Author Topic: What comes after the ACA?  (Read 1916306 times)

jim555

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Re: What comes after the ACA?
« Reply #2600 on: June 09, 2017, 12:16:17 PM »
Looks like the Senate wants to vote on 6/30.  No one even knows what is in it and hasn't even been written yet. No prob we will cram it through.  Tax cuts for billionaires MUST move forward!

protostache

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Re: What comes after the ACA?
« Reply #2601 on: June 09, 2017, 01:09:56 PM »
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Agree.  The more I consider it, the more I think the Dems (who are in complete infighting disarray themselves) would benefit more to shut up about impeachment, which isn't likely to happen anyway, and just focus on stopping the most horrifying aspects of the Ryan agenda while letting Trump's flailing make the GOP look bad.  The more miserable Trump is, the more he is likely to lash out at his own party as well as the Dems.  If Trump's base ever does shift at all, the GOP will turn all its attention to battling itself anyway.

On the other hand, there's always the real and frightening aspects of Trump continuing to sit in that office.

What a dumpster fire we're in.

Let's say though that it turns out the election results are determined to be invalid.  Any chance of an emergency special election happening? Even in the event of a successful impeachment, the succession plan ensures we'd be likely be stuck with more of the same types of policies.  In that case I would definitely agree about triaging the most critical areas like health care and climate change.

No. There is nothing in the Constitution that permits anything other than a regular election every four years. We (either Congress or the States) would have to pass an amendment that permits special elections.

nereo

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Re: What comes after the ACA?
« Reply #2602 on: June 09, 2017, 01:23:39 PM »
Any list of supreme court issues is incomplete without the Obergefell decision (re: gay marriage) and the freedom of private entities to discriminate. Evangelicals held their noses and voted for Trump because they expected someone like Gorsuch from him (and he delivered).

They don't regret it at all.
It's worth noting that (AFAIU) Gorsuch has not yet given a single ruling while a member of SCOTUS, nor even participated in arguments.
Most republicans assumed that Justice Roberts (Rehnquist's replacement) was going to be a staunch conservative to match Scalia and & Alito.  In reality his rulings have been less predictable and more centre-right.  He's not the only one to be a surprise

When there's no higher rung on the ladder and no way of being fired justices aren't always what you expect.

dividendman

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Re: What comes after the ACA?
« Reply #2603 on: June 09, 2017, 02:32:32 PM »

I strongly doubt the election results are invalid, because there is no evidence of actual vote tampering at all so far.  Sadly, I think this nation straight up elected Trump according to our current laws. I'm not sure what the process would be in that hypothetical situation, though.

There is a process. Since federal elections are conducted on a state by state basis, the state secretary of state has to confirm the election results. If a state believes their results are invalid or have been tampered with before the secretary has confirmed the results, they can take action.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #2604 on: June 09, 2017, 06:11:36 PM »
I don't think very many people supporting Gorsuch are as concerned about abortion as they are about the rule of law and limitations on government power.  And Gorsuch isn't an excuse.  The U.S. was one vote away from limiting freedom of speech in the political arena (which is almost the only arena that matters), gutting RFRA, negating the second amendment, etc.  Gorsuch was necessary for the right to live to fight another day.

Yes I think the Citizen's United decision needs to be modified, Koch brothers paid for political speech that influences elections needs to end.
RFRA is just an excuse to discriminate against glbt people. No a doctor doesn't have the right to withhold treatment from gay people in an emergency room situation for example.
The 2nd amendment isn't an excuse to have all guns all the time anywhere you want.

protostache

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Re: What comes after the ACA?
« Reply #2605 on: June 09, 2017, 06:48:37 PM »
Diane Feinstein and a bunch of other Democratic senators introduced legislation to remove the income cap on subsidies:

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Under current law, individuals and families making just one dollar more than 400 percent of the federal poverty level ($47,520 for an individual, $80,640 for a family of three) receive no financial help at all. This sharp cut-off contributes to affordability issues in individual markets nationwide.

Under the bill, no individual or family would pay more than 9.69 percent of their monthly income toward health insurance premiums. Currently, 9.69 percent of monthly income is the maximum contribution households are required to make toward their health plan if they make between 300 and 400 percent of the federal poverty level.

This bill will, clearly, not see the light of day in this session. That said, I'm glad that we're seeing some action from the Ds with regards to the problems that clearly need to be fixed in the ACA. If you're looking for more problems and potential solutions, the website ACASignups.net has a long, interesting list of them.

jim555

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Re: What comes after the ACA?
« Reply #2606 on: June 10, 2017, 08:22:10 AM »
They should extend the starting point from 100% FPL to 0% FPL to eliminate the Medicaid gap.  Also cap the max anyone pays for health insurance is 10% based on SLCSP, no matter what your income is.

protostache

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Re: What comes after the ACA?
« Reply #2607 on: June 10, 2017, 08:56:45 AM »
They should extend the starting point from 100% FPL to 0% FPL to eliminate the Medicaid gap.  Also cap the max anyone pays for health insurance is 10% based on SLCSP, no matter what your income is.

The latter is what the bill does, except it caps it at 9.69% instead of 10%. The other change is absolutely needed but I think Dems would rather see all states expand Medicaid. I would expect more bills in both of those directions in the coming months.

chasesfish

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Re: What comes after the ACA?
« Reply #2608 on: June 10, 2017, 10:18:11 AM »
So, I think we'll get an idea of "Trump's Base" with the Karen Handel / John Osoff special election going on in Georgia.   That particular district for 20 years was 1/2 Phil Gingry and 1/2 Newt Gingrich/Tom Price and democrats never bothered running any credible opponents against them during that time frame.   Now there's two really mediocre candidates running against each other (a 30 something democrat who doesn't live in the district running against a republican that manages to finish 2nd in everything she's ever run for).

I've started shopping some estimates for the existing Obamacare plans in potential states, DAMN they're expensive if you run the risk of using them and hitting the out of pocket max.  It would take a year or a year and a half out from retirement before I'd qualify for any subsidies.

I guess that's how we still have millions of uninsured, the penalty is a hell of a lot less than $11,000/year for a Silver plan for two people

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #2609 on: June 10, 2017, 12:29:51 PM »
So, I think we'll get an idea of "Trump's Base" with the Karen Handel / John Osoff special election going on in Georgia.   That particular district for 20 years was 1/2 Phil Gingry and 1/2 Newt Gingrich/Tom Price and democrats never bothered running any credible opponents against them during that time frame.   Now there's two really mediocre candidates running against each other (a 30 something democrat who doesn't live in the district running against a republican that manages to finish 2nd in everything she's ever run for).

I've started shopping some estimates for the existing Obamacare plans in potential states, DAMN they're expensive if you run the risk of using them and hitting the out of pocket max.  It would take a year or a year and a half out from retirement before I'd qualify for any subsidies.

I guess that's how we still have millions of uninsured, the penalty is a hell of a lot less than $11,000/year for a Silver plan for two people

Jon Osoff is not mediocre, and he lives in the district next door as his wife/fiancee is finishing up medical school. He's a highly motivated candidate for office and has done very well in that district for a Democrat, and it's not even supposed to be a competitive district.

If you think $11K is a lot to pay for 2 for a comprehensive medical plan, just think how expensive it is if you come down with a condition that requires medical care !!!

EnjoyIt

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Re: What comes after the ACA?
« Reply #2610 on: June 10, 2017, 12:36:51 PM »
Right, Kathy Griffin, my mistake.  I should have looked it up before I spoke.

Cathy Griffith posted pictures of a decapitated Donald Trump.  To do so she had to have a group of like minded people design everything necessary to take such photos and then post them. In their view of the world, Donald Trump is a monster that should be decapitated, ISIS style. They must have truly believed in their minds and in their hearts that what they were doing is right, and the rest of the US agrees with how they view Donald Trump.

I don't buy that interpretation of events for a second.  Griffin is a comedian who has made herself rich and famous by being deliberately inflammatory.  She partnered with an artist/photographer who is even more inflammatory. Tyler Shields's previous work has focused on graphic depictions of violence and sex, often involving stand-ins for US presidents and other celebrities.  Look him up, the guy's a real piece of shit.  His only goal life is to offend.

So no, I don't think that he thought for one minute that this photo shoot was okay.  He knew it was obscene, and that was the whole point. 

