[Discussion] Health Policies and ACA Reform/Repeal

The existing health thread is for discussion on how changes to current policy will/have personally affected you or those you know. This thread is for more general discussion of the subject.

Kehama wrote:

Not reforming healthcare for fear of destroying jobs is exactly the same kind of thinking that is going into the "bring back manufacturing jobs" push we're seeing right now. We're telling states and contractors to spend 78% more money for American steel than buying Chinese because all that cheap steel was costing American steel worker jobs. So, for healthcare, we'll just tell people to keep going into bankruptcy when they get a major illness because we don't want all those doctors, nurses, and nurse assistants to lose their jobs.

I don't disagree with this, but there is such a thing as being pot committed. Like I said, the country lost its collective mind over some 70k coal jobs. What the hell do you think it is going to do when massive change (and loss of asset value) happens to nearly 20% of our annual GDP?

I wonder if it might not be as negative of a reaction because coal jobs are 'real' jobs, and health care jobs are the kind of emasculating jobs your wife takes when you get laid off at the coal mine.

Irrational and sexist to treat the blue collar different than the pink collar? Of course. The sad reality? Possibly.

Also, remember that single payer would destroy a lot of jobs in health insurance, not jobs in actual health care provision. There'd still be just as many, if not more, doctors and nurses. We'd lose a lot of claims adjusters and the like. So, that'd suck for those specific people, but it won't cause any broad-based dismay among the sorts of folks who get pissed about manly coal or manufacturing jobs.

jonstock wrote:

Also, remember that single payer would destroy a lot of jobs in health insurance, not jobs in actual health care provision. There'd still be just as many, if not more, doctors and nurses. We'd lose a lot of claims adjusters and the like. So, that'd suck for those specific people, but it won't cause any broad-based dismay among the sorts of folks who get pissed about manly coal or manufacturing jobs.

But remember, the US government would now need a ton of those people to do somewhat similar roles in the new national healthcare payer system. That monstrous bureaucracy would need a huge workforce to run. I'm not in favor of government run hospitals, just the system for paying for those medical services.

jonstock wrote:

Also, remember that single payer would destroy a lot of jobs in health insurance, not jobs in actual health care provision. There'd still be just as many, if not more, doctors and nurses. We'd lose a lot of claims adjusters and the like. So, that'd suck for those specific people, but it won't cause any broad-based dismay among the sorts of folks who get pissed about manly coal or manufacturing jobs.

Yeah, no one gave a crap about telephone switchboard operators going out of style.

Presumably the amount of emergency care services provided would go down, but preventative care services would go way up. I imagine preventative care drugs would go way up, too. So I doubt there would be a huge loss, if any, of jobs related to actually providing healthcare. Just office jobs of insurance providers.

As a progressive, I think the government should help those people find new jobs to avoid economic downturns.

As a human, I don't feel that bad for people losing their job if that job is basically "Help some already rich white guys earn more money by paying for as little customer healthcare as possible, and make everything about the industry super confusing and annoying for regular people." Try auto insurance?

Nomad wrote:
jonstock wrote:

Also, remember that single payer would destroy a lot of jobs in health insurance, not jobs in actual health care provision. There'd still be just as many, if not more, doctors and nurses. We'd lose a lot of claims adjusters and the like. So, that'd suck for those specific people, but it won't cause any broad-based dismay among the sorts of folks who get pissed about manly coal or manufacturing jobs.

But remember, the US government would now need a ton of those people to do somewhat similar roles in the new national healthcare payer system. That monstrous bureaucracy would need a huge workforce to run. I'm not in favor of government run hospitals, just the system for paying for those medical services.

I realize I was being snarky earlier, but the point still remains. This shift to, effectively, a price control on insurance would have the net effect of eradicating the private insurance industry. Even a hybrid model (like Australia's) in which everyone pays into a single payer pool and can get supplemental health insurance for premium treatment would result in the health insurance market being less than a tenth of what it is today.

If you don't think those folks have lobbying power, you are being deliberately obtuse.

A single payer (as much as I would love such an option to be available in America) would cause too much financial dislocation to be tolerated. It would be like ending the war on drugs or stopping petrochemical subsidies.

Nomad wrote:

But remember, the US government would now need a ton of those people to do somewhat similar roles in the new national healthcare payer system. That monstrous bureaucracy would need a huge workforce to run. I'm not in favor of government run hospitals, just the system for paying for those medical services.

That "monstrous bureaucracy" would still be smaller than the hundreds of redundant companies providing healthcare insurance now by removing the redundancy. And if you streamlined all of the state-by-state differences in legal requirements, you would save even more people and money.

