purchase directly from sellers.

That's not the case for most people who either are covered through an employer, or are covered by any of the various government health care programs, though. Which is almost everyone.

-W

While I don't agree with the current system, I understand what you're saying.  My point was simply that someone who consumes more health care services probably should pay more than someone who only goes in for regular checkups.

Scortius

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Re: What comes after the ACA?
« Reply #1614 on: March 16, 2017, 09:27:33 AM »
Requiring people to have health insurance is a clearly sub-optimal way to get people healthcare. It would be much better to subsidize healthcare (which is what I just said) than the give massive subsidies to insurance companies so that they use a portion of that to pay for people's healthcare. Democrats clearly disagree, and so do Republicans, it seems, so I may be standing alone in this view.

I'm not sure tax liability is relevant; everyone in the country gets the same benefits from government services regardless if they pay taxes or not. If healthcare were a government service like defense or infrastructure, it could be available to everyone for far less money than we spend now. Health insurance is not a great proxy for healthcare and the country does not get equivalent benefits for replacing one with the other.

The Democrats are a big tent. That said, we are, were, and will continue to be almost completely united behind the idea of universal health care, with the notable exception of the unions that negotiated big health care benefits in lieu of cash compensation. If we hadn't tried for a year to compromise with an intractable GOP in 2009 we probably would have universal Medicare today.

Political reality as it stands means that "market based solutions" are the only thing on the table. This isn't what anyone who actually understands the problem we're trying to solve actually wants, including yourself.
I would have believed that before the ACA. The Dems had the votes, they had the opportunity, they had the presidency, they were even focused on healthcare reform - where is this universal healthcare they kept championing? Prior to that, where was it at their state level?  Democrats bowed to the insurance lobby and the union lobby interests, pandering to them with huge subsidies rather than advancing on the universal healthcare front; so I guess all three groups are to blame for the mess we have, and for the missed opportunity. Republicans have never claimed to want universal healthcare; in fact they've even championed getting rid of the programs that are the closest thing to it; terrible, but at least they're consistent. I just can't wrap my mind around how Democrats can keep blaming their own failings on Republicans who didn't, and didn't need to, vote for the program that Democrats never brought to the table anyway.

The Dems did not have the votes.  They were short by one.  Franken was mired in a recount.  Then Kennedy died.  Lieberman refused to support the public option, the end.

Iplawyer

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Re: What comes after the ACA?
« Reply #1615 on: March 16, 2017, 09:30:15 AM »
Metric Mouse - I'm going to call you on your lies again.  Why do you just make stuff up?  Please produce ANY evidence that Blue states are taker states.  What you will find is that Blue states are generally giver states.  It is the Red states that are generally  takers.    See:
https://wallethub.com/edu/states-most-least-dependent-on-the-federal-government/2700/#main-findings
I would imagine that a state that didn't need money from other states to pay for their own citizen's health insurance, and wished to supply that health insurance to its citizens, would not need an act of congress to do so? Massachusetts did so at one point, IIRC. I mean, one can't both argue that people in red states need to be taxed to provide healthcare for people in other states AND that those other states have enough money to do it all themselves.  It just seems illogical that all these blue states have the means and the desire to supply universal or greatly expanded healthcare, and yet they do not because the red states don't want to.
Please don't change your argument and please stop saying that Blue states want Red states to pay for their insurance.  That simply isn't true.  And most Blue states do have care for the elderly and poor that Red states do no. 

Exflyboy

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Re: What comes after the ACA?
« Reply #1616 on: March 16, 2017, 09:32:43 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.
I gladly pay the higher prices so that people can get lifesaving care regardless of ability to pay.

I know . millions of dead and dying Europeans right?

My Dad back in the UK is 84 and sees a cardiologist every six weeks or so.. For $zero out of pocket. He must have his appointment with the "Death Panel" any day now!

Cost of care in the US per person is about 2.5 times what they pay in the UK.. Is it a perfect system?.. Heck no but its a lot better than we got here.

