Author Topic: What comes after the ACA?  (Read 352733 times)

gerardc

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Re: What comes after the ACA?
« Reply #1650 on: March 20, 2017, 02:05:57 AM »
To those that think doctors are overpaid:

Please tell me what is more important than your health.

I would personally prefer that the best and brightest attend med school and are able to cure whatever shit I get myself into.  Without superior compensation the majority of those able to get through the process would NEVER consider it.

That argument is way too simplistic.

Getting food on your table is literally more crucial to your life than health care. Does that mean we should pay farmers and cashiers at Safeway $300k/year? No, because it's not that hard.

Similarly, being a doctor isn't that hard nowadays. You basically follow a handbook and (admittedly complex) set of rules to cure someone. Quality of care isn't determined by a doctor intelligence, but mostly by advances in medical sciences, and research for new treatments and drugs. Physicians merely apply knowledge of the medical field. You can pay a premium to get kids with 180 IQ to be your doctor, but they can only do so much with the current state of medecine. This becomes more true every day with advances in AI applied to medecine.

Time to realize as a society that we can get good affordable basic care for everyone, if only we stop putting those people on pedestals and letting them dictacte any price they want. They're not as powerful as they once were in the Middle Age.

So your grandma argument of "what is more important than health?" isn't any better than saying "we need air so let's charge everyone 100k a year for breathing it". Doesn't need to be that way, and isn't outside the US.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1651 on: March 20, 2017, 03:59:35 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.

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.
Such a funny world. Blue states need more states rights and a smaller government to provide for their citizens and red states need more federal funding and larger safety nets to provide for theirs - everyone seems to vote against their self interests.
« Last Edit: March 20, 2017, 05:48:11 AM by Metric Mouse »
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Iplawyer

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Re: What comes after the ACA?
« Reply #1652 on: March 20, 2017, 05:33:26 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.

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.

Metric Mouse - Please try and follow.  The Democrats were ONE VOTE short of being able to do a single payer plan.  Please stop obfuscating the point.  And by the way - had Kennedy not died - we would have a single payer plan today.  Period.

You made the statement that Blue states wanted Red states to pay for their insurance.  When I prove to you that it is just your opinion - and your opinion is WRONG - you don't honorably admit that and let it go - NO - you pivot the argument to another one of your OPINIONS that if Blue states wanted to they could provide universal health care to their citizens.  You never acknowledge that anything you say is wrong - maybe even an outright lie - like when you say that I don't want people to have life-saving care - and you move on to your next unsupportable claim.  You are a lot like somebody else in that regard.  And you are no longer credible at all.

And as far as state wide politics are concerned - I've already proven to you that Blue states are forced to give way more money to the feds than they get from the feds to support the Red states.  If they could have that money for themselves - they could have universal coverage for their citizens.  However - they cannot because they are being forced to SUPPORT THE RED STATES. So why are you continuing down this road? 

The polls show that more people support the ACA than don't.(http://www.cnn.com/2017/02/24/politics/pew-survey-obamacare-support-record-high/)  There may be some people that ended up with what they consider worse options.  But for over 20 million people - it was the only way that they could get insurance.  AS FOR ME - I'D RATHER PAY MORE TAXES TO HELP THOSE AMONG US THAT NEED  A HELPING HAND TO GET ALL THE HEALTHCARE THEY NEED FOR A NORMAL LIFE.  TrumpCare will put the old and poor out on the street again.  And while they may be able to go to the emergency room if they need imminent life saving care - they cannot go for care that would allow them to live normal lives or get ongoing life care like insulin for diabetes. 

I might remind you that you will not be young forever.  And - you cannot know for sure what your future holds.  How much 'stache do you need just pay your health insurance between the ages of 50 and when you will qualify for medicare if it still exists?  If that number is $20K per year - you'll need at least another $300K saved to retire - just for health insurance.

If TrumpCare passes and/or they do away with the capital gains medicare tax - I will benefit greatly.   But I'd rather that did not happen.  I'd rather the poor and elderly get health care.  So until and unless the GOP can come up with a plan that gets the old and poor healthcare - not just "access" then the ACA is the best thing we have.  Because "access" at a cost of $20K a year means that must won't be able to afford that "access."
« Last Edit: March 20, 2017, 05:57:27 AM by Iplawyer »

Metric Mouse

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Re: What comes after the ACA?
« Reply #1653 on: March 20, 2017, 05:49:27 AM »
Metric Mouse - Please try and follow.  The Democrats were ONE VOTE short of being able to do a single payer plan.  Please stop obfuscating the point.  And by the way - had Kennedy not died - we would have a single payer plan today.  Period.
Source?
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Iplawyer

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Re: What comes after the ACA?
« Reply #1654 on: March 20, 2017, 05:58:46 AM »
Metric Mouse - Please try and follow.  The Democrats were ONE VOTE short of being able to do a single payer plan.  Please stop obfuscating the point.  And by the way - had Kennedy not died - we would have a single payer plan today.  Period.
Source?

As soon as you supply a source for your many, many unsubstantiated claims - I will dig up a source for this. 

