Author Topic: The ACA/Obamacare Thread  (Read 8194 times)

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Offline hefdaddy42

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Re: The ACA/Obamacare Thread
« Reply #70 on: January 27, 2017, 12:43:58 PM »
It's NOT a death wish.  It's not WANTING people to die.

It's not really caring if they die or not.  That's a different thing.

You're splitting hairs.
I'm differentiating for accuracy.  "If someone dies, they die" and "Kill that motherfucker" are two entirely different things.

So, why do YOU think they pulled the advertising, which was already paid for?  Especially with the deadline so close?

And stop with the "repeal and replace", there is no such animal until there is an actual replacement plan.  And there isn't one.  Meanwhile, they've been trying to repeal the ACA for 7 years, with no replacement in sight.

Hef is right on all things. Except for when I disagree with him. In which case he's probably still right.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #71 on: January 27, 2017, 12:52:36 PM »
Separately - my understanding is that they are going to repeal and replace. Not just repeal. Now we can argue the merits of the replacement once announced, the pros and cons, that's all up for debate. But to the best of my knowledge their plan is to have a replacement of some sort.

That's certainly the official line they have been giving, but given that the house/senate has been trying to repeal obamacare for the last 7 years or so without so much as a peep of what the plan replacing it would be, and given that Trump/Bannon's current strategy seems to boil down to "burn it all", you'll have to forgive me for being skeptical that they plan to replace it with something/anything that would cover more people.

If that turns out to be wrong, I will gladly eat my hat, but until then I can only judge the republican legislature on what they have actually done the last few years, which is attempt to repeal and offer no replacement plan.

It is right and appropriate to be skeptical.  But change DOES happen, and the environment today is not the same as it was seven years ago.  You know full well that in a divided government (Dem in the White House and Rep in Congress or whatever) the dynamic is different than if there is unity.  There is no one to blame, no one to scapegoat if this fails, and I believe Republicans know this.   The quotes above prove this.  They care about people every bit as much as any Democrat, the only difference is that they don't show they care by throwing money at them and blaming their problems on the "rich".

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #72 on: January 27, 2017, 12:56:23 PM »
Both sides are guilty on occasion of not caring if people die for their cause.

Some on the right do not care if some lose insurance and get sick, just so they can repeal the ACA.

Some on the left do not care if people die during protests that during violent, because it's for their version of the greater good. 

It's foolish, naive and partisan to think otherwise.
I don't think it's that they're indifferent to death. I think they simply value deaths more or less than other things. These things will generally turn out to be personal interests. Is it worth a billion dollars to treat one 75 year old woman? What if the woman's your mom? What if she's a convicted criminal?

Doesn't that make the case that gov. shouldn't be involved in healthcare at all? Then there would be no concern over what gov. officials value more or less than death.

That just means you pass the buck on to private companies who give even less of a shit than the government who live and dies.

Death is bad for business.   My ex-wife (and her "new husband" with whom she celebrated "three years with"... about eight months after our divorce) both work for a major healthcare insurance provider.  I have PLENTY of bad things to say about them as people and professionals, but that is not one of them.   I have known people in that organization to cry when people they've been dealing with (through the claims process) have passed away.  Again, this scapegoating of the nameless, faceless, as if ONLY Democrats actually care about people.  Please.   

Offline jsbru

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Re: The ACA/Obamacare Thread
« Reply #73 on: January 27, 2017, 12:59:10 PM »
That's not what I mean, and you know it.  It's one thing to argue policies and politics, but to resort to ad hominem attacks like that, well, it speaks volumes.    If the argument FOR the coverage was so great and just, there wouldn't be any need to resort to such low tactics.   It's also fear-mongering, since there is absolutely no indication that those outcomes are likely.  It's not as if they STOPPED THE ENROLLMENT.  They halted ADVERTISEMENT, for a program that people already knew existed and in most cases, already started enrolling in.   At some point there has to be SOME personal accountability.   If I want healthcare, if I know where to get it, and simply don't complete the application, that's not on any one politician - Republican or Democrat - but it's on ME.   And it's egregious to attribute that to some morbid "death wish" on the part of politicians whose only crime is to not see things like you do.