Iplawyer

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Re: What comes after the ACA?
« Reply #1617 on: March 16, 2017, 09:36:57 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.
I gladly pay the higher prices so that people can get lifesaving care regardless of ability to pay.

Then why wouldn't you be willing to "pay more" for subsidizing health insurance so that these people can get regular care that is cheaper and means they won't need the very much more expensive "lifesaving care."  And by the way - it is only "emergency live saving care" that they can get.  They cannot get cancer treatments, blood pressure pills, insulin, etc.

And - are you even paying any taxes?
Requiring people to have health insurance is a clearly sub-optimal way to get people healthcare. It would be much better to subsidize healthcare (which is what I just said) than the give massive subsidies to insurance companies so that they use a portion of that to pay for people's healthcare. Democrats clearly disagree, and so do Republicans, it seems, so I may be standing alone in this view.

I'm not sure tax liability is relevant; everyone in the country gets the same benefits from government services regardless if they pay taxes or not. If healthcare were a government service like defense or infrastructure, it could be available to everyone for far less money than we spend now. Health insurance is not a great proxy for healthcare and the country does not get equivalent benefits for replacing one with the other.

No - you did not say it was better to "subsidize healthcare."  Providing emergency room services is not that.  You state your opinion as if it is fact.  And I disagree with your opinion.  If you provide some evidence - I'll look at it.  Until then - I call you on it. 

Re: tax liability.  You said "I'm happy to pay for lifesaving care."  That statement implies you pay taxes that pay for such.  I don't think you do.  Do you?  If not then what you are really saying is you are happy for me to pay for other's lifesaving care.  If I'm paying for it - I'd rather pay for a single payor system so that everybody gets the healthcare they need.


Iplawyer

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Re: What comes after the ACA?
« Reply #1618 on: March 16, 2017, 09:38:46 AM »
Funny how Republicans are happy to require hospitals to provide free emergency care to the uninsured while refusing to reimburse them for providing that care (EMTALA) but not happy to require individuals to have insurance which would reimburse the hospitals.
It's a funny sort of world. But as long as people can get help, that's the important thing. Hospital CEO/insurance lobby profit margins are less important, to me.
But the problem is that the money to pay for that uninsured care is not coming from CEO/insurance lobby profit margins.  It's coming from your and my pockets.  And it's a lot more than it would be if that same person was treated properly in the first place without waiting for the problem to be so bad that it requires emergency care.  Find me a country with universal healthcare where the cost of such healthcare is actually higher than it is in the US.
I gladly pay the higher prices so that people can get lifesaving care regardless of ability to pay.

I know . millions of dead and dying Europeans right?

My Dad back in the UK is 84 and sees a cardiologist every six weeks or so.. For $zero out of pocket. He must have his appointment with the "Death Panel" any day now!

Cost of care in the US per person is about 2.5 times what they pay in the UK.. Is it a perfect system?.. Heck no but its a lot better than we got here.

What you don't understand is Metric Mouse is only supportive of free emergency room care.  Your dad would be out of luck under Metric Mouse's view of necessary care.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1619 on: March 16, 2017, 09:44:49 AM »
What you don't understand is Metric Mouse is only supportive of free emergency room care.  Your dad would be out of luck under Metric Mouse's view of necessary care.
Where did you get this? How many times must I repeat that I think subsidizing healthcare would be great! Health insurance is not the same as healthcare, as all the metrics on U.S. healthcare spending, life expectancy and healthcare outcomes show...
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Re: What comes after the ACA?
« Reply #1620 on: March 16, 2017, 09:52:07 AM »
Japan has a mandated price list for every procedure and they seem to do ok.

But...freedom!!!11!

