Author Topic: What comes after the ACA?  (Read 822089 times)

Iplawyer

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Re: What comes after the ACA?
« Reply #1650 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 #1651 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 #1652 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 #1653 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 #1654 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 #1655 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 #1656 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 #1657 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 #1658 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 #1659 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 »

Iplawyer

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Re: What comes after the ACA?
« Reply #1660 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 #1661 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.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #1662 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.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1663 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.

Clean Shaven

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Re: What comes after the ACA?
« Reply #1664 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 #1665 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.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1666 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.

sol

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Re: What comes after the ACA?
« Reply #1667 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 #1668 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 #1669 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 #1670 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 #1671 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.

Metric Mouse

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Re: What comes after the ACA?
« Reply #1672 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.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #1673 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 #1674 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 #1675 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 #1676 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 #1677 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 #1678 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.

rantk81

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Re: What comes after the ACA?
« Reply #1679 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 #1680 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 #1681 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 #1682 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.

I'm a red panda

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Re: What comes after the ACA?
« Reply #1683 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 #1684 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 #1685 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 #1686 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 #1687 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.

rpr

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Re: What comes after the ACA?
« Reply #1688 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 #1689 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 #1690 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 #1691 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

Schaefer Light

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Re: What comes after the ACA?
« Reply #1692 on: March 23, 2017, 11:01:22 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

Then it's equally nonsensical to say that health care is a right.  After all, there's nothing in the Constitution that says it is a right.

waltworks

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Re: What comes after the ACA?
« Reply #1693 on: March 23, 2017, 11:05:51 AM »
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".

Agreed. Most existing rights are rights _from_ interference from others. That hasn't always been the case in human history, obviously.

I think we'd all agree that we have the "right" to use public roads to drive/bike around, air/water/food (in descending order of importance) that are at least not actively poisonous (otherwise the "right" to life doesn't mean much) and be defended by our military. All of those things, conversely, require something provided (sometimes unwillingly) by all of us collectively.

And again, established law (EMTALA) already makes health care a de facto right, it just limits it to emergency treatment (arguably the worst way to go about it, really).

-W

Scortius

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Re: What comes after the ACA?
« Reply #1694 on: March 23, 2017, 11:06:04 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".

I believe that within the borders of the USA, access to clean water is a human right.  You may disagree with this.  Access to clean water requires modern infrastructure paid for and maintained by the US government.  So yes, I do believe in the interpretation that certain human rights must be supported and enforced by our government and do require service from our fellow human beings.

Schaefer Light

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Re: What comes after the ACA?
« Reply #1695 on: March 23, 2017, 11:10:40 AM »

I believe that within the borders of the USA, access to clean water is a human right.  You may disagree with this.  Access to clean water requires modern infrastructure paid for and maintained by the US government.  So yes, I do believe in the interpretation that certain human rights must be supported and enforced by our government and do require service from our fellow human beings.

Access to clean water is not a right guaranteed by the federal government.  Some states and municipalities may have statutes on the books, though.

waltworks

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Re: What comes after the ACA?
« Reply #1696 on: March 23, 2017, 11:18:55 AM »

I believe that within the borders of the USA, access to clean water is a human right.  You may disagree with this.  Access to clean water requires modern infrastructure paid for and maintained by the US government.  So yes, I do believe in the interpretation that certain human rights must be supported and enforced by our government and do require service from our fellow human beings.

Access to clean water is not a right guaranteed by the federal government.  Some states and municipalities may have statutes on the books, though.

Federal law requires that employers provide "potable" water to all employees on demand, for free. The feds also require that municipalities/states treat their water supplies in certain ways to ensure safety. It's a right at least in those contexts.

Just FYI.

-W

teen persuasion

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Re: What comes after the ACA?
« Reply #1697 on: March 23, 2017, 11:49:49 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.

+1

I'm a red panda

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Re: What comes after the ACA?
« Reply #1698 on: March 23, 2017, 12:03:49 PM »
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

Then it's equally nonsensical to say that health care is a right.  After all, there's nothing in the Constitution that says it is a right.

Memorized from 3rd grade:

"We the People of the United States, in order to form a more perfect Union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America."

Seems to me that "promote the general welfare" was one of the main reasons the constitution was established.  Is healthcare not among that?  At the time, welfare was used to mean health; not the current usage of the word. 

The Bill of Rights and all the amendments only lists the things they forgot to put in there in the first place...
« Last Edit: March 23, 2017, 12:07:45 PM by iowajes »

Bumperpuff

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Re: What comes after the ACA?
« Reply #1699 on: March 23, 2017, 12:28:21 PM »
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".

You have the right to be represented by an attorney even if you can't afford one.  In that case the government does sometimes conscript practicing attorneys to provide the defense, but that's just part of being an attorney in some states.  In the US you have a right to k-12 education but I have yet to see teachers being conscripted or forced to work without pay. So, when I say you have a right to medical treatment, I mean that in the same way as saying you have the right to an attorney, an education, police protection, or the right to access areas of public accommodation.

The whole "you want to force doctors to work for free?" thing doesn't hold water.  I'm not implying that you meant that, but I have seen it in Facebook posts and figured I'd head it off here.