I'm not even talking about the repeal.  I'm talking about red states' original refusal to expand Medicaid.

I also live in a red state that refused to do so, and as a single white male with no kids, I do not qualify for Medicaid no matter how little I make.  And being that I was a voluteer employee for a while, I did not make enough to qualify for Obamacare.

The idea that additional deaths will result because of Republican-controlled states refusing to expand Medicaid has been the subject of numerous studies:

http://articles.mcall.com/2014-01-30/news/mc-pennsylvania-deaths-no-medicaid-expansion-20140130_1_medicaid-expansion-expanding-medicaid-medicaid-program#ixzz2s009cIx0

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Gathered by researchers from Harvard University and the City University of New York, the estimates show that in the states that opted out of expanding Medicaid, 7,000-17,000 additional deaths will occur among people who would have been covered had expansion been supported.

This chart tracks the needless deaths by state:
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Online cramx3

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Re: The ACA/Obamacare Thread
« Reply #74 on: January 27, 2017, 01:04:39 PM »
And stop with the "repeal and replace", there is no such animal until there is an actual replacement plan.  And there isn't one.  Meanwhile, they've been trying to repeal the ACA for 7 years, with no replacement in sight.

No. Why should anyone stop saying that if that's what the lawmakers are saying themselves.  I agree that skepticism is fair, but don't tell me to not repeat what our lawmakers are saying they plan on doing because you don't think it'll happen.  If the last week was proof of anything, it shows that Trump is going full steam ahead on his plans, like it or not. 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #75 on: January 27, 2017, 01:05:00 PM »
They can claim all they they like that they will REPEAL AND REPLACE, until they come up with a concrete replacement plan, all they have as a plan is repeal, and all they have tried to do for the last 7 years is repeal.

As I mentioned earlier, they have plans out there, just nothing finalized or decided at this point. Here is a quick read to touch on a couple:

http://www.npr.org/2017/01/26/511675435/republicans-have-plans-to-replace-obamacare-now-they-need-to-agree-on-one

And the biggest difference is that seven years ago, they not only had no support from the President, but zero support from their Democrat colleagues in Congress.  A lot of the "REPEAL" was just repeal, no replace, because a lot of it was for show, not dough.  The only real threat to Obamacare in 2009 was the Supreme Court, and they made their point clear.   Now, it's VERY different.  They have pledged (again, see my link) that this cannot and SHOULD NOT be done without Democrat cooperation.   

Even if you're right about Dems being perfect angels, and Reps being the spawn of Beelzebub - which you're not - presumably the angels would not give ANY cooperation to a replacement that was callous and callow about people dying. 


Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #76 on: January 27, 2017, 01:09:48 PM »
There is no one to blame, no one to scapegoat if this fails, and I believe Republicans know this.

Oh my sweet summer child. Rest assured that they will find someone else to blame. You only need look at the UK political system to see how unified governments are capable of deflecting their own failures. But I admire your optimism.

Death is bad for business.   

Can be, often isn't.

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My ex-wife (and her "new husband" with whom she celebrated "three years with"... about eight months after our divorce)

That sucks. I'm sorry to hear that.

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both work for a major healthcare insurance provider.  I have PLENTY of bad things to say about them as people and professionals, but that is not one of them.   I have known people in that organization to cry when people they've been dealing with (through the claims process) have passed away.  Again, this scapegoating of the nameless, faceless, as if ONLY Democrats actually care about people.  Please.

Which is all good and dandy, and I don't doubt there are decent emphatic people working there but the fact remains that US insurance companies only covered pre-existing conditions when forced to. I don't feel its a controversial statement to say that a system that prioritises profit (and all private institutions do ultimately) will treat less people than a system run by and run for the people. Comprehensive care, especially for chronic illnesses, is expensive and often not costs efficient after all.