There's a brief but good article about Japan and MRIs. At the time of the article, MRIs in Japan cost $160. That's crazy cheap if you've had one in the states. There are a couple reasons -- one is that radiologists make less money; the other is that machines just cost less than in the US. Like 2x less. Why? Because the manufacturers can.

http://www.npr.org/templates/story/story.php?storyId=120545569

Metric Mouse

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Re: What comes after the ACA?
« Reply #1621 on: March 16, 2017, 09:54:07 AM »
No - you did not say it was better to "subsidize healthcare."  Providing emergency room services is not that.  You state your opinion as if it is fact.  And I disagree with your opinion.  If you provide some evidence - I'll look at it.  Until then - I call you on it. 

Re: tax liability.  You said "I'm happy to pay for lifesaving care."  That statement implies you pay taxes that pay for such.  I don't think you do.  Do you?  If not then what you are really saying is you are happy for me to pay for other's lifesaving care.  If I'm paying for it - I'd rather pay for a single payor system so that everybody gets the healthcare they need.

Do you even know what you're arguing, or have you simply decided I was wrong and feel the need to rebut me?

Life-saving emergency care IS healthcare. That is literally what people get when they go into emergency rooms - healthcare. Since you say it is not, what would you say that it is people receive when they go to emergency rooms? I honestly can't think of any description of the acts that occur in an ER that is not synonomous with 'healthcare'.

Taxes are not used to pay for ER care for those unable to pay. This was settled above - so any taxes I (or anyone) pay or do not pay are not used for that purpose. I'm sorry you don't wish to pay for ER care for poor people; I think it is important for ER care to happen no matter one's ability to pay or not, but that is something we can disagree on.
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Metric Mouse

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Re: What comes after the ACA?
« Reply #1622 on: March 16, 2017, 09:57:51 AM »
Japan has a mandated price list for every procedure and they seem to do ok.
Cue all the people who will argue "You can't price shop when you need healthcare; it'll be an emergency!!" and "You can't know the price of a procedure going in! It's too complicated!". So tired of these arguments.
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Re: What comes after the ACA?
« Reply #1623 on: March 16, 2017, 10:07:06 AM »
Please don't change your argument and please stop saying that Blue states want Red states to pay for their insurance.  That simply isn't true.  And most Blue states do have care for the elderly and poor that Red states do no.

If Blue states do not have universal healthcare/insurance, why is this? Is it too expensive without federal money? If so, then they are by definition taking money from other states to fund their own programs.

If it is not because it is too expensive, then it must be because Democrats don't want it as badly as they claim. Looking at the national politics, it would seem this is the case.

The Dems did not have the votes.  They were short by one.  Franken was mired in a recount.  Then Kennedy died.  Lieberman refused to support the public option, the end.
Ahh - so now we can agree Democrats are not perhaps as united on this front as some of their supporters claim, and we can stop with the "Democrats wanted single payer, but republicans wouldn't give it to them" nonsense. If they don't have enough support even in their own ranks for single payer, it's hardly fair to blame the other guys, and makes both parties particularly useless in this particular issue.
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bacchi

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Re: What comes after the ACA?
« Reply #1624 on: March 16, 2017, 10:07:41 AM »
Japan has a mandated price list for every procedure and they seem to do ok.
Cue all the people who will argue "You can't price shop when you need healthcare; it'll be an emergency!!" and "You can't know the price of a procedure going in! It's too complicated!". So tired of these arguments.

That's a national common fee schedule, not a per provider or per insurance fee schedule. If you go to a hospital, any hospital, you know that a bypass will cost generally $14,760. That's a big difference from each provider setting their own prices for each medical emergency for each patient for each insurance plan.

Japan is also a good medical destination. There are sometimes "tourist" prices but they still beat any hospital in the US.

jim555

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Re: What comes after the ACA?
« Reply #1625 on: March 16, 2017, 10:19:51 AM »
The whole "rack rate" thing in the US is a total scam.  I don't know how they have gotten away with it for this long.

Exflyboy

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Re: What comes after the ACA?
« Reply #1626 on: March 16, 2017, 10:24:11 AM »
The whole "rack rate" thing in the US is a total scam.  I don't know how they have gotten away with it for this long.