I realize you disagree and of course you would.  Yes, Tyler Shields is a piece of shit, but Kathy felt like she knew what she was doing.  That's the problem with echo chambers, you and your friends always think you are right.  And Tyler was the perfect guy to take advantage of her.  You know that she really believes in what she did because she has the audacity to then say that Trump ruined her life. Instead of realizing she made a mistake cognitive dissidence set in.

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It turns out their perception was wrong.  A very large portion of people believe what Cathy Griffith did was a horrible atrocious act.  How is it possible?

His perception was exactly right.  He knew people would be outraged, and that's the reaction he was hoping for.  That's how he stays "famous".  Like I said, he's a piece of shit.

Still doesn't explain Kathy

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If Seniors are so likely to vote, do you really believe that there is a single candidate willing to destroy their largest base of voters?

I think you've confused the party's voters with the party's constituency. 

The Republican party represents wealthy business interests.  They promote lower taxes on rich people, higher taxes on poor people, and less regulation on what businesses can and can't do.  They want more law enforcement of poor black communities but less law enforcement of white collar crime.  They preach a gospel of individual liberty, unless you are a woman, or gay, or unintentionally pregnant, or brown.  They want fewer restrictions on gun ownership, except in inner cities.

In order to further these interests, they need voters.  In order to get voters, they need money to buy allegiance.  They aren't trying to sway elections by proposing ideas that are important to their voters, they are trying to sway elections by telling their voters which ideas should be important to them.  That strategy requires newspapers and tv networks, AM radio talk show hosts, and elected representatives who can be bought off enough to parrot their lies.  It needs money.  Money comes from wealthy business owners, not voters. 

The Republican health care plan is a giant fuck-you to senior citizens.  Compared to the ACA, their premiums would skyrocket and their coverage would be skimpier.  The GOP health care plan takes healthcare away from millions of poor and elderly Americans in order to pay for a tax cut for the wealthiest Americans.  Who do you think is the real constituency here?

They're not worried about losing the votes of senior citizens.  Those votes can be bought back with enough Fox News coverage about how our seniors made a noble sacrifice to save the country from ruin.  They're only worried about keeping the money flowing, and that means appeasing the Kochs and Adelsons of the world.

Here is the flaw in your statement you think only republicans need money but that is a flat out lie.  Democrats need money too and Hillary raised a hell of a lot more cash from wealthy Americans than Trump did.  Outside of a select few, the reality is that both democrat and republican politicians are scum who will do anything for money and to get reelected. Democrats say they are for the poor but in reality they take money from the rich and only provide the minimum of services to make the poor tolerate them. They should be looking for ways to get the poor out of the slums instead of just providing them with some cheap housing and government subsidized food.  All this does is make those people dependent on those services and vote for more democrats.  It is kinda slimy.  Don't get me wrong, that is not the outcome in totality.  Many people utilize those resources to better themselves, but the reality is that there are more people on social services today than 20 years ago.  Is that a good thing?  I don't, on the one hand it could be that we are providing for more people that really need it.  On the other hand we may have created more dependents that should be able to take care of themselves but don't. Like everything else, I would bet the real answer lies somewhere in the middle.

Also, the ACA did nothing to help senior citizens. And repealing it will do nothing to harm them. Senior Citizens are on Medicare so that topic is kinda moot. It affected reimbursement from Medicare, but does absolutely nothing regarding how senior citizens get medical care. 

I also love the comment regarding cutting taxes for the rich.
1) ACA taxed the rich and therefor repealing it would repeal the tax increase.
2) Since the rich pay the most taxes, obviously any tax cut will affect them the most. duhhh.
3) The comment is just as disingenuous as saying "most Americans don't pay taxes."  That is also not true most Americans pay Social Security, Medicare tax and sales tax.  They don't pay income tax.
4) It is really easy to spin a topic to sound worse than it is using misleading phrasing as I described above.

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Maybe you are wrong and maybe the goal of conservatives is not to "fuck over the elderly."

I used to spend more time and effort trying to give them the benefit of the doubt.  I thought long and hard about why the GOP could possibly think supply side economics would work this time, when it never has before.  Why they thought taking health insurance from tens of millions of Americans would fulfill their campaign promise of coverage for everyone.  About why they think the way to improve public education is to gut its funding, why they think the way to deal with climate change is to make it worse, why they think the way to fight terrorism is to start wars.  The only unifying theme that I found in all of these ideas is (and maybe you're catching on enough that this won't be a surprise at this point) is that all of these seemingly asinine ideas are good for business.  They make even more money for the wealthiest Americans, at the expense of average Americans.  They promote the wealth inequality that is the very foundation of the Republican party.

I'm open to hearing other ideas, if you have any genius suggestions for what alternative unifying theme might motivate such a seemingly disparate array of republican policy positions.

You are correct that there are plenty of far right republicans who are racist horrible human beings.  Just as there are plenty of far left democrats who are equally repugnant for other reasons.  It is disingenuous to judge all republicans and democrats based on the views of the far right and the far left.  There is a middle ground in there where most people actually fall into.  But to think that all republicans, ~50% of the population voted to destroy the poor and the minorities is preposterous. Just as preposterous for a republican to think that democrats are actually communists. 

The reality is that both sides of the isle promote whatever their lobbyists are asking for. I actually believe we need to dismantle the department of education and send all that money back to the states.  Our education has gotten worse since its inception and I think all it does is create more bureaucracy in the education system. Also, democrats fight wars also, Obama and Clinton ordered their own bombings. McCain in my opinion is a pawn of the military complex and will do anything that leads to more military spending.

Supply side economics:  I think there is a line where too much regulation and too much taxes hinders economic growth, while a the same time not enough regulation allows corporations to run wild putting employees and sometimes consumers at risk.Since I know healthcare the most, I think we have crossed that line towards too much regulation. With regards to other commerce I do not know and would prefer to defer my views to someone who lives and understands it better.

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Equally there is a large percentage of poor people who vote conservative.  They also don't think their elected officials are trying to fuck them over.

They've been deceived.  Many poor people who vote republican have been tricked into that support with seductive advertising about "personal responsibility" and "individual liberty" even though our wealthiest citizens don't really believe in any of that.  Trump inherited his fortune and appears to lack a moral compass, how personally responsible is he?  Individual liberty sounds great, unless you're black or gay or muslim, in which case it usually rings a little hollow as the republican party systematically deprives you of your individual liberties.

Kinda funny again, you are the wealthiest of citizens.  The really wealthy, the so called 0.1% is a tiny tiny fraction of the US, many of which buy political power from both sides of the isle. It is all a big orgy of cash for favors.

I would also like to point out that although there are racist republicans out there, the majority are not and have no issues of civil liberty regardless off race or gender.  I'm not quite sure how the republican party deprives you of individual liberties except maybe abortion and gay marriage. Democrats deprive you of liberties like gun control, freedom of speech, and higher taxes.  Maybe it is just the liberties you are willing to give up. I will elaborate, there are some liberals, not all who are willing to slander and even riot when conservatives want to congregate together ad practice their freedom of speech. 

Islam is an in interesting subject regarding human rights.  On the one hand we want to allow people the right of freedom of religion.  But on the other hand the religion preaches homophobia and minimizing the rights of women. Makes the subject very confusing and difficult to agree on the right thing. There is a lot of Islamophobia in the world today, and up until recently there was very little denouncing of radical Islam by Muslim communities. Only in the last few years are we seeing it more publicly.  I think we need a bit more of that to be seen in the media.  Maybe we would have less recruitment of most Muslims were blatant about how wrong that type of thinking is.

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Poor rural white Americans sometimes support the republican party platform of enhancing wealth inequality.  Not because they actually support a system that keeps them poor while enriching the born Trumps of the world, but because they have been deceived into believing that their systematic economic oppression is a necessary part of their perceived economic opportunity.  They want to believe that they too can become rich like Trump, if they just support enough crony capitalist politicians who further enhance wealth inequality, without realizing that their support of those politicians is the very thing preventing them from rising out of poverty.  You think the Trumps of the world give a rat's ass about poor people? 

Again, it is the political system as a whole not just democrats or republicans that are the problem.  Healthcare, the actual topic of this thread is a great example.  Not a single political figure is willing to work on cutting the cost of healthcare.  They still want the corporations on top to make all that money, we just argue about who will foot the bill.