MOD EDIT: You two need to stop.
« Last Edit: March 22, 2017, 06:35:37 AM by arebelspy »

Metric Mouse

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Re: What comes after the ACA?
« Reply #1655 on: March 20, 2017, 05:59:45 AM »
Metric Mouse - Please try and follow.  The Democrats were ONE VOTE short of being able to do a single payer plan.  Please stop obfuscating the point.  And by the way - had Kennedy not died - we would have a single payer plan today.  Period.
Source?

As soon as you supply a source for your many, many unsubstantiated claims - I will dig up a source for this.
https://yourlogicalfallacyis.com/tu-quoque

MOD EDIT: You two need to stop.
« Last Edit: March 22, 2017, 06:36:36 AM by arebelspy »
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infogoon

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Re: What comes after the ACA?
« Reply #1656 on: March 20, 2017, 08:01:05 AM »
One other thing to consider in the discussion about "why don't blue states just set up their own single-payer system?" is that states are not uniformly blue. I live in New York, which is widely considered to be about as blue as it gets -- but really, that's just for statewide elections like Senators and Presidential electors, where the population of New York City drowns out the votes from the rest of the state. Huge swaths of the state are rural Republican strongholds, and I don't see the state-level legislators from those areas wanting anything to do with single-payer.

Look at this map from the last Gubernatorial election, and bear in mind that the Democratic candidate won in a landslide, by nearly fifteen points.

https://en.wikipedia.org/wiki/New_York_gubernatorial_election,_2014#/media/File:New_York_Governor_Election_Results_by_County,_2014.svg

thenextguy

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Re: What comes after the ACA?
« Reply #1657 on: March 20, 2017, 08:49:38 AM »
Metric Mouse - Please try and follow.  The Democrats were ONE VOTE short of being able to do a single payer plan.  Please stop obfuscating the point.  And by the way - had Kennedy not died - we would have a single payer plan today.  Period.

I'm sorry, but this is completely untrue. Neither Obama nor Clinton ran on a single payer plan in 2008. And at no point was single payer up for discussion in 2009 after Obama won. Kennedy died in August of 2009, the health care plan was in development for several months prior to that and single payer was never being considered.

Iplawyer

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Re: What comes after the ACA?
« Reply #1658 on: March 20, 2017, 09:36:20 AM »
Metric Mouse - Please try and follow.  The Democrats were ONE VOTE short of being able to do a single payer plan.  Please stop obfuscating the point.  And by the way - had Kennedy not died - we would have a single payer plan today.  Period.

I'm sorry, but this is completely untrue. Neither Obama nor Clinton ran on a single payer plan in 2008. And at no point was single payer up for discussion in 2009 after Obama won. Kennedy died in August of 2009, the health care plan was in development for several months prior to that and single payer was never being considered.

The house passed a "public option" and the senate thought it had time to reconcile its plan and the house plan but it did not because Mass. electected a republican to replace Ted Kennedy.  Please review your history. The intent was to have a public option in the end.

thenextguy

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Re: What comes after the ACA?
« Reply #1659 on: March 20, 2017, 10:05:30 AM »
Metric Mouse - Please try and follow.  The Democrats were ONE VOTE short of being able to do a single payer plan.  Please stop obfuscating the point.  And by the way - had Kennedy not died - we would have a single payer plan today.  Period.

I'm sorry, but this is completely untrue. Neither Obama nor Clinton ran on a single payer plan in 2008. And at no point was single payer up for discussion in 2009 after Obama won. Kennedy died in August of 2009, the health care plan was in development for several months prior to that and single payer was never being considered.

The house passed a "public option" and the senate thought it had time to reconcile its plan and the house plan but it did not because Mass. electected a republican to replace Ted Kennedy.  Please review your history. The intent was to have a public option in the end.

The public option and a single payer system are different things. By definition the mere fact that there is an option negates the possibility of a single payer.

Iplawyer

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Re: What comes after the ACA?
« Reply #1660 on: March 20, 2017, 11:14:51 AM »
Metric Mouse - Please try and follow.  The Democrats were ONE VOTE short of being able to do a single payer plan.  Please stop obfuscating the point.  And by the way - had Kennedy not died - we would have a single payer plan today.  Period.

I'm sorry, but this is completely untrue. Neither Obama nor Clinton ran on a single payer plan in 2008. And at no point was single payer up for discussion in 2009 after Obama won. Kennedy died in August of 2009, the health care plan was in development for several months prior to that and single payer was never being considered.

The house passed a "public option" and the senate thought it had time to reconcile its plan and the house plan but it did not because Mass. electected a republican to replace Ted Kennedy.  Please review your history. The intent was to have a public option in the end.

The public option and a single payer system are different things. By definition the mere fact that there is an option negates the possibility of a single payer.

It was generally considered at the time that the public option would become single payer because insurance companies would not have been able to compete with the government.  That was both a pro and a con for it.   

Paul der Krake

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Re: What comes after the ACA?
« Reply #1661 on: March 20, 2017, 11:47:03 AM »
Oh please. Single payer means it's mostly the government, then additional private insurance if you so choose.

You know, just like every other country that has implemented "single payer". Everybody who has spent just 10 minutes researching different systems understands this.



doggyfizzle

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Re: What comes after the ACA?
« Reply #1662 on: March 20, 2017, 12:36:34 PM »
It was generally considered at the time that the public option would become single payer because insurance companies would not have been able to compete with the government.  That was both a pro and a con for it.