Really you don't?....:)

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Re: What comes after the ACA?
« Reply #1627 on: March 16, 2017, 11:05:24 AM »
If Blue states do not have universal healthcare/insurance, why is this? Is it too expensive without federal money? If so, then they are by definition taking money from other states to fund their own programs.

Not when, overall, more cash is flowing from that state to the federal government than is coming back to that state from the federal government.
The first step is acknowledging you have a problem, right?

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Re: What comes after the ACA?
« Reply #1628 on: March 16, 2017, 11:16:18 AM »
If Blue states do not have universal healthcare/insurance, why is this? Is it too expensive without federal money? If so, then they are by definition taking money from other states to fund their own programs.

Not when, overall, more cash is flowing from that state to the federal government than is coming back to that state from the federal government.
My point exactly. If it's not too expensive, then there must be another reason that it hasn't been implemented in blue states.
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jim555

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Re: What comes after the ACA?
« Reply #1629 on: March 16, 2017, 11:19:10 AM »
The medical lobby is very strong even in blue states, that is why things are the way they are.

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Re: What comes after the ACA?
« Reply #1630 on: March 16, 2017, 11:26:58 AM »
If Blue states do not have universal healthcare/insurance, why is this? Is it too expensive without federal money? If so, then they are by definition taking money from other states to fund their own programs.

Not when, overall, more cash is flowing from that state to the federal government than is coming back to that state from the federal government.
My point exactly. If it's not too expensive, then there must be another reason that it hasn't been implemented in blue states.

What? No. You're just talking in circles now.

States like California are paying out more than they're getting back. If they weren't paying Mississippi for existing, then they'd have more money to fund their own healthcare program.
The first step is acknowledging you have a problem, right?

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Re: What comes after the ACA?
« Reply #1631 on: March 16, 2017, 11:28:53 AM »
If it's not too expensive, then there must be another reason that it hasn't been implemented in blue states.

Subsidized/free universal coverage only really works if everyone gets it and everyone pays for it.  If my state pays for it but anyone can come here and take advantage, then my state system will collapse.

They need some way to exclude out out state people from getting free healthcare.  Countries with universal coverage accomplish this with immigration restrictions and citizenship requirements, but the US is built on free markets operating across state lines.  If you live in NJ but could get free care from NY or PA taxpayers, you are likely to abuse the system.

The "universal" part of universal health care means paid for by everyone, not just available to everyone.

Rocket

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Re: What comes after the ACA?
« Reply #1632 on: March 16, 2017, 11:32:22 AM »
I'm thinking and hoping that Universal healthcare will come slowly state by state.  Just like in Canada where province after province enacted a public option until finally it was done.  California is already talking about it.  Mass is another likely state to do something.  "America will always do the right thing but only after exhausting all other possibilities", pretty much sums up are current dilemma.

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Re: What comes after the ACA?
« Reply #1633 on: March 16, 2017, 11:38:10 AM »
If it's not too expensive, then there must be another reason that it hasn't been implemented in blue states.

Subsidized/free universal coverage only really works if everyone gets it and everyone pays for it.  If my state pays for it but anyone can come here and take advantage, then my state system will collapse.

They need some way to exclude out out state people from getting free healthcare.  Countries with universal coverage accomplish this with immigration restrictions and citizenship requirements, but the US is built on free markets operating across state lines.  If you live in NJ but could get free care from NY or PA taxpayers, you are likely to abuse the system.

The "universal" part of universal health care means paid for by everyone, not just available to everyone.

This is exactly why states who wish to be more progressive provide subsidized insurance for residents, rather than free/universal healthcare.

sol

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Re: What comes after the ACA?
« Reply #1634 on: March 16, 2017, 11:43:49 AM »
I'm thinking and hoping that Universal healthcare will come slowly state by state.  Just like in Canada where province after province enacted a public option until finally it was done.  California is already talking about it.  Mass is another likely state to do something.  "America will always do the right thing but only after exhausting all other possibilities", pretty much sums up are current dilemma.