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Some use terms like "class warfare" to describe the liberal movement.  Are the conservative voters just stupid? 

It absolutely IS class warfare, but they'e got the wrong party.  The Democratic party has spent three generations fighting for the rights of blue collar workers, while Republicans further divide America into the haves and the have-nots.  It's Republicans like Trump who are conducting class warfare, by using a calculated public performance of success and wealth to inspire our poorest citizens to self-destructively support further social and economic inequality.  They're like 1850s plantation slaves pressed into service to hunt down runaway slaves with the argument that runaways make it harder for the slaves left behind.

I used the words "class warfare" to describe another bullshit statement. America has amazing ability for class mobility.  All you need is discipline and education.  Yes it is harder if your parents don't promote education or hard work.  But I see so many people of different gender and ethnicity in every level of wealth.  I am a prime example of being a minority starting out in a very poor environment and now living the so called American Dream. Indeed I was lucky that my parents were married and not alcoholics or drug addicts. I am just as lucky I was not born a female in Iran for example. It doesn't mean that government has any ability to change my luck.

Over my short life I see laws passed from both sides of the isle that either help the poor or help the rich but seams to always affect the middle class the most.  I honestly do not believe that democrats have done anything of value for the middle class in the last 30 years.  I have the same comment about the republicans.  Unfortunately all these laws just keep squeezing the middle class the most. ACA is a wonderful example of the middle class being forced to pay more for their own healthcare. Higher taxes affect the middle class the most. The rich can afford a percent or two, The middle class that is scraping by will feel it the most.  I think the middle class getting fucked over is the exact reason why we keep switching between democrats and republicans in office.  They just keep hoping something will be different.

BTW, comparing class warfare to slavery is just as ridiculous as comparing Trump to Hitler. Statements like that are used when logic fails and we need to continue to argue. It would be no different than calling your neighbor a racist because he voted republican last year. Some people believe that using such terminology is a sign of cognitive dissonance.

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What I do know is when we use such blatant comments as "fuck over the poor" or "class warfare" all it shows is that we are stuck in an echo chamber of like minded individuals who may be estranged from reality and the possibility that our perceptions may be flawed.

I don't feel like I'm in an echo chamber, I feel like I'm shouting into the void.  All three branches of US government currently parrot the Trump/Ryan philosophy of America, which I find repulsive.  Everyone around me says the only way to save America is to destroy everything we have built together, and I feel like the one lone rational voice left in a sea of lies, stupidity, and complicity.

I kinda agree with you here except I think we are all stuck in some form of echo chamber. I think our government is very corrupt from far left all the way to far right.  I just don't see many genuine representative any more.  I would love to see some term limits in Congress as that may change things up a bit, but I doubt that will ever happen.

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I choose to use inflammatory language to describe the destruction of the American ethos because I find it a deeply inflammatory development.  I'm always open to having my views changed, if I find an argument that relies on rationality and history and makes a compelling case, but so far that hasn't described anything the GOP has done in the past few cycles.

Unfortunately when you use inflammatory langue that is where you hear your echo the most.  the only people who respond are the like minded folks. Unfortunately, those who have differing views tend to stay quite as they were just insulted by said inflammatory language.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #2611 on: June 10, 2017, 01:08:46 PM »
I honestly do not believe that democrats have done anything of value for the middle class in the last 30 years.

Democrats have enforced labor laws to protect salaried workers from being overworked, and requiring employers to start shelling out more for overtime.
Democrats have provided subsidies to pay for health insurance on the individual market, expanded Medicaid to more lower middle class income groups.
Democrats have strived to lower interest rates on student loans though the Republicans fight this tooth and nail.

ACA is a wonderful example of the middle class being forced to pay more for their own healthcare.
I'm middle class and subsidies have enabled me to afford health insurance that is of good quality.

I think our government is very corrupt from far left all the way to far right.  I just don't see many genuine representative any more. 

The corruption right now is most remarkably occurring in the  Trump administration as oligarchs around the world rent rooms in Trump hotels and buy Trump development properties to curry favor with the president.

"Saudi lobbyists spent large sums at the Trump Washington hotel."
Wrecking the Ship of State https://nyti.ms/2s3dMb1
http://thehill.com/homenews/administration/336444-saudis-spent270000-at-trump-hotel-as-part-of-lobbying-efforts-report
« Last Edit: June 10, 2017, 01:13:54 PM by DavidAnnArbor »

chasesfish

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Re: What comes after the ACA?
« Reply #2612 on: June 10, 2017, 01:56:58 PM »
It's actually 25k if sick because it's $11,000 + $14,5000 out of pocket.

We'll agree to disagree on Osoff, the guys only job is being a staffer for the congressman who asked if Guam fell over.

That being said, Karen Handel will find a way to finish second, republicans eat their own and could loose this district.

I'm all for healthcare, but I'm not going to pretend the ACA will work without enforcing a mandate,  Obama didn't enforce it nor will trump.  No health insurance, no tax refund, period.

nereo

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Re: What comes after the ACA?
« Reply #2613 on: June 10, 2017, 03:05:27 PM »
Quote from:  EnjoyIt
Islam is an in interesting subject regarding human rights.  On the one hand we want to allow people the right of freedom of religion.  But on the other hand the religion preaches homophobia and minimizing the rights of women. Makes the subject very confusing and difficult to agree on the right thing. There is a lot of Islamophobia in the world today, and up until recently there was very little denouncing of radical Islam by Muslim communities. Only in the last few years are we seeing it more publicly.  I think we need a bit more of that to be seen in the media.  Maybe we would have less recruitment of most Muslims were blatant about how wrong that type of thinking is

As I was reading this I couldn't help but make parallels to Catholicism for most of our country's history and many sects of Christianity even today. And I say this as a lifelong catholic.
I know several people that are practicing muslims in the western/northern European style.  I find them far more progressive and tolerant than people from my birthplace in Virginia that identify as "deeply religious christians". Those are the sorts I see protesting the gay pride parades and pushing for a "defense of marriage act" and whatnot.

I also think you have it completely backwards regarding Muslim leaders not calling out extremists - the trepidation for many Muslim leaders to denounce extremists within the faith is relatively new.  This is in part because many militant groups have become so damn powerful that public denouncations can be downright dangerous.  It's also not a coincidence that their increasing leathality comes after we've spent decades and billions arming and training this faction or that faction, all the way back to the soviets.

EnjoyIt

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Re: What comes after the ACA?
« Reply #2614 on: June 11, 2017, 08:51:38 AM »
DavidAnnArbor,
You say the ACA subsidies have helped you while right below is Chasesfish who feels screwed over by the available ACA options. Also, the student loans that are so easily given out is the reason why higher education is so over priced. Our children are really eating screwed over by that one.

Nereo,
I agree Islam is paralleling many religions. Unfortunately there has been so much death and evil done in Gods name. Not just Islam but all religions. If you are right that the Islamic leaders are afraid to speak out these days, it is really sad because I fear that will lead to even more violence. Looking at countries that have a high percentage of Muslim immigrants you tend to see a higher incidence in violence. Without good leadership to teach real morals those areas will continue to suffer and islamophophia will worsen. If it took Cristianty close to 1900 years to mature out of death, violence and bigotry, we may have a long way to go to see similar from Islam.

beltim

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Re: What comes after the ACA?
« Reply #2615 on: June 11, 2017, 10:18:30 AM »
Looking at countries that have a high percentage of Muslim immigrants you tend to see a higher incidence in violence.

Citation needed.  In most countries, including the US, immigrants are less likely to commit crime (violent or otherwise) than the native-born population.


http://www.nber.org/papers/w13229
http://onlinelibrary.wiley.com/doi/10.1111/j.1745-9125.2009.00162.x/abstract
https://www.americanimmigrationcouncil.org/research/criminalization-immigration-united-states
https://www.ncjrs.gov/criminal_justice2000/vol_1/02j.pdf

EnjoyIt

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Re: What comes after the ACA?
« Reply #2616 on: June 11, 2017, 12:41:34 PM »
Beltim, I think there are no studies out there specifically towards Muslim immigration that I can find.  My thinking can very well be biased based on my mind being brainwashed by media. I would like to say I am amendable to change that thinking. Allow me to elaborate my thoughts and then allow you to give your feedback. I hope to not be closed minded on the subject which is very difficult to do.