What about all the different Medicare Advantage plans that compete with Medicare and seem to be plenty profitable for Humana, UnitedHealth, etc?  My point is that I believe eventually most of the O-care plans would have turned a profit for the insurers that chose to participate; judging the success in just the first couple years seems silly, especially since reliable access to healthcare has been so difficult for so many people in this country that make a bit too much for Medicaid but didn't have employer-provided insurance, were not Medicare-eligible, had a pre-existing medical condition that allowed for policy cancellation, etc.  Below is a link to an article about a company and suggested ACA improvements from my state (California) I've followed with interest for years:

http://www.healthcarefinancenews.com/news/molina-aca-success-story-backs-fixing-law-over-replacing-it

Iplawyer

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Re: What comes after the ACA?
« Reply #1663 on: March 20, 2017, 06:11:49 PM »
Oh please. Single payer means it's mostly the government, then additional private insurance if you so choose.

You know, just like every other country that has implemented "single payer". Everybody who has spent just 10 minutes researching different systems understands this.

Whatever - since most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now.  Everybody who has spend just 10 minutes researching would understand this.  And given that most would have gone with the cheaper public option - what are you saying is the difference.  It's mostly government, then additional private insurance if you so choose.

Iplawyer

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Re: What comes after the ACA?
« Reply #1664 on: March 20, 2017, 06:13:14 PM »
It was generally considered at the time that the public option would become single payer because insurance companies would not have been able to compete with the government.  That was both a pro and a con for it.

What about all the different Medicare Advantage plans that compete with Medicare and seem to be plenty profitable for Humana, UnitedHealth, etc?  My point is that I believe eventually most of the O-care plans would have turned a profit for the insurers that chose to participate; judging the success in just the first couple years seems silly, especially since reliable access to healthcare has been so difficult for so many people in this country that make a bit too much for Medicaid but didn't have employer-provided insurance, were not Medicare-eligible, had a pre-existing medical condition that allowed for policy cancellation, etc.  Below is a link to an article about a company and suggested ACA improvements from my state (California) I've followed with interest for years:

http://www.healthcarefinancenews.com/news/molina-aca-success-story-backs-fixing-law-over-replacing-it

Medicare advantage doesn't compete with Medicare - it works with Medicare.

jim555

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Re: What comes after the ACA?
« Reply #1665 on: March 20, 2017, 06:35:35 PM »
Oh please. Single payer means it's mostly the government, then additional private insurance if you so choose.

You know, just like every other country that has implemented "single payer". Everybody who has spent just 10 minutes researching different systems understands this.

Whatever - since most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now.  Everybody who has spend just 10 minutes researching would understand this.  And given that most would have gone with the cheaper public option - what are you saying is the difference.  It's mostly government, then additional private insurance if you so choose.
In NY ACA Medicaid is all by Managed Care companies like UHC, BCBS, Fidelis, etc.  They are paid a flat monthly capitation fee per enrollee.  Each has its own network of doctors.  Much like Medicare Advantage.

Iplawyer

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Re: What comes after the ACA?
« Reply #1666 on: March 20, 2017, 09:10:00 PM »
Oh please. Single payer means it's mostly the government, then additional private insurance if you so choose.

You know, just like every other country that has implemented "single payer". Everybody who has spent just 10 minutes researching different systems understands this.

Whatever - since most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now.  Everybody who has spend just 10 minutes researching would understand this.  And given that most would have gone with the cheaper public option - what are you saying is the difference.  It's mostly government, then additional private insurance if you so choose.
In NY ACA Medicaid is all by Managed Care companies like UHC, BCBS, Fidelis, etc.  They are paid a flat monthly capitation fee per enrollee.  Each has its own network of doctors.  Much like Medicare Advantage.

And it is still a single payor system. The plans have to provide the services dictated by ACA and the state and New York pays for it. 

Metric Mouse

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Re: What comes after the ACA?
« Reply #1667 on: March 21, 2017, 03:33:31 AM »
Oh please. Single payer means it's mostly the government, then additional private insurance if you so choose.

You know, just like every other country that has implemented "single payer". Everybody who has spent just 10 minutes researching different systems understands this.

Whatever - since most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now.  Everybody who has spend just 10 minutes researching would understand this.  And given that most would have gone with the cheaper public option - what are you saying is the difference.  It's mostly government, then additional private insurance if you so choose.
This is an incredibly weak argument. Now you're actually arguing that we have a single payer system healthcare system in the US? Brovo for the spin...

MOD EDIT: No need to be rude.  Attack the argument, not the person.
« Last Edit: March 22, 2017, 06:35:05 AM by arebelspy »
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Iplawyer

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Re: What comes after the ACA?
« Reply #1668 on: March 21, 2017, 07:40:23 AM »
Oh please. Single payer means it's mostly the government, then additional private insurance if you so choose.

You know, just like every other country that has implemented "single payer". Everybody who has spent just 10 minutes researching different systems understands this.