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Even if you're right about Dems being perfect angels, and Reps being the spawn of Beelzebub - which you're not - presumably the angels would not give ANY cooperation to a replacement that was callous and callow about people dying.

Well I never claimed that, so ...yeah. There's plenty of shitty practices and people within the Democratic party.
« Last Edit: January 27, 2017, 01:15:28 PM by XJDenton »

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #77 on: January 27, 2017, 01:13:50 PM »
And stop with the "repeal and replace", there is no such animal until there is an actual replacement plan.  And there isn't one.  Meanwhile, they've been trying to repeal the ACA for 7 years, with no replacement in sight.

No. Why should anyone stop saying that if that's what the lawmakers are saying themselves.  I agree that skepticism is fair, but don't tell me to not repeat what our lawmakers are saying they plan on doing because you don't think it'll happen.  If the last week was proof of anything, it shows that Trump is going full steam ahead on his plans, like it or not.

I'm not stopping either.  No offense, Hef, but I believe that you are slightly misstating what "repeal" means.    If you tell your kids, at 6 pm, that "THE TV IS GOING OFF NOW!"  You are repealing the TV.   If you say "THE TV IS GOING OFF NOW!  READ A DAMN BOOK!"  You are repealing the TV and replacing the TV with a book.  If you say, at 6 pm, that "THE TV IS GOING OFF AT 8 SHARP!"  You are ALSO repealing the TV.   But you are letting them have more TV.    If you say, at 6 pm, that "THE TV IS GOING OFF AS SOON AS MOM GETS HOME.  SHE WILL DECIDE IF YOU NEED TO TAKE A BATH OR GO RIGHT TO BED".  You have repealed the TV, and replaced it perhaps with a bath, perhaps with something else.  That's up to Mom.  But Mom WILL decide.   That's where we're at.  I get it that "uncertainty" bugs some people,  but you get your TV (Obamacare) until Mom gets home (the replacement is spelled out).   


Offline hefdaddy42

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Re: The ACA/Obamacare Thread
« Reply #78 on: January 27, 2017, 01:19:43 PM »
I hope you are right, but I have seen absolutely no evidence whatsoever that that is the case.

Hell, if they come up with a replacement that works better, I will be a huge cheerleader, because the ACA is certainly far from perfect.

But I will believe it when I see it.

Hef is right on all things. Except for when I disagree with him. In which case he's probably still right.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #79 on: January 27, 2017, 01:20:51 PM »
Which is all good and dandy, and I don't doubt there are decent emphatic people working there but the fact remains that US insurance companies only covered pre-existing conditions when forced to. I don't feel its a controversial statement to say that a system that prioritises profit (and all private institutions do ultimately) will treat less people than a system run by and run for the people. Care, especially for chronic illnesses, is expensive after all.


Specifically on preexisting conditions:  it DID exist when your coverage was through an employer.  My father had debilitating arthritis at a young age (by the time he was 50, he had both knees replaced - one twice - and both hips done, and has been on a daily cocktail of meds since I was in middle school) and was literally never once denied coverage, although to be fair, he never had to buy an individual plan.  The other cases were not denied because insurers were scumbags, but because that's not the role of insurance.  I don't get to wreck my Porsche then call GEICO and see if they can save me 15%.  It's called "insuring the burning building".   That government "made them do it" was not because of some egregious behavior by the insurers, it was one of those very few areas where we call on government to intervene.   It was the right thing to do, but it's a little - no, a LOT - disingenuous to go back and say "wow you guys are assholes for not doing that".  It's like calling Gordie Howe an asshole for not wearing a hockey helmet. 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #80 on: January 27, 2017, 01:22:00 PM »
I hope you are right, but I have seen absolutely no evidence whatsoever that that is the case.

Hell, if they come up with a replacement that works better, I will be a huge cheerleader, because the ACA is certainly far from perfect.

But I will believe it when I see it.

And on that we've found our middle ground of sorts.  I think I'm more optimistic than you, but I have my own skepticism, but I am willing to wait and see what is produced. 