Mixolyde wrote:
jonstock wrote:

Also, remember that single payer would destroy a lot of jobs in health insurance, not jobs in actual health care provision. There'd still be just as many, if not more, doctors and nurses. We'd lose a lot of claims adjusters and the like. So, that'd suck for those specific people, but it won't cause any broad-based dismay among the sorts of folks who get pissed about manly coal or manufacturing jobs.

Yeah, no one gave a crap about telephone switchboard operators going out of style.

Presumably the amount of emergency care services provided would go down, but preventative care services would go way up. I imagine preventative care drugs would go way up, too. So I doubt there would be a huge loss, if any, of jobs related to actually providing healthcare. Just office jobs of insurance providers.

As a progressive, I think the government should help those people find new jobs to avoid economic downturns.

As a human, I don't feel that bad for people losing their job if that job is basically "Help some already rich white guys earn more money by paying for as little customer healthcare as possible, and make everything about the industry super confusing and annoying for regular people." Try auto insurance?

Connected to this idea is the benefit of emergency care service quality going way up, potentially saving countless lives due to expedited treatment times when the weight of people who wait until their medical issue is critical due to lack of insurance is lifted. There are also a huge number of people that use the ER services as a family physician as a result of their inability to pay for a family doctor as well. A single payer solution virtually eliminates these issues.

If only these poor guys in Congress hadn't been blindsided with this unexpected need to come up with a replacement plan.

"It's a bad strategy," Paul told reporters Thursday. "I think this strategy's a real poor one and I've already told them, I'm not voting for a new entitlement program. If they want new entitlement programs and they want new government, Obamacare-lite, they can put that separately as a replacement bill, but the repeal bill ought to be a repeal."
Other Republicans say that there is still room to for lawmakers to make changes, but they warn lawmakers not to let perfect be the enemy of the good.
"Anybody that has really good ideas. This is the time to bring 'em. Anybody who thinks that their bill is the only bill that can pass, that's not realistic," House Majority Whip Rep. Steve Scalise said Thursday. "At the end of the day, we're going to repeal Obamacare and replace it."

Wasn't the time to bring their best ideas on healthcare reform around 2010?

And the however many dozen times they tried to repeal the ACA...

I think it is safe to say that nobody who voted for Trump knew health care would be this complicated.

Paleocon wrote:

I think it is safe to say that nobody who voted for Trump knew health care would be this complicated.

Why are the Democrats making this so complicated! It's easy! You're sick, you go to the Doctor, someone pays for that, and then you get better! I don't know why Obama had to mess with a good thing!

LeapingGnome wrote:

Robear are you mixing up Communism and Socialism again?

No, actually, this is what a number of my Republican friends and co-workers say, that Democrats are Communists. That is, well beyond Socialist. They usually justify it by saying that while Socialism is bad, the implementation of Socialist policies by the Federal government - a *Central* government - turns stuff like Social Security and Medicare/Medicaid into actual Communist programs.

You've never had this thrown at you? You're lucky.

For example, this. That's the kind of stuff they are reading.

The shear amount of snearing I can hear when Rand Paul says the words "entitlements" is a good indicator of how many feel about any public assistance programs. It all goes back to the belief that everyone should work for everything they have in life, up to and including basic healthcare to keep you alive. If you can't work hard enough and make enough money to keep yourself alive then, oh well. The idea of hyper capitalism is seen as making its people strong and self sufficient while socialism/communism is just going to turn out a bunch of citizens with no work ethic and who are always looking for a handout. These are the kinds of conversations I used to have with my ex in-laws. When I would ask what we should do about the disabled or simply the normal number of unemployed any nation is going to have simply because there aren't enough jobs to go around, the answer was friends and family can take care of them, or charities like soup kitchens and homeless shelters. Basically, if you can't afford what you need in life then you should suffer until you figure out a way to afford it. When you have a good chunk of US citizens that feel this way about social programs it's going to be a hard sell for "free" healthcare for all.

Our new (proposed) healthcare reform, everybody!

http://thehill.com/policy/healthcare/322609-gop-releases-bill-to-repeal-and-replace-obamacare

The two measures dismantle the core aspects of ObamaCare, including its subsidies to help people buy coverage, its expansion of Medicaid, its taxes and its mandates for people to have insurance...

In its place, Republicans would put in place a new system centered on a tax credit to help people buy insurance.

That tax credit would range from $2,000 to $4,000 a year, increasing with someone’s age. That system would provide less financial assistance for low-income and older people than ObamaCare, but it could give more assistance to younger people and those with higher incomes.