Whatever - since most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now.  Everybody who has spend just 10 minutes researching would understand this.  And given that most would have gone with the cheaper public option - what are you saying is the difference.  It's mostly government, then additional private insurance if you so choose.
This is an incredibly weak argument. Now you're actually arguing that we have a single payer system healthcare system in the US? Brovo for the spin...

METRIC MOUSE - PLEASE STOP SAYING THAT I SAID THINGS I DID NOT SAY.  YOU DO IT OVER AND OVER AND OVER AGAIN. 

I said, and I quote,  "most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now." 

Metric Mouse

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Re: What comes after the ACA?
« Reply #1669 on: March 21, 2017, 07:47:47 AM »
Oh please. Single payer means it's mostly the government, then additional private insurance if you so choose.

You know, just like every other country that has implemented "single payer". Everybody who has spent just 10 minutes researching different systems understands this.

Whatever - since most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now.  Everybody who has spend just 10 minutes researching would understand this.  And given that most would have gone with the cheaper public option - what are you saying is the difference.  It's mostly government, then additional private insurance if you so choose.
This is an incredibly weak argument. Now you're actually arguing that we have a single payer system healthcare system in the US? Brovo for the spin...

METRIC MOUSE - PLEASE STOP SAYING THAT I SAID THINGS I DID NOT SAY.  YOU DO IT OVER AND OVER AND OVER AGAIN. 

I said, and I quote,  "most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now."
Whew. I thought you were arguing again that Democrats wanted single payer, when they clearly voted for something else. Sorry for my confusion. The conflating of public option insurance and Medicaid and the quote
Quote
since most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now.
did throw me off. Clearly didn't mean to mis quote you.
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Re: What comes after the ACA?
« Reply #1670 on: March 21, 2017, 07:57:34 AM »
If we were to start from scratch we would have a single payer system for health care in the US.

But now there are too many vested interests that would lobby Congress to prevent that.

So we now have a complex system, a public/private partnership, with insurance companies that under the ACA are tightly regulated.

It's not the perfect system, but the ACA is now the most effective way to reach out to the uninsured.
Yes ACA should be improved upon, not repealed. The Republicans clearly are lost and unable to come up with a better plan than the ACA, and what they have come up with will throw millions of people off of  having any health insurance.
It's clear which party is trying to help people, and which party is ideologically off the rails. To claim that both political parties are doing the same thing is completely inaccurate.

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Re: What comes after the ACA?
« Reply #1671 on: March 21, 2017, 08:07:58 AM »
If we were to start from scratch we would have a single payer system for health care in the US.

But now there are too many vested interests that would lobby Congress to prevent that.
I don't know that the bolded part is true. While I would vastly prefer such a system, I'm not sure America as a whole agrees with me, as evidenced by the previous systems was have tried.
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Re: What comes after the ACA?
« Reply #1672 on: March 21, 2017, 08:09:00 AM »
So, back to the topic... While my preference is to have single payer, that's not what's available right now.

Trumpcare goes for a vote today and seems dead in the water. Predictions for what comes next? Another draft? Seems like the problem for the Republicans is the rift between the hard right (repeal ACA, who cares about the implications) and the moderate right (can't repeal ACA without addressing the effects). I don't know how they reach consensus.

Any speculation?

Iplawyer

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Re: What comes after the ACA?
« Reply #1673 on: March 21, 2017, 08:11:47 AM »
If we were to start from scratch we would have a single payer system for health care in the US.

But now there are too many vested interests that would lobby Congress to prevent that.

So we now have a complex system, a public/private partnership, with insurance companies that under the ACA are tightly regulated.

It's not the perfect system, but the ACA is now the most effective way to reach out to the uninsured.
Yes ACA should be improved upon, not repealed. The Republicans clearly are lost and unable to come up with a better plan than the ACA, and what they have come up with will throw millions of people off of  having any health insurance.
It's clear which party is trying to help people, and which party is ideologically off the rails. To claim that both political parties are doing the same thing is completely inaccurate.

Exactly - and the Dems did try to get the public option.  The house plan had it, the senate plan did not, Congress thought they had time to reconcile the two - but a republican was voted in in Mass. so they did not have the chance to reconcile and get the public option.  In any case - the Dems tried to provide everyone affordable health care.  They succeeded for most on the ACA by opening up Medicaid to so many and highly subsidizing so many others.  Personally - I think we should expand Medicare and the Medicare tax and cover everyone.  We are an affluent country that can afford to provide for all.  And I'd much rather everyone had healthcare than a silly border wall.

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Re: What comes after the ACA?
« Reply #1674 on: March 21, 2017, 08:12:40 AM »
So, back to the topic... While my preference is to have single payer, that's not what's available right now.

Trumpcare goes for a vote today and seems dead in the water. Predictions for what comes next? Another draft? Seems like the problem for the Republicans is the rift between the hard right (repeal ACA, who cares about the implications) and the moderate right (can't repeal ACA without addressing the effects). I don't know how they reach consensus.

Any speculation?

I think the vote is on Thursday.
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Re: What comes after the ACA?
« Reply #1675 on: March 21, 2017, 08:17:08 AM »
Trumpcare goes for a vote today and seems dead in the water. Predictions for what comes next? Another draft? Seems like the problem for the Republicans is the rift between the hard right (repeal ACA, who cares about the implications) and the moderate right (can't repeal ACA without addressing the effects). I don't know how they reach consensus.