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Re: The ACA/Obamacare Thread
« Reply #81 on: January 27, 2017, 01:23:08 PM »
And stop with the "repeal and replace", there is no such animal until there is an actual replacement plan.  And there isn't one.  Meanwhile, they've been trying to repeal the ACA for 7 years, with no replacement in sight.

No. Why should anyone stop saying that if that's what the lawmakers are saying themselves.  I agree that skepticism is fair, but don't tell me to not repeat what our lawmakers are saying they plan on doing because you don't think it'll happen.  If the last week was proof of anything, it shows that Trump is going full steam ahead on his plans, like it or not.

I'm not stopping either.  No offense, Hef, but I believe that you are slightly misstating what "repeal" means.    If you tell your kids, at 6 pm, that "THE TV IS GOING OFF NOW!"  You are repealing the TV.   If you say "THE TV IS GOING OFF NOW!  READ A DAMN BOOK!"  You are repealing the TV and replacing the TV with a book.  If you say, at 6 pm, that "THE TV IS GOING OFF AT 8 SHARP!"  You are ALSO repealing the TV.   But you are letting them have more TV.    If you say, at 6 pm, that "THE TV IS GOING OFF AS SOON AS MOM GETS HOME.  SHE WILL DECIDE IF YOU NEED TO TAKE A BATH OR GO RIGHT TO BED".  You have repealed the TV, and replaced it perhaps with a bath, perhaps with something else.  That's up to Mom.  But Mom WILL decide.   That's where we're at.  I get it that "uncertainty" bugs some people,  but you get your TV (Obamacare) until Mom gets home (the replacement is spelled out).

And it should bug people though.  We are messing with something that is very important to every single person's life in America.  While I want a better system, I still understand the impact of changing such a system.  And if you were someone who benefitted from the ACA then you likely aren't just bugged, you are scared for your life (literally).  I don't think anyone wants to just repeal the ACA and see what happens, that's not good for anyone.  This needs to be done carefully and I do agree, with bipartisanship. This needs to be for everyone.

But I will believe it when I see it.

As will most, including myself.  I am not sure how Trump will make this work, but he says he will do it and that's all I can go by for now until something changes.

Offline jsbru

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Re: The ACA/Obamacare Thread
« Reply #82 on: January 27, 2017, 01:26:53 PM »
I fail to believe the opposition to Obamacare was anything more than purely political.  It really wasn't a partisan bill.  Obama had non-partisan experts basically write it.  It borrowed heavily from Romneycare.  It incorporated a number of Republican ideas that Republicans suddenly turned against because Obama supported them.

It could use a few tweaks here and there, but there's really no obvious and easy way to make it better without either denying more people coverage, giving people less comprehensive coverage, or raising taxes.

Any alternative Republican plan is going to have to incorporate at least one (if not all) of those things, and people are not going to like it either way.
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Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #83 on: January 27, 2017, 01:29:27 PM »
Specifically on preexisting conditions:  it DID exist when your coverage was through an employer.  My father had debilitating arthritis at a young age (by the time he was 50, he had both knees replaced - one twice - and both hips done, and has been on a daily cocktail of meds since I was in middle school) and was literally never once denied coverage, although to be fair, he never had to buy an individual plan.  The other cases were not denied because insurers were scumbags, but because that's not the role of insurance.  I don't get to wreck my Porsche then call GEICO and see if they can save me 15%.  It's called "insuring the burning building".   That government "made them do it" was not because of some egregious behavior by the insurers, it was one of those very few areas where we call on government to intervene.   It was the right thing to do, but it's a little - no, a LOT - disingenuous to go back and say "wow you guys are assholes for not doing that".  It's like calling Gordie Howe an asshole for not wearing a hockey helmet. 

Well they could be the role of insurance, if the insurance framework was set up to prioritise patient care, like for example, every national health insurance system in western civilisation. However these insurance companies weren't set up like that. They were set up to be profitable. And hence they didn't cover these people, even though that would lead to additional deaths.