Of course, they're also proposing to completely de-fund Planned Parenthood if they perform abortions at all, in spite of government funding never going anywhere near those services.

If it looks like sh*t and tastes like sh*t, it is definitely sh*t.

Luckily (?), there are several key republicans in the senate that said (based on a previous draft of this proposal) they'll oppose any measure that will revoke people's coverage, which this one is practically guaranteed to do.

There's also this analysis from WaPo:

Under two bills drafted by separate House committees, the government would no longer penalize Americans for failing to have health insurance but would try to encourage people to maintain coverage by allowing insurers to impose a surcharge of 30 percent for those who have a gap between health plans.

So instead of penalties for lack of insurance going back into the system to pay for the subsidies, insurance companies can charge up to 30% to pay.... themselves.

I just do not understand how a conservative-minded adult can justify voting for the kind of people who propose this sort of sh*t. This isn't fiscal conservatism, it's capitalist cronyism.

From various comments I've seen:

-Conservatives vehemently oppose a tax on not buying health insurance but are OK with forcing companies to charge more for people who let their insurance lapse.

-A tax on not having insurance encourages people to buy insurance. An increased premium encourages people to not buy insurance if it lapses.

-What's to stop someone from not buying insurance until they get cancer? An extra 30% in premiums is well worth saving the hundreds of thousands it will cost you to cover cancer treatments.

-This bill solves no "policy problem". This bill isn't an attempt at solving an actual issue but at making Republicans 'feel good' about themselves.

-The bill forbids any of the extremely modest credits from being used on insurance plans that cover abortion.

Basically, abolish Medicaid and Medicare and replace them with block grants to states that cover only 1/3 of the previous outlay. Wave flags and pass out silly hats.

IMAGE(https://pbs.twimg.com/media/C6SPzRNUoAAhVso.jpg)

Ha!

(Except not really b/c people will actually die.)

Has anyone that put that bill together looked at the cost of health insurance for a year? $2k is barely going to make a dent and that's for sub-par coverage. As someone who works in insurance, I also get the impression they have no clue how risk pools work and how these goofy changes are going to affect underwriting of policies. This bill basically says, "remember how good things were before the ACA? Let's go back to that!" and they're branding it as some big new fix.

Kehama wrote:

Has anyone that put that bill together looked at the cost of health insurance for a year? $2k is barely going to make a dent and that's for sub-par coverage. As someone who works in insurance, I also get the impression they have no clue how risk pools work and how these goofy changes are going to affect underwriting of policies. This bill basically says, "remember how good things were before the ACA? Let's go back to that!" and they're branding it as some big new fix.

This also has the completely, totally, 100% absolutely unintentional effect that any family that doesn't make enough money to pay $2k in federal taxes isn't helped at all by that credit. This is surely a mistake and not part of a pattern of behavior that shows that Republicans want poor people to hurry up and die already.

I thought I read that they were getting around the "don't make enough to pay taxes" thing by making the credit refundable regardless of your tax burden. This solves the not paying taxes thing, doesn't solve the thing where it's not enough to cover the insurance costs, and creates another handout, which I thought the right really super duper hated about the ACA.

The "refundable" part is the part that will likely get it killed ironically. They won't be able to get that past folks like Ted Cruz and Rand Paul as they believe that the idea of giving poor people anything is tantamount to rounding up small businessmen and shooting them in the back of the head in public.

Let's cover some basic definitions

"Freedom"
Democrats - Having the government provide some basic human services to everyone, so that people are free to contribute to society and take care of their families, instead of worrying about whether they should pay their medical bills, their emergency loan or credit card bills, their rent, or feed their kids.

Republicans - Corporations and the Government have the freedom to screw you over as much as possible. If you're poor, you have the freedom to STFU and die already.

Mixolyde wrote:

Let's cover some basic definitions

"Freedom"
Democrats - Having the government provide some basic human services to everyone, so that people are free to contribute to society and take care of their families, instead of worrying about whether they should pay their medical bills, their emergency loan or credit card bills, their rent, or feed their kids.

Republicans - Corporations and the Government have the freedom to screw you over as much as possible. If you're poor, you have the freedom to STFU and die already.

Don't forget responsibility, where it's apparently people's personal responsibility for getting chronic and congenital health issues that they had zero choice in avoiding thanks to... genetics, environmental factors that Republican policies will make worse, etc...