Any speculation?

I speculate that they'll pass a watered down version.  Republicans seem pretty unified in their desire to deconstruct Medicaid, restrict abortion rights, and repeal the ACA taxes.  Even if they can't agree on how to restructure the subsidies, or anything else, I think they will all get behind those three things and pass that more limited version, while blaming the Democrats for their inability to do more.

Iplawyer

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Re: What comes after the ACA?
« Reply #1676 on: March 21, 2017, 08:18:10 AM »
Trumpcare goes for a vote today and seems dead in the water. Predictions for what comes next? Another draft? Seems like the problem for the Republicans is the rift between the hard right (repeal ACA, who cares about the implications) and the moderate right (can't repeal ACA without addressing the effects). I don't know how they reach consensus.

Any speculation?

I speculate that they'll pass a watered down version.  Republicans seem pretty unified in their desire to deconstruct Medicaid, restrict abortion rights, and repeal the ACA taxes.  Even if they can't agree on how to restructure the subsidies, or anything else, I think they will all get behind those three things and pass that more limited version, while blaming the Democrats for their inability to do more.

The cannot gut the taxes without taking away the subsidies. 

thenextguy

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Re: What comes after the ACA?
« Reply #1677 on: March 21, 2017, 08:20:05 AM »
Oh please. Single payer means it's mostly the government, then additional private insurance if you so choose.

You know, just like every other country that has implemented "single payer". Everybody who has spent just 10 minutes researching different systems understands this.

Whatever - since most of the these people covered under the ACA are on Medicaid - it is essentially a single payer plan now.  Everybody who has spend just 10 minutes researching would understand this.  And given that most would have gone with the cheaper public option - what are you saying is the difference.  It's mostly government, then additional private insurance if you so choose.

It is not "essentially a single payer plan" now.

Quote
Medicaid might account for slightly more than half of those who gained coverage. Most people wouldnít say that amounts to the vast majority, but it is likely still the majority.

http://www.politifact.com/truth-o-meter/statements/2017/jan/15/rand-paul/medicaid-expansion-drove-health-insurance-coverage/

As the Politifact mentions, it's difficult to get an accurate count, but most think that slightly more than half who gained coverage under the ACA do so via Medicaid. I'm curious as to how one could make the leap from that reality to "it is essentially a single payer plan now." That's quite a leap.

jim555

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Re: What comes after the ACA?
« Reply #1678 on: March 21, 2017, 08:21:22 AM »
Paul Ryan's Manager's Amendments:
These are to appease the maniac caucus.
The bill is sweetened by drowning a basket of kittens.

https://rules.house.gov/sites/republicans.rules.house.gov/files/115/PDF/115-AHCA-SxS-MNGR-Policy.pdf

NoStacheOhio

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Re: What comes after the ACA?
« Reply #1679 on: March 21, 2017, 08:37:20 AM »
Paul Ryan's Manager's Amendments:
These are to appease the maniac caucus.
The bill is sweetened by drowning a basket of kittens.

https://rules.house.gov/sites/republicans.rules.house.gov/files/115/PDF/115-AHCA-SxS-MNGR-Policy.pdf

This summarizes it nicely: http://www.vox.com/policy-and-politics/2017/3/20/14991750/republican-health-bill-ahca-amendments-changes

Quote
This is a trap for Republicans. Both the process and the substance of the American Health Care Act have revealed a political party that has lost sight of the fact that the true test of legislation isnít whether it passes, but whether it works.

Republican leaders have moved this bill as fast as possible, with as little information as possible, and with no evident plan for what will happen if the bill actually becomes law and wreaks havoc in peopleís lives. This is not the health reform package Donald Trump promised his voters, itís not the health reform package conservative policy experts recommended to House Republicans, and itís not the health reform package that polling shows people want.
The first step is acknowledging you have a problem, right?

https://forum.mrmoneymustache.com/journals/digging-out-of-a-hole/

Metric Mouse

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Re: What comes after the ACA?
« Reply #1680 on: March 21, 2017, 08:56:46 AM »
Paul Ryan's Manager's Amendments:
These are to appease the maniac caucus.
The bill is sweetened by drowning a basket of kittens.

https://rules.house.gov/sites/republicans.rules.house.gov/files/115/PDF/115-AHCA-SxS-MNGR-Policy.pdf
Are these admendments really that bad? I mean, the rest of the bill isn't great, but I don't see how these changes would make it substantially worse. (Excepting possibly some inhabitants of New York City.) Perhaps I'm missing something.
Give me one fine day of plain sailing weather and I can mess up anything.

MustacheMathTM

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #1681 on: March 21, 2017, 09:11:16 AM »
The ACA helped rural states like West Virginia because it expanded Medicaid and provided stability to hospitals and health care systems.
As it turns out West Virginia's decline in coal mining employment has been decades in the making, and mountain top coal mining and destroying the environment won't improve on that metric.
Health care employment is a growing occupation in places like West Virginia, and this employment was bolstered by ACA/Obamacare.
So the one source of growing employment in rural areas will be damaged by the Trump and republican health care changes.

https://krugman.blogs.nytimes.com/2017/03/01/coal-is-a-state-of-mind/

sol

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Re: What comes after the ACA?
« Reply #1682 on: March 21, 2017, 10:34:13 AM »
The cannot gut the taxes without taking away the subsidies.