Also, I have no idea who Geodie Howe is. Is he a sportsball player renowned for sporting well?

Offline mikeyd23

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Re: The ACA/Obamacare Thread
« Reply #84 on: January 27, 2017, 01:31:59 PM »
Also, I have no idea who Geodie Howe is. Is he a sportsball player renowned for sporting well?

 :lol He is considered to be one of the greatest hockey players ever. He definitely sported well.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #85 on: January 27, 2017, 01:37:46 PM »
I fail to believe the opposition to Obamacare was anything more than purely political.  It really wasn't a partisan bill.  Obama had non-partisan experts basically write it.  It borrowed heavily from Romneycare.  It incorporated a number of Republican ideas that Republicans suddenly turned against because Obama supported them.

It could use a few tweaks here and there, but there's really no obvious and easy way to make it better without either denying more people coverage, giving people less comprehensive coverage, or raising taxes.

Any alternative Republican plan is going to have to incorporate at least one (if not all) of those things, and people are not going to like it either way.

That's a common trope; it borrowed three main tenets from Romneycare - healthcare for everyone, mandatory compliance, and subsidies for those that can't afford it - but there were a LOT of differences, and even Romney said he tried to veto certain aspects of his bill and couldn't.  It was no secret that he felt the plan "gave too much away" in terms of subsidies.

The biggest difference is that Romneycare worked at the state level, with a FRACTION of the people, and a fraction of the cost.   Massachusetts also had a LOT less uninsured.  (If I remember right, the numbers were 5 million people in Mass, and about 500,000 uninsured, whereas the US is 325 million and at the time of Obamacare I think it was 45 million uninsured).  Romneycare didn't have to contend with state-by-state boundaries for it's insurers, and for the insurers, they had only one regulatory scheme to comply with.   

One of the big problems with the exchanges was that there was a push to get companies to participate in all of them, but not all the insurers were able to do business with all the exchanges because of the geography.  Plus there are restrictions on the Blues - they are largely state-by-state franchises, some of which are non-profit - that would work at the state level, but not the national level. Then there's the whole taxation aspect of it.  Finally, if a company didn't like it, they could move.  It's not a coincidence that, for example, MassMutual, a Massachusetts company, has a massive office complex not a mile from the Mass border in Connecticut.  Likewise, CIGNA in Delaware.   

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #86 on: January 27, 2017, 01:48:45 PM »
Specifically on preexisting conditions:  it DID exist when your coverage was through an employer.  My father had debilitating arthritis at a young age (by the time he was 50, he had both knees replaced - one twice - and both hips done, and has been on a daily cocktail of meds since I was in middle school) and was literally never once denied coverage, although to be fair, he never had to buy an individual plan.  The other cases were not denied because insurers were scumbags, but because that's not the role of insurance.  I don't get to wreck my Porsche then call GEICO and see if they can save me 15%.  It's called "insuring the burning building".   That government "made them do it" was not because of some egregious behavior by the insurers, it was one of those very few areas where we call on government to intervene.   It was the right thing to do, but it's a little - no, a LOT - disingenuous to go back and say "wow you guys are assholes for not doing that".  It's like calling Gordie Howe an asshole for not wearing a hockey helmet. 

Well they could be the role of insurance, if the insurance framework was set up to prioritise patient care, like for example, every national health insurance system in western civilisation. However these insurance companies weren't set up like that. They were set up to be profitable. And hence they didn't cover these people, even though that would lead to additional deaths.

Also, I have no idea who Geodie Howe is. Is he a sportsball player renowned for sporting well?

Arguably one of the three greatest hockey players to ever play the game, and reknowned for playing the game into his 50's.  Pure legend.  I don't know where you live, but I'm sure you have an analogue of sorts in some capacity. 