I look at 3 countries in particular Sweden, Germany and France wh have some of the heist influx of Muslim refugees and immigrants. In Sweden currently 67 people are sexually assaulted per 100,000 making Sweden the 5th highest sexual assault country in the world. Not all are from Muslim immigrants, but it is still a very large percentage in a population that is only 5% Muslim.
http://www.nationalreview.com/article/445169/sweden-rape-sexual-assault-non-muslim-immigrants

We then look at Germany and France that have seen an increase in terrorism and rape in the last decade. Lastly, we can't continue without bringing up England and the recent 3 attacks in the last 3 months.

The problem doesn't necessarily lie with muslims in general.  In America for example, we have a very stringent refugee pathway that can take up to 18-24 months to be approved access into the US.  Also, the US imports people of wealth and intelligence.  Many of American Muslims are scientists and as we all know eduction is the biggest weapon against radicalization and crime.  On the other hand, Sweden, France, and Germany have imported a large percentage of poor, uneducated people who come from a world of Shiria Law.  If we look into what Shiria Law means we come to understand that homosexuality is a crime, women are treated as second class citizens who are prosecuted themselves if they are raped and report it.  In Sweden for example there is a 42% unemployment rate in muslim immigrants.  What do you think will happen when they have no jobs and no money and live on government subsidies alone? Imagine you growing up in a country where women are barely allowed to show their face, are not allowed to speak for themselves, and are "honor killed" if they claim they were raped.  Now you are 25 years old imagine being placed in a country with no job and little money where women wear skimpy clothes and are so damn sexy.  The result is inevitable.  But I believe with good leadership and education this pathway can change.

BTW, regarding refugees, about 4 months ago I did not understand how stringent the US refugee policy was, and agreed that we needed to properly vet these people.  Turns out after educating myself I learned our vetting process is sufficient and does not require any further action. I say this because I would like to think that I am amendable to changing my views.

As humans we are bombarded with tons of information. To keep any form of sanity our brain learns to ignore most of it. For example right now I hear my AC running, but until I decided to look for some noise I ignored it completely.  Same goes regarding news and information. Our brains are designed to ignore what we perceive as unimportant.  By doing that we start to create views of the world around us that fits what we see and happen to not ignore.  We subconsciously take in just the information we want that sits well with our preconceived views of the world and ignore everything else. This is where our biases come in and no one is immune to those biases. It is why we can have two people discuss the exact same event but with completely different results.  A perfect example is the Affordable Care Act that shows 20 million people now have health insurance and some lower paid americans get subsidies. The other side of the story shows 20 million people received health insurance where most can't afford their deductibles and also the cost of healthcare has skyrocketed to the middle class that is outside the subsidy level. Right above this post is DavidAnnArbor and Chasesfish proving my point precisely.  Both sides of the story are accurate but how the results are perceived can be argued for 2500+ posts.

Why I mention this. Sometimes to get the whole story we really need to dig through the weeds and try to see both sides of the argument in the hopes of not ignoring all the details.

Looking at countries that have a high percentage of Muslim immigrants you tend to see a higher incidence in violence.

Citation needed.  In most countries, including the US, immigrants are less likely to commit crime (violent or otherwise) than the native-born population.


http://www.nber.org/papers/w13229
http://onlinelibrary.wiley.com/doi/10.1111/j.1745-9125.2009.00162.x/abstract
https://www.americanimmigrationcouncil.org/research/criminalization-immigration-united-states
https://www.ncjrs.gov/criminal_justice2000/vol_1/02j.pdf

chasesfish

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Re: What comes after the ACA?
« Reply #2617 on: June 11, 2017, 04:05:18 PM »
DavidAnnArbor,
You say the ACA subsidies have helped you while right below is Chasesfish who feels screwed over by the available ACA options. Also, the student loans that are so easily given out is the reason why higher education is so over priced. Our children are really eating screwed over by that one.

I want to say I have mixed feelings about the ACA, I still think the challenge is neither party is willing to tell the constituents bad news.  There's only a few viable options available and we keep playing in the middle..

1) We go to a government & private system, where everyone has access to Veterans Admin style care, then people with means pay for something better.  This is most of the world, with even the best government options still have the wealthiest patients leaving the country for faster care.

2) We go to a mandatory insurance system, where you enforce the mandate or charge a flat fee against the tax returns for a medicare option.  Its not an optional fee, you either prove continuous private coverage or get charged a line-item fee on your tax return for medicaid. 

Right now, the charity care in ERs is being covered by all the people paying.  With the current track of the ACA or the replacement plan the House passed, you're going to run out of payers for the number of takers.   The fallacy in the numbers about "X amount more will lose coverage under the ACHA" is it assumes for-profit insurers will keep taking sustained losses or will be directly subsidized by the government. 

Both sides need to grow up and admit where this is heading.  Instead we just putz around and inefficiently deliver care through ERs when a patient gets really bad.

gaja

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Re: What comes after the ACA?
« Reply #2618 on: June 11, 2017, 04:17:35 PM »
Rape statistics say more about women's trust in police, and the society's attitude towards rape victims, than anything else. Sweden is an extreme example of that:
1. Have you ever met a Swede? They are the most law abiding people you will ever see. If they found a fiver in the street, they would go to the police and get a report written about it. The same goes for sexual harassment, rape, molestation, etc. You can't compare the reported numbers in that kind of country, with the numbers in Dubai, where a woman reporting a rape will get arrested for having sex outside the marriage.
2. What is the definition of rape? Do you count rape if it happens inside the marriage? Is it rape if sexual organs are touched, or only if they are penetrated? Does it count as rape if the woman wanted to say no, or only if she screamed and fought? The Swedes include a lot more in their "sexual offences" category than most other countries, including indecent exposure and prostitution.
3. If a woman breakes out of an abusive relationship and reports that she was raped by her boyfriend 110 times over the last 5 years - how do you count that in the statistics? Most countries count one case, the Swedes will register all 110 rapes as separate cases.

The last thing alone caused the Swedish rape statistics to skyrocket around 2013, when the laws for what should be counted sas a sexual offence, and how the statistics should be reported, changed. http://www.bbc.com/news/uk-politics-39056786


Sure, there are problems in the Nordic countries too, and we should have done much more to integrate the refugees. Also, I have zero respect for the attitudes shown by some of the old geezers coming here, thinking they should be placed on pedestals just because they are old men. I absolutely support forcing them to attend classes in feminism and how to treat women. But honestly, most of the sex offenders and misogynists are homemade pasty white "christian" idiots.

jim555

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Re: What comes after the ACA?
« Reply #2619 on: June 11, 2017, 05:05:26 PM »
I wish we would keep this thread on topic.  This issue will have a lot of news in the next few months.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #2620 on: June 11, 2017, 07:01:47 PM »
  A perfect example is the Affordable Care Act that shows 20 million people now have health insurance and some lower paid americans get subsidies. The other side of the story shows 20 million people received health insurance where most can't afford their deductibles and also the cost of healthcare has skyrocketed to the middle class that is outside the subsidy level.

As has been discussed in GoCurryCracker's blog, as well as the Tax forum on this blog, if you lower your AGI by contributing to a self employed 401K plan, a tIRA, and an HSA account, you can qualify for ACA health insurance subsidies even with an upper middle income.

If you're married filing joint you have even less of an income hurdle to meet for ACA subsidies, than someone single like me.

But if you're making $200,000 no you're not going to get healthcare subsidies.

The Democrats at least are trying to make qualifying for the subsidies a more gradual transition. The Republicans continue their scorched earth opposition to improving the ACA, and in so doing will destroy the lives of millions who will lose access to healthcare.

brooklynguy

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Re: What comes after the ACA?
« Reply #2621 on: June 12, 2017, 08:39:05 AM »
This issue will have a lot of news in the next few months.

Unfortunately not nearly as much as there should be, at least not when it really matters.  Senate Republicans, despite their vow not to repeat the House's rushed and surreptitious legislative process, are working on their repeal bill in secret, behind closed doors, with no apparent plans for public hearings, and with the reported intention of getting a bill on the Senate floor for a vote before the month is out.  Public scrutiny is their enemy--what they're trying to do is both unsound and deeply unpopular, and they know it--so they're trying to jam it through quickly and quietly, away from the eyes of the press and the public, which in any case are distracted by the machinations of the executive branch.

nereo

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Re: What comes after the ACA?
« Reply #2622 on: June 12, 2017, 09:23:12 AM »
This issue will have a lot of news in the next few months.