Why not?

Did you mean to say that they can only cut the taxes without repealing the subsidies if the tax cuts only last for a decade, to avoid the filibuster?

Because if that's the case, I might remind you that the last republican administration, immediately after taking office, also passed massive tax cuts for the rich with a ten year sunset clause in order to avoid a democratic filibuster.  Remember the Bush tax cuts?

I assure you that republicans will do anything and everything in their power to cut taxes on the rich.  Gutting healthcare is just a means to an end.  They would prefer permanent tax cuts, of course, but that doesn't mean they wouldn't be thrilled to get a decade's worth of temporary tax cuts, with each new republican administration.


teen persuasion

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Re: What comes after the ACA?
« Reply #1683 on: March 22, 2017, 05:51:14 AM »
Paul Ryan's Manager's Amendments:
These are to appease the maniac caucus.
The bill is sweetened by drowning a basket of kittens.

https://rules.house.gov/sites/republicans.rules.house.gov/files/115/PDF/115-AHCA-SxS-MNGR-Policy.pdf

This summarizes it nicely: http://www.vox.com/policy-and-politics/2017/3/20/14991750/republican-health-bill-ahca-amendments-changes

Quote
This is a trap for Republicans. Both the process and the substance of the American Health Care Act have revealed a political party that has lost sight of the fact that the true test of legislation isnít whether it passes, but whether it works.

Republican leaders have moved this bill as fast as possible, with as little information as possible, and with no evident plan for what will happen if the bill actually becomes law and wreaks havoc in peopleís lives. This is not the health reform package Donald Trump promised his voters, itís not the health reform package conservative policy experts recommended to House Republicans, and itís not the health reform package that polling shows people want.

Quote
  Changing Medicaid reimbursement procedures in a way that advantages county governments over state governments (for idiosyncratic reasons, Republicans from New York are high on this provision)

You can apparently thank Rep Chris Collins for this piece of idiocy.  NY had pushed a good portion of Medicaid costs down to the county level, and "unfunded mandates" has been a sore spot in NY politics for quite a while.  From what the news mentioned this morning, NY is the only state to do it this way.  As the governor remarked, there us no fairy to suddenly replace the $$$ this new rule would shift away from counties and back to the state level.

  http://www.syracuse.com/politics/index.ssf/2017/03/cuomo_house_gop_health_bill_tells_ny_to_drop_dead.html

http://www.politico.com/story/2017/03/health-care-new-york-medicaid-236328?lo=ap_d1

thenextguy

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Re: What comes after the ACA?
« Reply #1684 on: March 22, 2017, 02:09:15 PM »
Quote
Retirement dreams fizzle for some with 'Obamacare' repeal

Workers dreaming of early retirement are getting the jitters as Washington debates replacing the Obama-era health care law with a system that could be a lot more expensive for many older Americans.

The uncertainty over the cost of coverage in the individual market has caused some in their 50s and early 60s to put plans on hold. Others who already left jobs with health benefits before reaching Medicare age are second-guessing their move to self-employment.

With her mobile home paid off, social worker Mary Lytle-Gaines planned to retire next year and work part time.

(more)

http://abcnews.go.com/Health/wireStory/retirement-dreams-fizzle-obamacare-repeal-46305124

« Last Edit: March 22, 2017, 02:11:13 PM by thenextguy »

Clean Shaven

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Re: What comes after the ACA?
« Reply #1685 on: March 22, 2017, 02:44:02 PM »
Not sure if this was posted somewhere in this thread, but I stumbled across this today:

Kaiser has an interactive map comparing premiums and tax credits between the ACA and AHCA (not the most recent edit of the AHCA, but close-ish):

http://kff.org/interactive/tax-credits-under-the-affordable-care-act-vs-replacement-proposal-interactive-map/

NoStacheOhio

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Re: What comes after the ACA?
« Reply #1686 on: March 23, 2017, 06:28:46 AM »
You can apparently thank Rep Chris Collins for this piece of idiocy.  NY had pushed a good portion of Medicaid costs down to the county level, and "unfunded mandates" has been a sore spot in NY politics for quite a while.  From what the news mentioned this morning, NY is the only state to do it this way.  As the governor remarked, there us no fairy to suddenly replace the $$$ this new rule would shift away from counties and back to the state level.

  http://www.syracuse.com/politics/index.ssf/2017/03/cuomo_house_gop_health_bill_tells_ny_to_drop_dead.html

http://www.politico.com/story/2017/03/health-care-new-york-medicaid-236328?lo=ap_d1

NYS politics are fucking bonkers. All local taxes get routed through Albany, then sent back to the cities/counties. There's also a truly massive ideological split between the Hudson Valley and the rest of the state. It makes the urban/rural split in Ohio look like slightly different shades of grey. It doesn't surprise me even a little bit that this is a result of that system.
The first step is acknowledging you have a problem, right?

https://forum.mrmoneymustache.com/journals/digging-out-of-a-hole/

rantk81

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Re: What comes after the ACA?
« Reply #1687 on: March 23, 2017, 06:39:53 AM »
(Please feel free to ignore the following post. I just feel like ranting right now. I'm not trying to be a jerk... really...)