Large liberal states can already do this.  The market is healthy in NY and MA and WA and CA, these places would be thrilled to offer universal coverage to their citizens if they didn't have to pay so much in taxes to support rural red states.

But liberals want all Americans to have better care, and widening the wealth gap by punishing rural red state voters, even if it's what they've been taught to say they want, does not make America stronger.

Sometimes I think we should just let Trump screw the poor red states.  His policies are good for me, as a wealthy white married professional.  But then I remember that I'm not a total dickhead, and I would feel bad for letting that giant orange cheeto ruin America while I prosper.

thenextguy

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Re: What comes after the ACA?
« Reply #1635 on: March 16, 2017, 11:49:23 AM »
I'm thinking and hoping that Universal healthcare will come slowly state by state.  Just like in Canada where province after province enacted a public option until finally it was done.  California is already talking about it.  Mass is another likely state to do something.  "America will always do the right thing but only after exhausting all other possibilities", pretty much sums up are current dilemma.

Canada has a single-payer system. Just to be clear, that's much different than what is referred to as a "public option" as it relates to the health care debates in the US. The public option was intended to be an insurer run by the government that sold plans on the ACA exchanges.

Scortius

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Re: What comes after the ACA?
« Reply #1636 on: March 16, 2017, 11:50:10 AM »
If Blue states do not have universal healthcare/insurance, why is this? Is it too expensive without federal money? If so, then they are by definition taking money from other states to fund their own programs.

Not when, overall, more cash is flowing from that state to the federal government than is coming back to that state from the federal government.
My point exactly. If it's not too expensive, then there must be another reason that it hasn't been implemented in blue states.

I'm a supporter of the public option, and I do think this is a somewhat interesting point. Vermont tried to do exactly this and it failed.

A few reasons I can think of that might suggest this would work at the Federal level but not the State level.
  • It's been proven to work just fine at the Federal level by almost every other first-world country.
  • A system limited to a single state's boundary allows for 'seepage', where outside people come in, and national health companies pull out.
  • A state's ability to fund such a system is much more limited as compared to the US Government.
I'm not an expert though, so I'd be curious to hear other opinions.


NoStacheOhio

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Re: What comes after the ACA?
« Reply #1637 on: March 16, 2017, 11:52:02 AM »
Sometimes I think we should just let Trump screw the poor red states.  His policies are good for me, as a wealthy white married professional.  But then I remember that I'm not a total dickhead, and I would feel bad for letting that giant orange cheeto ruin America while I prosper.

Donate here to assuage your guilt: https://ramusa.org/
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Exflyboy

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Re: What comes after the ACA?
« Reply #1638 on: March 16, 2017, 12:03:40 PM »
If Blue states do not have universal healthcare/insurance, why is this? Is it too expensive without federal money? If so, then they are by definition taking money from other states to fund their own programs.

Not when, overall, more cash is flowing from that state to the federal government than is coming back to that state from the federal government.
My point exactly. If it's not too expensive, then there must be another reason that it hasn't been implemented in blue states.

I'm a supporter of the public option, and I do think this is a somewhat interesting point. Vermont tried to do exactly this and it failed.

A few reasons I can think of that might suggest this would work at the Federal level but not the State level.
  • It's been proven to work just fine at the Federal level by almost every other first-world country.
  • A system limited to a single state's boundary allows for 'seepage', where outside people come in, and national health companies pull out.
  • A state's ability to fund such a system is much more limited as compared to the US Government.
I'm not an expert though, so I'd be curious to hear other opinions.

I think we might seepage right of the country.. Sad

Metric Mouse

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Re: What comes after the ACA?
« Reply #1639 on: March 16, 2017, 12:13:20 PM »
If it's not too expensive, then there must be another reason that it hasn't been implemented in blue states.