Unfortunately not nearly as much as there should be, at least not when it really matters.  Senate Republicans, despite their vow not to repeat the House's rushed and surreptitious legislative process, are working on their repeal bill in secret, behind closed doors, with no apparent plans for public hearings, and with the reported intention of getting a bill on the Senate floor for a vote before the month is out.  Public scrutiny is their enemy--what they're trying to do is both unsound and deeply unpopular, and they know it--so they're trying to jam it through quickly and quietly, away from the eyes of the press and the public, which in any case are distracted by the machinations of the executive branch.

I wonder, if under those circumstances, the senate wants their bill to pass or die a quiet death.  Either the Senate passes something close to what the House passed (bettering its chance or ultimate signing) OR they pass something more moderate (thereby ensuring it'll die in the House). With either strategy they somehow have to ensure that Cruz/Paul/Lee will be happy enough with it to support while also keeping moderate GOPers like Portman/Capito/Collins.

I can't imagine many lawmakers are thrilled with the idea of approving a plan which is currently so unpopular when the midterm campaign cycle is about six months away.  Certainly some of them have to see the historical irony in voting for a plan which could cause a groundswell of opposition.

Then again, most of the GOP senators are safe this cycle, so this would basically be launching a live grenade back into the House..

EnjoyIt

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Re: What comes after the ACA?
« Reply #2623 on: June 12, 2017, 09:36:47 AM »


As has been discussed in GoCurryCracker's blog, as well as the Tax forum on this blog, if you lower your AGI by contributing to a self employed 401K plan, a tIRA, and an HSA account, you can qualify for ACA health insurance subsidies even with an upper middle income.

If you're married filing joint you have even less of an income hurdle to meet for ACA subsidies, than someone single like me.

But if you're making $200,000 no you're not going to get healthcare subsidies.

The Democrats at least are trying to make qualifying for the subsidies a more gradual transition. The Republicans continue their scorched earth opposition to improving the ACA, and in so doing will destroy the lives of millions who will lose access to healthcare.

Most Americans are not maximizing their retirement accounts and HSA accounts.  Actually most American's have no idea what an HSA is, or how to save for retirement.  Therefor, for most Americans the advice of GoCurryCracker are useless.  When most Americans live paycheck to paycheck or close to it paying $10k/yr for their families health insurance and another $12k/yr in deductibles for chronic conditions is simply not affordable. 

I mentioned this earlier.  We can't just look at a small segment of society and think it is a representation of everyone.  The likeminded Mustachians around you are very able to cut their taxable income by saving $42,500/yr in joint 401ks and HSA accounts.  Unfortunately you are missing the rest of the US who doesn't think exactly like you.


Both sides need to grow up and admit where this is heading.  Instead we just putz around and inefficiently deliver care through ERs when a patient gets really bad.

Agreed


Gaja,
I don't think you read what I wrote.  My comment was for sexual assault and not rape.  You assumed I said rape because of the public rhetoric, but I strategically used the word sexual assault knowing exactly what you wrote.  Regarding the sexual assault, in a country that approximately 5% Muslim where almost 40% of said Muslims are jobless living in so called projects getting government subsidies. The crime rate is disproportionately >5% committed by said Muslims.  It just shows that Muslims in Sweden commit more crime than non Muslims.  Also, based on the birthrates of Muslims and non Muslims that 5% figure will double to 10% in the next 10-15 years and will likely double again 15 years later.  Hopefully during this expansion there will be education and economic growth to sustain this population of people or more crime and sexual assault is to be expected. Again, education and employment should fix the problem but difficult to sustain without economic growth and a leadership that is willing to tackle the education process.

And yes, most Swedes are amazingly nice, good hearted people which is probably why they are in the current predicament they are in today.  I also find the healthcare in Sweden very interesting.  (I hope the next section is about Sweden and I'm not confusing it with another country.) In particular I am amazed that after someone in Sweden falls and gets a cut, after they get it repaired by a doctor, the government will provide the patient with money because they sustained a scar.  Scars on the face pay out more than scars on the torso.  It makes no difference if the scar was self inflicted or not. To me this is a very peculiar practice.

sol

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Re: What comes after the ACA?
« Reply #2624 on: June 12, 2017, 10:20:09 AM »
Most Americans are not maximizing their retirement accounts and HSA accounts.  Actually most American's have no idea what an HSA is, or how to save for retirement.  Therefor, for most Americans the advice of GoCurryCracker are useless. 

Most Americans are overweight because they eat too much fast food and watch to much television.  That is totally irrelevant to the utility of healthy lifestyle advice.  The advice is still good, even if people are too dumb to listen. 

What you're doing is akin to blaming fit people for fat people being fat.  Fat people are fat because they made bad choices, not because they were given bad advice by healthy people on how to be healthy.

Next you're going to tell me that seatbelts are useless because some people don't wear them.  Is it the seat belt industry's fault that dumb people don't buckle up?

nereo

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Re: What comes after the ACA?
« Reply #2625 on: June 12, 2017, 10:46:58 AM »
The NYTimes has an interesting article about how the new AHCA would limit workers flexibility, and how this is becoming an emergent issue in the fight to repeal/repace the ACA:

Quote
    The Affordable Care Act has enabled many of those workers to get transitional coverage that provides a bridge to the next phase of their lives — a stopgap to get health insurance if they leave a job, are laid off, start a business or retire early. If the Republican replacement plan approved by the House becomes law, changing jobs or careers could become much more difficult.

https://www.nytimes.com/2017/06/11/health/health-insurance-transitional-coverage.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news&_r=0

EnjoyIt

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Re: What comes after the ACA?
« Reply #2626 on: June 12, 2017, 11:23:21 AM »
Most Americans are not maximizing their retirement accounts and HSA accounts.  Actually most American's have no idea what an HSA is, or how to save for retirement.  Therefor, for most Americans the advice of GoCurryCracker are useless. 

Most Americans are overweight because they eat too much fast food and watch to much television.  That is totally irrelevant to the utility of healthy lifestyle advice.  The advice is still good, even if people are too dumb to listen. 

What you're doing is akin to blaming fit people for fat people being fat.  Fat people are fat because they made bad choices, not because they were given bad advice by healthy people on how to be healthy.

Next you're going to tell me that seatbelts are useless because some people don't wear them.  Is it the seat belt industry's fault that dumb people don't buckle up?

If I was to follow your logic, then we should not blame the poor people for being lazy and not getting an education and having $100k+ incomes so that they can afford their own healthcare. You and I both know that is silly, just as your examples above.

I am simply showing that for many middle class Americans healthcare is extremely expensive and has gotten more expensive due to the ACA. Yes it helped many Americans get coverage, especially those with preexisting conditions which is a positive aspect of the law.  But we can't be so naive as to ignore the rest of the population who have been financially squeezed by the same law.  Even those who qualify for subsidies still must come up with the high deductibles that they still can't afford.

Gin1984

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Re: What comes after the ACA?
« Reply #2627 on: June 12, 2017, 11:44:33 AM »
The NYTimes has an interesting article about how the new AHCA would limit workers flexibility, and how this is becoming an emergent issue in the fight to repeal/repace the ACA:

Quote
    The Affordable Care Act has enabled many of those workers to get transitional coverage that provides a bridge to the next phase of their lives — a stopgap to get health insurance if they leave a job, are laid off, start a business or retire early. If the Republican replacement plan approved by the House becomes law, changing jobs or careers could become much more difficult.

https://www.nytimes.com/2017/06/11/health/health-insurance-transitional-coverage.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news&_r=0
My husband was looking at jobs and one place he did not apply because they don't give insurance for the first 90 days. 

sol

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Re: What comes after the ACA?
« Reply #2628 on: June 12, 2017, 11:53:32 AM »
The whole point of this website is that making good financial decisions is a skill everyone needs, regardless of income.  You can retire early if you save more than half your income, and it doesn't matter how much you make.  Doctors can live paycheck to paycheck just as easily as can retail workers.  Retail workers can retire early just as result as can doctors.  There is always someone living a happier life than you on half of your income.