OK, so I'm not at all happy with the folks that were voted in during the past election... especially not happy with the clown that is residing part-time in the whitehouse right now.

I think affordable healthcare should be a human right that is provided to everyone in this great wealthy country, regardless of income or net worth or state in which you live, or age, or gender, or sexual orientation, or race, or anything.

Well, it seems like the non-coastal folks voted in these clowns... and now these clowns are going to pass a law that directly impacts their voting base in a very bad way.

Well FINE, you redstate folks have it your way. I know for one that I will be better off with much higher HSA contribution limits, and now being able to buy extremely high-deductible catastrophic insurance.  Win for me.  Yeah, we'd all be better off with something else, but this is what YOU wanted, so here's what we're getting.


jim555

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Re: What comes after the ACA?
« Reply #1688 on: March 23, 2017, 07:08:42 AM »
It will eventually dawn on the DJT supporters how much they are getting screwed by him.

Man who attended 45 rallies now opposes Trump
https://www.youtube.com/watch?v=LQbGQvwkw7s

farmecologist

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Re: What comes after the ACA?
« Reply #1689 on: March 23, 2017, 08:10:38 AM »
(Please feel free to ignore the following post. I just feel like ranting right now. I'm not trying to be a jerk... really...)

OK, so I'm not at all happy with the folks that were voted in during the past election... especially not happy with the clown that is residing part-time in the whitehouse right now.

I think affordable healthcare should be a human right that is provided to everyone in this great wealthy country, regardless of income or net worth or state in which you live, or age, or gender, or sexual orientation, or race, or anything.

Well, it seems like the non-coastal folks voted in these clowns... and now these clowns are going to pass a law that directly impacts their voting base in a very bad way.

Well FINE, you redstate folks have it your way. I know for one that I will be better off with much higher HSA contribution limits, and now being able to buy extremely high-deductible catastrophic insurance.  Win for me.  Yeah, we'd all be better off with something else, but this is what YOU wanted, so here's what we're getting.


Well..that's exactly why we are seeing a fair number of Republican house members opposing it.  They are smart enough to know that it will eventually be 'political suicide' in their district to vote for the bill.  I wonder if we will see some abstain from the vote?  Should be interesting to see if they can resist Trump's "I'm coming for you" bully tactics.






infogoon

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Re: What comes after the ACA?
« Reply #1690 on: March 23, 2017, 08:29:09 AM »
You can apparently thank Rep Chris Collins for this piece of idiocy.  NY had pushed a good portion of Medicaid costs down to the county level, and "unfunded mandates" has been a sore spot in NY politics for quite a while.  From what the news mentioned this morning, NY is the only state to do it this way.  As the governor remarked, there us no fairy to suddenly replace the $$$ this new rule would shift away from counties and back to the state level.

  http://www.syracuse.com/politics/index.ssf/2017/03/cuomo_house_gop_health_bill_tells_ny_to_drop_dead.html

http://www.politico.com/story/2017/03/health-care-new-york-medicaid-236328?lo=ap_d1

NYS politics are fucking bonkers. All local taxes get routed through Albany, then sent back to the cities/counties. There's also a truly massive ideological split between the Hudson Valley and the rest of the state. It makes the urban/rural split in Ohio look like slightly different shades of grey. It doesn't surprise me even a little bit that this is a result of that system.

Also, Chris Collins is a gladhanding shitbag.

iowajes

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Re: What comes after the ACA?
« Reply #1691 on: March 23, 2017, 08:32:37 AM »
Quote
That analysis found a 64-year-old earning $26,500 would pay $14,600 out of pocket for insurance under the GOP plan

How can people even be expected to live with this kind of bill? 
How would they pay for rent and food with what is left over after medical insurance?  That is absolutely insane.

Paul der Krake

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Re: What comes after the ACA?
« Reply #1692 on: March 23, 2017, 09:11:00 AM »
NYS politics are fucking bonkers. All local taxes get routed through Albany, then sent back to the cities/counties.
I know nothing about NY, but such a system sounds great. Local taxes only funding your local schools is what drives the ever increasing divide between successful areas and unsuccessful ones, and distorts real estate prices even further. I'd much rather have school funding be pooled and redistributed at the State level.

Schaefer Light

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Re: What comes after the ACA?
« Reply #1693 on: March 23, 2017, 09:16:17 AM »
I think affordable healthcare should be a human right that is provided to everyone in this great wealthy country, regardless of income or net worth or state in which you live, or age, or gender, or sexual orientation, or race, or anything.

Just out of curiosity, what makes something a human right?

waltworks

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Re: What comes after the ACA?
« Reply #1694 on: March 23, 2017, 09:22:58 AM »
I think affordable healthcare should be a human right that is provided to everyone in this great wealthy country, regardless of income or net worth or state in which you live, or age, or gender, or sexual orientation, or race, or anything.

Just out of curiosity, what makes something a human right?

A human right is whatever we collectively decide it is. I mean, free speech, freedom from being enslaved or murdered by those more powerful than you, freedom to practice your religion, etc weren't "human rights" until we collectively created a legal framework that guaranteed those things.