Subsidized/free universal coverage only really works if everyone gets it and everyone pays for it.  If my state pays for it but anyone can come here and take advantage, then my state system will collapse.

They need some way to exclude out out state people from getting free healthcare.  Countries with universal coverage accomplish this with immigration restrictions and citizenship requirements, but the US is built on free markets operating across state lines.  If you live in NJ but could get free care from NY or PA taxpayers, you are likely to abuse the system.

The "universal" part of universal health care means paid for by everyone, not just available to everyone.
Why would anyone be allowed to use it? Why would it not be open only to residents of that state? No different if someone is a visitor to Canada; they don't get free healthcare just because they drove up to Toronto for the weekend. Again, blue states are already paying for far more than their citizens use, so a little bit of abuse, which is probably inevitable in any system, wouldn't destroy the program. As was pointed out, Canada did this very thing at a province by province level - didn't collapse their system.

I'm not even saying full single-payer system either; what about a state that just completely subsidized insurance for everyone? I mean, one example of universal health insurance/coverage being adopted by a state other than a Republican state. I have not heard of one.

I just don't buy the argument that 'We, the richest states in the Union (who pay to fund the entire government) can't afford it without those broke red states we already give money to pitching in money they don't have. Also, we want them to have it too, so if everybody can't have it, then no one can.' I mean, the Federal Government gets all of its money from citizens and the states, so it would be the same money just circulating a different direction.
« Last Edit: March 16, 2017, 12:22:13 PM by Metric Mouse »
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Rocket

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Re: What comes after the ACA?
« Reply #1640 on: March 16, 2017, 12:17:35 PM »
Thanks for the clarification, you are correct.  I'm in favor of a single payer system. 

I'm thinking and hoping that Universal healthcare will come slowly state by state.  Just like in Canada where province after province enacted a public option until finally it was done.  California is already talking about it.  Mass is another likely state to do something.  "America will always do the right thing but only after exhausting all other possibilities", pretty much sums up are current dilemma.

Canada has a single-payer system. Just to be clear, that's much different than what is referred to as a "public option" as it relates to the health care debates in the US. The public option was intended to be an insurer run by the government that sold plans on the ACA exchanges.

JLee

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Re: What comes after the ACA?
« Reply #1641 on: March 16, 2017, 12:51:50 PM »
As mentioned, this seems to be what Americans voted for. The poor voted to pay fort their own healthcare, even though it would cost the rich less.

Most Trump voters don't get their healthcare from Medicaid or Obamacare. They are a-ok under this plan. For now at least.

And to be fair, Trump promised better health care. None of us believed a word of it, but I guess the poor Trump voters did.
Do you have stats on that? Seems like a large number of people live in Republican states that expanded medicaid, and they still vited for Trump.  Or is your argument that no poor people voted for Trump?

To be fair, Obama  made similar promises. Better healthcare cheaper. Didn't happen either. Seems like it's a complex issue.

http://www.businessinsider.com/exit-polls-who-voted-for-trump-clinton-2016-11/#the-racial-divide-between-democratic-and-republican-voters-was-clear-3

By income, Clinton led only among voters with a 2015 family income under $50,000

A minority of people in the <$50K group voted Trump.
A majority of people in the >$50K group voted Trump.

Most people in the >$50K group get health insurance through work or Medicare. They aren't on Medicaid.

I think it's correct to say that most Trump voters don't get their healthcare from Medicaid or Obamacare. They are fine under this new plan, because it doesn't affect them. For now at least.

Another perspective: http://fivethirtyeight.com/features/education-not-income-predicted-who-would-vote-for-trump/

JLee

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Re: What comes after the ACA?
« Reply #1642 on: March 16, 2017, 12:55:52 PM »
If it's not too expensive, then there must be another reason that it hasn't been implemented in blue states.

Subsidized/free universal coverage only really works if everyone gets it and everyone pays for it.  If my state pays for it but anyone can come here and take advantage, then my state system will collapse.