The fact that a majority of Americans make bad financial decisions and refuse to optimize their spending in order to qualify for heavily subsidized ACA healthcare does not mean that heavily subsidized ACA healthcare isn't a wonderful benefit that is available to them.  Some old people refuse to sign up for Medicare, too, but that doesn't mean Medicare sucks.

For most Americans (literally most, as in more than half) the ACA has either lowered their healthcare costs or given them access to healthcare where they previously had none.  It caps the cost to them by subsidizing all costs above 10% of their income.  It has been hugely successful at expanding coverage and limiting the cost to consumers, and less successful at slowing the cost increases charged by providers, but it has made up the difference with taxes on the very wealthiest people who already have extra income and aren't harmed by the taxes as much as poor people are harmed by not getting medical care.  It's been a net benefit to society.

The places where the ACA is struggling are the places where health insurance was already struggling before the ACA, rural areas with too few providers and too few insurers.  That is not the fault of a program that increased the pool of paying patients.  If anything, the ACA gets blamed for regional failures in places where it has marginally improved an already disastrous situation.


DavidAnnArbor

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Re: What comes after the ACA?
« Reply #2629 on: June 12, 2017, 01:40:36 PM »
The whole point of this website is that making good financial decisions is a skill everyone needs, regardless of income.  You can retire early if you save more than half your income, and it doesn't matter how much you make.  Doctors can live paycheck to paycheck just as easily as can retail workers.  Retail workers can retire early just as result as can doctors.  There is always someone living a happier life than you on half of your income.

The fact that a majority of Americans make bad financial decisions and refuse to optimize their spending in order to qualify for heavily subsidized ACA healthcare does not mean that heavily subsidized ACA healthcare isn't a wonderful benefit that is available to them.  Some old people refuse to sign up for Medicare, too, but that doesn't mean Medicare sucks.

For most Americans (literally most, as in more than half) the ACA has either lowered their healthcare costs or given them access to healthcare where they previously had none.  It caps the cost to them by subsidizing all costs above 10% of their income.  It has been hugely successful at expanding coverage and limiting the cost to consumers, and less successful at slowing the cost increases charged by providers, but it has made up the difference with taxes on the very wealthiest people who already have extra income and aren't harmed by the taxes as much as poor people are harmed by not getting medical care.  It's been a net benefit to society.

The places where the ACA is struggling are the places where health insurance was already struggling before the ACA, rural areas with too few providers and too few insurers.  That is not the fault of a program that increased the pool of paying patients.  If anything, the ACA gets blamed for regional failures in places where it has marginally improved an already disastrous situation.

+11111

jim555

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Re: What comes after the ACA?
« Reply #2630 on: June 12, 2017, 01:43:54 PM »
There are many ways to maximize the ACA, (geographical arbitrage, MAGI manipulation) which is completely feasible for an early retiree.  It need not have unaffordable deductibles and co-pays or premiums.  The Republican spin machine constantly spews lies and BS on it, not to mention sabotage.

Midwest

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Re: What comes after the ACA?
« Reply #2631 on: June 12, 2017, 02:20:17 PM »

The places where the ACA is struggling are the places where health insurance was already struggling before the ACA, rural areas with too few providers and too few insurers.  That is not the fault of a program that increased the pool of paying patients.  If anything, the ACA gets blamed for regional failures in places where it has marginally improved an already disastrous situation.

I don't think you can blame what Anthem is doing on rural area's.  If ACA was profitable to them, I don't think they would be exiting.  IMO, they are using the uncertainty as cover to dump the ACA.

http://medcitynews.com/2017/04/will-anthem-exit-aca-exchanges/

Unfortunately, the problems with the ACA predate Trump. Also unfortunately, no one seems to have a viable plan to fix healthcare.

nereo

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Re: What comes after the ACA?
« Reply #2632 on: June 12, 2017, 02:56:04 PM »

The places where the ACA is struggling are the places where health insurance was already struggling before the ACA, rural areas with too few providers and too few insurers.  That is not the fault of a program that increased the pool of paying patients.  If anything, the ACA gets blamed for regional failures in places where it has marginally improved an already disastrous situation.

I don't think you can blame what Anthem is doing on rural area's.  If ACA was profitable to them, I don't think they would be exiting.  IMO, they are using the uncertainty as cover to dump the ACA.

Here's you've brought up a three important things: i) profitability, ii) uncertainty and iii) a lack of real competition in rural areas.

Of course insurers would favor no ACA in these areas - cost restrictions is one of the signature accomplishments of the ACA, and whenever there's a de-facto monopoly (which there is in many places in the country) there's no free-market forces to restrict profits. Roughly 40% of Americans live in these regions.
Uncertainty is the excuse they need to make an exit, and lack of competition is their moat; it's highly unlikely that someone else will swoop in to fill the void.

Midwest

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Re: What comes after the ACA?
« Reply #2633 on: June 12, 2017, 03:11:15 PM »

The places where the ACA is struggling are the places where health insurance was already struggling before the ACA, rural areas with too few providers and too few insurers.  That is not the fault of a program that increased the pool of paying patients.  If anything, the ACA gets blamed for regional failures in places where it has marginally improved an already disastrous situation.

I don't think you can blame what Anthem is doing on rural area's.  If ACA was profitable to them, I don't think they would be exiting.  IMO, they are using the uncertainty as cover to dump the ACA.

Here's you've brought up a three important things: i) profitability, ii) uncertainty and iii) a lack of real competition in rural areas.

Of course insurers would favor no ACA in these areas - cost restrictions is one of the signature accomplishments of the ACA, and whenever there's a de-facto monopoly (which there is in many places in the country) there's no free-market forces to restrict profits. Roughly 40% of Americans live in these regions.
Uncertainty is the excuse they need to make an exit, and lack of competition is their moat; it's highly unlikely that someone else will swoop in to fill the void.

Nereo - Anthem is exiting an entire state (Ohio), not just the rural parts.  They may have had a monopoly in the more rural parts of the state, but certainly not in the more populace areas. 

https://www.nytimes.com/interactive/2017/06/09/us/counties-with-one-or-no-obamacare-insurer.html

Is your theory they are exiting in the hopes that rates will go up?  That may be plausible.  An alternative theory would be that the ACA is simply unprofitable for them.  Either way, it's not just the rural areas they are exiting and/or considering exiting.

Paul der Krake

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Re: What comes after the ACA?
« Reply #2634 on: June 12, 2017, 03:15:36 PM »
Rural areas distrust the ACA and are more likely to only sign up when they really need it. It's the same people who bitch about the government size, but demand the state maintain roads that serve tiny communities with no real tax base, and have their automobile-dependent lifestyle subsidized at every level. They also sign up for the military, a government program that keeps millions of people on payroll just in case, in much higher numbers. The irony is painful.

Sparse populations are incredibly inefficient and will always require subsidies. Nothing new here.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #2635 on: June 12, 2017, 03:28:02 PM »

Nereo - Anthem is exiting an entire state (Ohio), not just the rural parts.  They may have had a monopoly in the more rural parts of the state, but certainly not in the more populace areas. 

https://www.nytimes.com/interactive/2017/06/09/us/counties-with-one-or-no-obamacare-insurer.html

Is your theory they are exiting in the hopes that rates will go up?  That may be plausible.  An alternative theory would be that the ACA is simply unprofitable for them.  Either way, it's not just the rural areas they are exiting and/or considering exiting.

They are exiting Ohio, but the parts of Ohio that won't have any marketplace insurers are in rural areas. Individuals there can still buy individual insurance, but it's outside the marketplace, and therefore they won't be able to get the subsidies that make the insurance affordable. 
Other parts of Ohio, the urban areas, will have other insurers that will offer insurance through the ACA marketplace, which are eligible for subsidies.

Other states have very successful ACA marketplace individual insurance exchanges.

Trump's unwillingness to unequivocally state he'll provide the cost-sharing subsidies combined with the Republican AHCA bills is causing the ACA to become unstable.
The Republican states unwillingness to expand Medicaid is also destabilizing to the ACA marketplace.

Midwest

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Re: What comes after the ACA?
« Reply #2636 on: June 12, 2017, 03:35:18 PM »

Nereo - Anthem is exiting an entire state (Ohio), not just the rural parts.  They may have had a monopoly in the more rural parts of the state, but certainly not in the more populace areas. 

https://www.nytimes.com/interactive/2017/06/09/us/counties-with-one-or-no-obamacare-insurer.html

Is your theory they are exiting in the hopes that rates will go up?  That may be plausible.  An alternative theory would be that the ACA is simply unprofitable for them.  Either way, it's not just the rural areas they are exiting and/or considering exiting.