There's nothing stopping us from deciding that free ponies are a human right too (or healthcare in some form). Whether that would be beneficial to society or not could of course be debated.

I guess I don't understand your question. Humans in nature are just animals with no "rights" whatsoever. When we create societies (whether religious or secular) we create a set of ground rules that we sometimes refer to as "rights", but they are inherently made-up moral/ethical constructs. There's no logical way to argue that anything can't be a "right" because a right is whatever we decide it is.

-W

NoStacheOhio

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Re: What comes after the ACA?
« Reply #1695 on: March 23, 2017, 09:26:15 AM »
NYS politics are fucking bonkers. All local taxes get routed through Albany, then sent back to the cities/counties.
I know nothing about NY, but such a system sounds great. Local taxes only funding your local schools is what drives the ever increasing divide between successful areas and unsuccessful ones, and distorts real estate prices even further. I'd much rather have school funding be pooled and redistributed at the State level.

The way we fund schools is idiotic, yes. However, New York is pretty dysfunctional, and Albany only cares about Albany.
The first step is acknowledging you have a problem, right?

https://forum.mrmoneymustache.com/journals/digging-out-of-a-hole/

rpr

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Re: What comes after the ACA?
« Reply #1696 on: March 23, 2017, 09:32:43 AM »
I think affordable healthcare should be a human right that is provided to everyone in this great wealthy country, regardless of income or net worth or state in which you live, or age, or gender, or sexual orientation, or race, or anything.

Just out of curiosity, what makes something a human right?

A human right is whatever we collectively decide it is. I mean, free speech, freedom from being enslaved or murdered by those more powerful than you, freedom to practice your religion, etc weren't "human rights" until we collectively created a legal framework that guaranteed those things.

There's nothing stopping us from deciding that free ponies are a human right too (or healthcare in some form). Whether that would be beneficial to society or not could of course be debated.

I guess I don't understand your question. Humans in nature are just animals with no "rights" whatsoever. When we create societies (whether religious or secular) we create a set of ground rules that we sometimes refer to as "rights", but they are inherently made-up moral/ethical constructs. There's no logical way to argue that anything can't be a "right" because a right is whatever we decide it is.

-W
I agree. We as a society collectively agree on rights. For a long time, one of the agreements was that women did not have the right to vote. So rights can and do change with time as society evolves and changes.

sol

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Re: What comes after the ACA?
« Reply #1697 on: March 23, 2017, 09:38:36 AM »
We as a society collectively agree on rights. For a long time, one of the agreements was that women did not have the right to vote. So rights can and do change with time as society evolves and changes.

At some point in time, I lost my right to own black people.  I mention it only to highlight that rights can evolve to both expand and contract.  Change does not only mean that we add new rights for everybody.  Sometimes, some people need to have their current rights stripped away.
« Last Edit: March 23, 2017, 11:07:04 AM by sol »

Schaefer Light

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Re: What comes after the ACA?
« Reply #1698 on: March 23, 2017, 10:55:11 AM »
I think affordable healthcare should be a human right that is provided to everyone in this great wealthy country, regardless of income or net worth or state in which you live, or age, or gender, or sexual orientation, or race, or anything.

Just out of curiosity, what makes something a human right?

A human right is whatever we collectively decide it is. I mean, free speech, freedom from being enslaved or murdered by those more powerful than you, freedom to practice your religion, etc weren't "human rights" until we collectively created a legal framework that guaranteed those things.

There's nothing stopping us from deciding that free ponies are a human right too (or healthcare in some form). Whether that would be beneficial to society or not could of course be debated.

I guess I don't understand your question. Humans in nature are just animals with no "rights" whatsoever. When we create societies (whether religious or secular) we create a set of ground rules that we sometimes refer to as "rights", but they are inherently made-up moral/ethical constructs. There's no logical way to argue that anything can't be a "right" because a right is whatever we decide it is.

-W

I agree.  I guess what I was getting at was that human rights don't typically require the service of another human being.  Health care requires having people who are capable of administering health care to others.  Free speech, freedom of religion, etc., are rights that anyone can practice and enjoy without the aid of another person.  If we decide that people have a right to something, that implies (at least to my way of thinking) that the government must have the power to force other people to provide that "something".

waltworks

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Re: What comes after the ACA?
« Reply #1699 on: March 23, 2017, 10:58:24 AM »
My assumption is that Schaefer Light was making the argument (a common one) that "healthcare is not a right".

That is only sort of true legally in the US, though. EMTALA (signed into law by Reagan himself) guarantees you healthcare for life threatening conditions regardless of ability to pay and is widely accepted as just/moral/impossible to repeal. I think that would probably give healthcare (at least life-saving healthcare) enough legal standing to talk about it in terms of "rights", though it's status is a bit uncertain since it's not in the constitution, and it only includes emergency treatment.

Even if you disagree with that assessment, there's no point in arguing that "healthcare isn't a right" because rights are whatever we decide they are. Argue that guaranteeing access to healthcare will collectively hurt our society, or that it's inherently unfair to those who can afford it on their own, or something like that. I may not agree with you but at least the argument can be rationally made. 

Forget the rights argument, because it inherently makes no sense.

-W