Demosthenes wrote:
Mixolyde wrote:

Let's cover some basic definitions

"Freedom"
Democrats - Having the government provide some basic human services to everyone, so that people are free to contribute to society and take care of their families, instead of worrying about whether they should pay their medical bills, their emergency loan or credit card bills, their rent, or feed their kids.

Republicans - Corporations and the Government have the freedom to screw you over as much as possible. If you're poor, you have the freedom to STFU and die already.

Don't forget responsibility, where it's apparently people's personal responsibility for getting chronic and congenital health issues that they had zero choice in avoiding thanks to... genetics, environmental factors that Republican policies will make worse, etc...

I was reading a comment somewhere this morning from a person who was listing expenses from having broken an ankle during white water rafting, with the implication that even a small accident would cost way, way more than a $500 phone, and someone responded that injuries from such activities shouldn't be covered by insurance as others shouldn't have to pay for people making "stupid, dangerous" choices.

Tkyl wrote:

From various comments I've seen:

-What's to stop someone from not buying insurance until they get cancer? An extra 30% in premiums is well worth saving the hundreds of thousands it will cost you to cover cancer treatments.

A million times this.

mindset.threat wrote:
Tkyl wrote:

From various comments I've seen:

-What's to stop someone from not buying insurance until they get cancer? An extra 30% in premiums is well worth saving the hundreds of thousands it will cost you to cover cancer treatments.

A million times this.

I think you can only sign up for Obamacare during an open enrolment period. It's something like three months, and there are only a few cases where you can sign up outside of that period. So sure, you might get lucky-unlucky and get sick during the 'right' time, but you also might just miss the deadline and have to wait months. Even if you could sign up at any time there are medical emergencies even more time-critical that can bankrupt you.

I just don't think the Individual Mandate is the hill for us to die on. If the Republicans want to get rid of it, let them take the heat of finding a new way to fund this thing. That thing was an albatross around our necks that, from what I remember, was at best in the spirit of bipartisanship, and at worst was because Obama didn't want to break a campaign pledge about raising taxes on the middle class.

If we ever get back in power, replace the funding that used to come from the Individual Mandate with higher taxes on...basically people who wouldn't think about going without insurance. People who think about going without insurance should be getting insurance so subsidized that it's attractive to them with only the carrot and no stick. Why respond to 21st century conservatives by acting like 20th century conservatives?

bekkilyn wrote:
Demosthenes wrote:
Mixolyde wrote:

Let's cover some basic definitions

"Freedom"
Democrats - Having the government provide some basic human services to everyone, so that people are free to contribute to society and take care of their families, instead of worrying about whether they should pay their medical bills, their emergency loan or credit card bills, their rent, or feed their kids.

Republicans - Corporations and the Government have the freedom to screw you over as much as possible. If you're poor, you have the freedom to STFU and die already.

Don't forget responsibility, where it's apparently people's personal responsibility for getting chronic and congenital health issues that they had zero choice in avoiding thanks to... genetics, environmental factors that Republican policies will make worse, etc...

I was reading a comment somewhere this morning from a person who was listing expenses from having broken an ankle during white water rafting, with the implication that even a small accident would cost way, way more than a $500 phone, and someone responded that injuries from such activities shouldn't be covered by insurance as others shouldn't have to pay for people making "stupid, dangerous" choices.

I mean, I got walking pneumonia because I used to work with the public. I ended up going to the hospital that night when it really hit me because my mom had literally JUST got out of the hospital (after being there for 4 days) because of a really bad case of the flu. I thought I had gotten it too.

X-ray, 2 hours of monitoring, and the equivalent of 4 tylenol was almost $9,000... plus the cost for my prescriptions. A two hour visit to the hospital because some asshole came through my checkout lane sick and got me sick cost more than I made in almost a year.

TOTALLY MY FAULT THOUGH RIGHT GOP?! TAKE RESPONSIBILITY FOR MY ACTIONS TRYING TO WORK.

*headdesk*

Demosthenes wrote:

I mean, I got walking pneumonia because I used to work with the public. I ended up going to the hospital that night when it really hit me because my mom had literally JUST got out of the hospital (after being there for 4 days) because of a really bad case of the flu. I thought I had gotten it too.

X-ray, 2 hours of monitoring, and the equivalent of 4 tylenol was almost $9,000... plus the cost for my prescriptions. A two hour visit to the hospital because some asshole came through my checkout lane sick and got me sick cost more than I made in almost a year.

TOTALLY MY FAULT THOUGH RIGHT GOP?! TAKE RESPONSIBILITY FOR MY ACTIONS TRYING TO WORK.

*headdesk*

You totally should have a year's worth of wages saved up in case of emergencies. #bootstraps