They are exiting Ohio, but the parts of Ohio that won't have any marketplace insurers are in rural areas. Individuals there can still buy individual insurance, but it's outside the marketplace, and therefore they won't be able to get the subsidies that make the insurance affordable. 
Other parts of Ohio, the urban areas, will have other insurers that will offer insurance through the ACA marketplace, which are eligible for subsidies.

Other states have very successful ACA marketplace individual insurance exchanges.

Trump's unwillingness to unequivocally state he'll provide the cost-sharing subsidies combined with the Republican AHCA bills is causing the ACA to become unstable.
The Republican states unwillingness to expand Medicaid is also destabilizing to the ACA marketplace.

Agreed, the rural areas are the most harmed.  However, if the ACA is good for Anthem, why are they leaving they leaving the entire state? and not just the unprofitable counties.  With regard to your comment on Medicaid, my understanding is that Ohio went along with the expansion despite having a republican governor.

Regarding the ACA in general, it was in trouble well before Trump won.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #2637 on: June 12, 2017, 04:52:59 PM »

Nereo - Anthem is exiting an entire state (Ohio), not just the rural parts.  They may have had a monopoly in the more rural parts of the state, but certainly not in the more populace areas. 

https://www.nytimes.com/interactive/2017/06/09/us/counties-with-one-or-no-obamacare-insurer.html

Is your theory they are exiting in the hopes that rates will go up?  That may be plausible.  An alternative theory would be that the ACA is simply unprofitable for them.  Either way, it's not just the rural areas they are exiting and/or considering exiting.

They are exiting Ohio, but the parts of Ohio that won't have any marketplace insurers are in rural areas. Individuals there can still buy individual insurance, but it's outside the marketplace, and therefore they won't be able to get the subsidies that make the insurance affordable. 
Other parts of Ohio, the urban areas, will have other insurers that will offer insurance through the ACA marketplace, which are eligible for subsidies.

Other states have very successful ACA marketplace individual insurance exchanges.

Trump's unwillingness to unequivocally state he'll provide the cost-sharing subsidies combined with the Republican AHCA bills is causing the ACA to become unstable.
The Republican states unwillingness to expand Medicaid is also destabilizing to the ACA marketplace.

Agreed, the rural areas are the most harmed.  However, if the ACA is good for Anthem, why are they leaving they leaving the entire state? and not just the unprofitable counties.  With regard to your comment on Medicaid, my understanding is that Ohio went along with the expansion despite having a republican governor.

Regarding the ACA in general, it was in trouble well before Trump won.

Each state is a different story with respect to ACA. Some states are doing fine, but what the Republicans are doing to it has destabilized the ACA.

Trump, Shouting ‘Death Spiral,’ Has Nudged Affordable Care Act Downward
https://nyti.ms/2qFLUch

TrudgingAlong

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Re: What comes after the ACA?
« Reply #2638 on: June 12, 2017, 07:25:20 PM »



Agreed, the rural areas are the most harmed.  However, if the ACA is good for Anthem, why are they leaving they leaving the entire state? and not just the unprofitable counties.  With regard to your comment on Medicaid, my understanding is that Ohio went along with the expansion despite having a republican governor.

Regarding the ACA in general, it was in trouble well before Trump won.


This brings up an interesting question to me: Are we concerned the ACA hurts insurers? Or was it supposed to help consumers? Why should I care if an insurer is leaving because their profits are down? Although I'm completely okay with capitalism in every other arena, health care is where it seems like a disgusting exercise. You have a captive set of consumers who will die without what you're peddling. Add in an extra layer of profit (insurers) and it becomes even more exploitive.

I have no real answers, sadly, but our system is so fucked up. It's amazing to me how many Americans brag on how "world class" healthcare in the US. Those fancy hospital rooms are amazing, after all...

Roland of Gilead

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Re: What comes after the ACA?
« Reply #2639 on: June 12, 2017, 08:56:32 PM »
You have a captive set of consumers who will die without what you're peddling. Add in an extra layer of profit (insurers) and it becomes even more exploitive.

So people and businesses in the medical field should not be allowed to make a profit?

What about manufacturers of medical equipment, like MRI machines?   People will die without those.

Ambulance manufacturers?

Airlines and helicopters which do life flights or carry donor organs?

What about the company who provides the basic or prepared food to the hospitals?  Should they also be non profit?

Actually what about farmers in general?  People will die without what they are peddling.   Evil for them to make a profit (not many probably do anyway).

TrudgingAlong

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Re: What comes after the ACA?
« Reply #2640 on: June 12, 2017, 11:04:52 PM »
Not saying no profit, but there should be limits on how much someone can be fleeced. Epi-pens being a great example. Just because you can charge something doesn't mean you should. I really have no good solutions as I will freely admit I don't understand all of it, but if love to see some of the fat removed. Insurers feel like fat to me, at least on a non-catastrophic level. I'd much rather know the costs going in and paying my doctor directly instead of forty middle men. That feels like a pipe dream here, through.

So, yes, I admit I feel no sadness for insurers who are not getting amazing profits. I don't think this should be an industry where people go to get rich. But they can, because someone will always pay when life is on the line.

chasesfish

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Re: What comes after the ACA?
« Reply #2641 on: June 13, 2017, 05:39:57 AM »
Not saying no profit, but there should be limits on how much someone can be fleeced. Epi-pens being a great example. Just because you can charge something doesn't mean you should. I really have no good solutions as I will freely admit I don't understand all of it, but if love to see some of the fat removed. Insurers feel like fat to me, at least on a non-catastrophic level. I'd much rather know the costs going in and paying my doctor directly instead of forty middle men. That feels like a pipe dream here, through.

So, yes, I admit I feel no sadness for insurers who are not getting amazing profits. I don't think this should be an industry where people go to get rich. But they can, because someone will always pay when life is on the line.

Just require that the private pay patients can't be billed any higher than 5% above the lowest contracted insurance rate.  That would solve a lot of the catastrophes of the uninsured.   We get a bill for 3x the actual cost of service and then need a Big 4 insurer or medicare/medicaid to get the real price.

BookValue

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Re: What comes after the ACA?
« Reply #2642 on: June 13, 2017, 05:58:13 AM »
What about manufacturers of medical equipment, like MRI machines?   People will die without those.

MRI is an interesting example, because as a country we are paying far more for the machines than somewhere like Japan, where the cost for an MRI is 1/10 what it is here. Yet the manufacturers are still willing and able to sell machines for such a low cost, somehow....
http://www.npr.org/templates/story/story.php?storyId=120545569

Gin1984

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Re: What comes after the ACA?
« Reply #2643 on: June 13, 2017, 06:52:06 AM »
Not saying no profit, but there should be limits on how much someone can be fleeced. Epi-pens being a great example. Just because you can charge something doesn't mean you should. I really have no good solutions as I will freely admit I don't understand all of it, but if love to see some of the fat removed. Insurers feel like fat to me, at least on a non-catastrophic level. I'd much rather know the costs going in and paying my doctor directly instead of forty middle men. That feels like a pipe dream here, through.

So, yes, I admit I feel no sadness for insurers who are not getting amazing profits. I don't think this should be an industry where people go to get rich. But they can, because someone will always pay when life is on the line.
Here is an example.  I just had to get an insulin pen.  Now, I am ok with the companies getting a profit, however, the pen without insurance costs a little over $100 and can only be used for two weeks even though there is still meds in them (so planned to cause people to need more than the medication they actually use and I know this because another brand does set it up so you can use it for longer).  However, when I look at the same medication but on direct vet med sites, it is only $50.  My insurance negotiated it down to $60/pen, but still $10 more than what they sell on vet sites.  Why is that?  Because people need it to live and therefore they can charge anything they want.  And that, I have a problem with.  And consequences, if you can be a reasonable human being, then your choices get curtailed.  Aka, I am fine with the government determining the profit for you, if you are an asshole.