They need some way to exclude out out state people from getting free healthcare.  Countries with universal coverage accomplish this with immigration restrictions and citizenship requirements, but the US is built on free markets operating across state lines.  If you live in NJ but could get free care from NY or PA taxpayers, you are likely to abuse the system.

The "universal" part of universal health care means paid for by everyone, not just available to everyone.
Why would anyone be allowed to use it? Why would it not be open only to residents of that state? No different if someone is a visitor to Canada; they don't get free healthcare just because they drove up to Toronto for the weekend. Again, blue states are already paying for far more than their citizens use, so a little bit of abuse, which is probably inevitable in any system, wouldn't destroy the program. As was pointed out, Canada did this very thing at a province by province level - didn't collapse their system.

I'm not even saying full single-payer system either; what about a state that just completely subsidized insurance for everyone? I mean, one example of universal health insurance/coverage being adopted by a state other than a Republican state. I have not heard of one.

I just don't buy the argument that 'We, the richest states in the Union (who pay to fund the entire government) can't afford it without those broke red states we already give money to pitching in money they don't have. Also, we want them to have it too, so if everybody can't have it, then no one can.' I mean, the Federal Government gets all of its money from citizens and the states, so it would be the same money just circulating a different direction.

I've had STI testing done (free) when I was in Canada for a summer.  I've also gone for an emergency eye doctor's appointment - the initial emergency visit, the followup visit, and the prescription combined cost about half of what my single follow-up (involving no treatment - just validation that I was fine) in the US cost (WITH INSURANCE).

So no, not "free" -- but I'm not sure your perspective is quite accurate either.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1643 on: March 16, 2017, 01:16:44 PM »
I've had STI testing done (free) when I was in Canada for a summer.  I've also gone for an emergency eye doctor's appointment - the initial emergency visit, the followup visit, and the prescription combined cost about half of what my single follow-up (involving no treatment - just validation that I was fine) in the US cost (WITH INSURANCE).

So no, not "free" -- but I'm not sure your perspective is quite accurate either.
Isn't this just highlighting the fact that USA has expensive healthcare, while displaying my exact argument that Universal Healthcare states could rather easily charge people from other areas?
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JLee

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Re: What comes after the ACA?
« Reply #1644 on: March 16, 2017, 01:21:20 PM »
I've had STI testing done (free) when I was in Canada for a summer.  I've also gone for an emergency eye doctor's appointment - the initial emergency visit, the followup visit, and the prescription combined cost about half of what my single follow-up (involving no treatment - just validation that I was fine) in the US cost (WITH INSURANCE).

So no, not "free" -- but I'm not sure your perspective is quite accurate either.
Isn't this just highlighting the fact that USA has expensive healthcare, while displaying my exact argument that Universal Healthcare states could rather easily charge people from other areas?

Yep. I just wanted to point out that Canada will happily accommodate non-residents.

Iplawyer

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Re: What comes after the ACA?
« Reply #1645 on: March 16, 2017, 01:45:15 PM »
Please don't change your argument and please stop saying that Blue states want Red states to pay for their insurance.  That simply isn't true.  And most Blue states do have care for the elderly and poor that Red states do no.

If Blue states do not have universal healthcare/insurance, why is this? Is it too expensive without federal money? If so, then they are by definition taking money from other states to fund their own programs.

If it is not because it is too expensive, then it must be because Democrats don't want it as badly as they claim. Looking at the national politics, it would seem this is the case.

The Dems did not have the votes.  They were short by one.  Franken was mired in a recount.  Then Kennedy died.  Lieberman refused to support the public option, the end.
Ahh - so now we can agree Democrats are not perhaps as united on this front as some of their supporters claim, and we can stop with the "Democrats wanted single payer, but republicans wouldn't give it to them" nonsense. If they don't have enough support even in their own ranks for single payer, it's hardly fair to blame the other guys, and makes both parties particularly useless in this particular issue.