Roland of Gilead

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Re: What comes after the ACA?
« Reply #2644 on: June 13, 2017, 07:29:00 AM »
Here is an example.  I just had to get an insulin pen.  Now, I am ok with the companies getting a profit, however, the pen without insurance costs a little over $100 and can only be used for two weeks even though there is still meds in them (so planned to cause people to need more than the medication they actually use and I know this because another brand does set it up so you can use it for longer).  However, when I look at the same medication but on direct vet med sites, it is only $50.  My insurance negotiated it down to $60/pen, but still $10 more than what they sell on vet sites.  Why is that?  Because people need it to live and therefore they can charge anything they want.  And that, I have a problem with.  And consequences, if you can be a reasonable human being, then your choices get curtailed.  Aka, I am fine with the government determining the profit for you, if you are an asshole.

Comparing vet drugs to human drugs is silly.   It is like saying "See, Apple provides schools with computers for free so why does my Macbook Air cost $2000?"

The government could control things more I guess.  Housing is sort of needed for people to live.  Housing in parts of California is very expensive.  Perhaps the government should step in and regulate the price homes can be sold?   I see a lot of greedy people selling their homes for millions of dollars making gross profit.

Gin1984

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Re: What comes after the ACA?
« Reply #2645 on: June 13, 2017, 07:36:35 AM »
Here is an example.  I just had to get an insulin pen.  Now, I am ok with the companies getting a profit, however, the pen without insurance costs a little over $100 and can only be used for two weeks even though there is still meds in them (so planned to cause people to need more than the medication they actually use and I know this because another brand does set it up so you can use it for longer).  However, when I look at the same medication but on direct vet med sites, it is only $50.  My insurance negotiated it down to $60/pen, but still $10 more than what they sell on vet sites.  Why is that?  Because people need it to live and therefore they can charge anything they want.  And that, I have a problem with.  And consequences, if you can be a reasonable human being, then your choices get curtailed.  Aka, I am fine with the government determining the profit for you, if you are an asshole.

Comparing vet drugs to human drugs is silly.   It is like saying "See, Apple provides schools with computers for free so why does my Macbook Air cost $2000?"

The government could control things more I guess.  Housing is sort of needed for people to live.  Housing in parts of California is very expensive.  Perhaps the government should step in and regulate the price homes can be sold?   I see a lot of greedy people selling their homes for millions of dollars making gross profit.
Actually it is not silly.  They are the same medication, made with the same restrictions and oversite, on the same equipment, by the same people.  And both are sold for profit.
Your example was of a company doing a donation.  Mine is of selling it to two different companies.  To actually be equivalent to my example it would have to be apple sold some Macs at one store for $2000 and the identical Macs for $1000 at a different store and only certain people could use either store.

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boarder42

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Re: What comes after the ACA?
« Reply #2646 on: June 13, 2017, 08:01:32 AM »
Here is an example.  I just had to get an insulin pen.  Now, I am ok with the companies getting a profit, however, the pen without insurance costs a little over $100 and can only be used for two weeks even though there is still meds in them (so planned to cause people to need more than the medication they actually use and I know this because another brand does set it up so you can use it for longer).  However, when I look at the same medication but on direct vet med sites, it is only $50.  My insurance negotiated it down to $60/pen, but still $10 more than what they sell on vet sites.  Why is that?  Because people need it to live and therefore they can charge anything they want.  And that, I have a problem with.  And consequences, if you can be a reasonable human being, then your choices get curtailed.  Aka, I am fine with the government determining the profit for you, if you are an asshole.

Comparing vet drugs to human drugs is silly.   It is like saying "See, Apple provides schools with computers for free so why does my Macbook Air cost $2000?"

The government could control things more I guess.  Housing is sort of needed for people to live.  Housing in parts of California is very expensive.  Perhaps the government should step in and regulate the price homes can be sold?   I see a lot of greedy people selling their homes for millions of dollars making gross profit.
Actually it is not silly.  They are the same medication, made with the same restrictions and oversite, on the same equipment, by the same people.  And both are sold for profit.
Your example was of a company doing a donation.  Mine is of selling it to two different companies.  To actually be equivalent to my example it would have to be apple sold some Macs at one store for $2000 and the identical Macs for $1000 at a different store and only certain people could use either store.

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agreed same analogy can be applied to the epipens ... have you seen what other countrys pay compared to the US.  either we are subsidising the world Pharma market or we're getting gouged b/c of the ridiculous insurance/payment systems in the US.

Midwest

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Re: What comes after the ACA?
« Reply #2647 on: June 13, 2017, 08:01:52 AM »
Here is an example.  I just had to get an insulin pen.  Now, I am ok with the companies getting a profit, however, the pen without insurance costs a little over $100 and can only be used for two weeks even though there is still meds in them (so planned to cause people to need more than the medication they actually use and I know this because another brand does set it up so you can use it for longer).  However, when I look at the same medication but on direct vet med sites, it is only $50.  My insurance negotiated it down to $60/pen, but still $10 more than what they sell on vet sites.  Why is that?  Because people need it to live and therefore they can charge anything they want.  And that, I have a problem with.  And consequences, if you can be a reasonable human being, then your choices get curtailed.  Aka, I am fine with the government determining the profit for you, if you are an asshole.

Comparing vet drugs to human drugs is silly.   It is like saying "See, Apple provides schools with computers for free so why does my Macbook Air cost $2000?"

The government could control things more I guess.  Housing is sort of needed for people to live.  Housing in parts of California is very expensive.  Perhaps the government should step in and regulate the price homes can be sold?   I see a lot of greedy people selling their homes for millions of dollars making gross profit.

What about generic drug prices - http://www.health.harvard.edu/blog/why-many-generic-drugs-are-becoming-so-expensive-201510228480 or the epi-pen issue?

I understand high drug prices on new drugs, but older generics?

Roland of Gilead

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Re: What comes after the ACA?
« Reply #2648 on: June 13, 2017, 08:13:50 AM »
agreed same analogy can be applied to the epipens ... have you seen what other countrys pay compared to the US.  either we are subsidising the world Pharma market or we're getting gouged b/c of the ridiculous insurance/payment systems in the US.

We are subsidizing the world Pharma market to some extent, exactly the same as you subsidize the school system who gets free Apple computers when you buy a $2000 Macbook.

A country like India, where the per capita income is around $1600 a year, they cannot afford to pay $50,000 for a life saving drug, or even $5,000.   Thus the drug companies drastically lower the price there, almost like charity.   They make it up in other rich countries, just like Apple makes up for the free computers they give away by selling Macbooks for $2000 to rich people.

It still costs about $2B to as much as $4B to bring a drug to market.   If you subtract the possible initial government grant research on those drugs then it costs $1,990,000,000 to $3,990,000,000 or so to bring a drug to market (this is including the rolled in costs of failed drug trials, which is totally fair from an investment standpoint).

I am not sure, but I feel like the dog and cat market for drugs is a lot like the third world country market.   People are not going to pay $50,000 to treat a dog or cat, so the drugs are provided at a massive charity discount.   It could also be that dogs and cats don't sue the drug companies for multi million dollar lawsuits.

Midwest

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Re: What comes after the ACA?
« Reply #2649 on: June 13, 2017, 08:23:27 AM »
agreed same analogy can be applied to the epipens ... have you seen what other countrys pay compared to the US.  either we are subsidising the world Pharma market or we're getting gouged b/c of the ridiculous insurance/payment systems in the US.

We are subsidizing the world Pharma market to some extent, exactly the same as you subsidize the school system who gets free Apple computers when you buy a $2000 Macbook.

A country like India, where the per capita income is around $1600 a year, they cannot afford to pay $50,000 for a life saving drug, or even $5,000.   Thus the drug companies drastically lower the price there, almost like charity.   They make it up in other rich countries, just like Apple makes up for the free computers they give away by selling Macbooks for $2000 to rich people.

It still costs about $2B to as much as $4B to bring a drug to market.   If you subtract the possible initial government grant research on those drugs then it costs $1,990,000,000 to $3,990,000,000 or so to bring a drug to market (this is including the rolled in costs of failed drug trials, which is totally fair from an investment standpoint).

I am not sure, but I feel like the dog and cat market for drugs is a lot like the third world country market.   People are not going to pay $50,000 to treat a dog or cat, so the drugs are provided at a massive charity discount.   It could also be that dogs and cats don't sue the drug companies for multi million dollar lawsuits.

If the pricing subsidy is only benefiting the 3rd world, why are some drugs in Canada so much cheaper than the US?