Are you dense?  Blue states pay more to the feds than they get back and it goes to   ... Red states.  Maybe if Blue states only had to pay for themselves they'd offer universal health care.  And some Blue states do have some form of health care even though they are subsidizing Red states.  California and Mass. are examples.

MOD EDIT: Rule #1.
« Last Edit: March 22, 2017, 06:32:20 AM by arebelspy »

Iplawyer

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Re: What comes after the ACA?
« Reply #1646 on: March 16, 2017, 01:53:40 PM »
No - you did not say it was better to "subsidize healthcare."  Providing emergency room services is not that.  You state your opinion as if it is fact.  And I disagree with your opinion.  If you provide some evidence - I'll look at it.  Until then - I call you on it. 

Re: tax liability.  You said "I'm happy to pay for lifesaving care."  That statement implies you pay taxes that pay for such.  I don't think you do.  Do you?  If not then what you are really saying is you are happy for me to pay for other's lifesaving care.  If I'm paying for it - I'd rather pay for a single payor system so that everybody gets the healthcare they need.

Do you even know what you're arguing, or have you simply decided I was wrong and feel the need to rebut me?

Life-saving emergency care IS healthcare. That is literally what people get when they go into emergency rooms - healthcare. Since you say it is not, what would you say that it is people receive when they go to emergency rooms? I honestly can't think of any description of the acts that occur in an ER that is not synonomous with 'healthcare'.

Taxes are not used to pay for ER care for those unable to pay. This was settled above - so any taxes I (or anyone) pay or do not pay are not used for that purpose. I'm sorry you don't wish to pay for ER care for poor people; I think it is important for ER care to happen no matter one's ability to pay or not, but that is something we can disagree on.

Nothing was "settled" above.  You always express your opinion as fact, when, in fact, it is just your opinion.  I have a line item on my taxes for the public hospital that funds those that do not pay.   

A cancer patient cannot get chemotherapy at the emergency room - even though it is life saving.  Therefor - I'd rather provide that patient with proper care for their entire treatment instead of trips to the emergency room while they are dying without it. 

I have asked you numerous times not to put words in my mouth.  Please show where I ever said that I don't think poor people should get life saving care at an ER.  I think poor people should get the healthcare they need.  That is what I have said over and over.  But you try very hard to twist things and divert and pivot. 

Why don't you want poor people to have the healthcare they need - like chemotherapy? 

NESailor

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Re: What comes after the ACA?
« Reply #1647 on: March 16, 2017, 02:28:18 PM »


The Dems did not have the votes.  They were short by one.  Franken was mired in a recount.  Then Kennedy died.  Lieberman refused to support the public option, the end.

Wasn't Joe from Connecticut?  Why would he ever oppose the public option?  Oh yeah...Aetna and Cigna are CT companies.  Even if the majority of Democratic voters support universal coverage/care, we know it's not really the individual voters who shape public policy as expressed by our elected officials.  And we were so close 8 years ago...:)

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Re: What comes after the ACA?
« Reply #1648 on: March 17, 2017, 06:02:10 PM »


The Dems did not have the votes.  They were short by one.  Franken was mired in a recount.  Then Kennedy died.  Lieberman refused to support the public option, the end.

Wasn't Joe from Connecticut?  Why would he ever oppose the public option?  Oh yeah...Aetna and Cigna are CT companies.  Even if the majority of Democratic voters support universal coverage/care, we know it's not really the individual voters who shape public policy as expressed by our elected officials.  And we were so close 8 years ago...:)

I believe Lieberman was an Independent, initially a Democrat, but lost the primary so he ran in the general election as an Independent and he won.

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Re: What comes after the ACA?
« Reply #1649 on: March 20, 2017, 12:11:20 AM »
AARP sent out a notice that AHCA kills older people with high premiums calling it an age tax.  Like magic Paul Ryan is making noises that the tax credits need to be higher for the older age bands.  The maniac caucus definitely won't be on board for more handouts of O-care Lite.