I don't know what I'm to make of that last sentence.  Since when is it an arbitrary corporations responsibility to just fund someone's needs?   If healthcare insurers are responsible for someone dying, because that person didn't protect him/herself before they got sick, why is it not, say, Apple's fault that Butch Trucks shot himself?   Or may DelMonte should be responsible for Greg Lake's passing?   Is Samsung responsible for me not seeing the Super Bowl, because I didn't buy my TV in time?   Perhaps BMW would be kind enough to reimburse me, because I was late to a job interview; I didn't have a car so I took the bus and it broke down.   

If you're bemoaning "healthcare being for profit", well that's a fair beef, but it isn't part of "Obamacare".  That goes back to almost Ben Franklin times, and is a more existential question.  (For the record, you should know that my preferred means of insuring our people here - once we assume that it's a "right" and not a "privilege") is single payer.  If we're going to be "in" the healthcare game, be all in.  The layers and opaqueness of the current system is why it doesn't work, not because "Aetna has a profit target".   

If you're so right about the evils of "profitability", it would make far more sense to have as many healthy, insured people as they can; with the premiums, that's virtually an annuity.  Not JUST the healthy, but get everyone healthy. WELLNESS!  You can't scream "PROFIT!" like it's screaming the "n-word", then ignore all the behaviors that belie the profit motive. 

Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #87 on: January 27, 2017, 02:07:09 PM »
Arguably one of the three greatest hockey players to ever play the game, and reknowned for playing the game into his 50's.  Pure legend.  I don't know where you live, but I'm sure you have an analogue of sorts in some capacity. 

British originally. Last time we had a climate suitable for Ice Hockey you could walk to France. I guess someone like Ian Botham or Bobby Charlton would be our equivalent.

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I don't know what I'm to make of that last sentence.  Since when is it an arbitrary corporations responsibility to just fund someone's needs?

It isn't. That's why it is a shitty system for ensuring care.

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If you're bemoaning "healthcare being for profit", well that's a fair beef, but it isn't part of "Obamacare".  That goes back to almost Ben Franklin times, and is a more existential question.  (For the record, you should know that my preferred means of insuring our people here - once we assume that it's a "right" and not a "privilege") is single payer.  If we're going to be "in" the healthcare game, be all in.

Ah good. We agree.

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If you're so right about the evils of "profitability", it would make far more sense to have as many healthy, insured people as they can; with the premiums, that's virtually an annuity.  Not JUST the healthy, but get everyone healthy. WELLNESS!  You can't scream "PROFIT!" like it's screaming the "n-word", then ignore all the behaviors that belie the profit motive.

It's not evil, its just not well suited for solving certain types of problems, in particular ones that require protection for all people regardless of individual ability to fund it, hence why capitalist societies still have core services like Police, Firefighting etc funded publicly. This is my main point of contention with most right wingers I have met:  the market does not always solve the problem well.

Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #88 on: January 27, 2017, 02:17:25 PM »
ON the subject of REPEAL AND REPLACE TM:

The history of the development of the Republican alternative to Obamacare since the beginning of the health-care debate, in 2009, has been an endless loop of loud promises that a full plan will be announced soon, followed by quiet admissions that it will not. Seventeen days ago, Donald Trump promised a vote to repeal the law “probably some time next week” with a vote for a replacement “very quickly or simultaneously, very shortly thereafter.” At a meeting in Philadelphia yesterday, Trump and his House Republican allies produced no agreement on a plan. If there is a consensus, it is that there will be no replacement plan at all.

Representative Greg Walden, a key leader of the House Republican efforts on health care, tells Julie Rovner, “There’s no single fix. There’s no single plan.” Representative Marsha Blackburn touted bills to limit medical malpractice lawsuits and to allow the sale of state-regulated insurance across state lines. Neither of these proposals would have any significant impact on insurance coverage. If Obamacare is repealed, this would leave the individual-health-insurance market a smoldering crater.

Republicans are portraying the lack of a plan as a philosophical aversion to lengthy legislation. “If you’re waiting for another 2,700-page bill to emerge, you’re going to have to wait until the sun doesn’t come up, because that’s not how we’re going to do it,” says Walden. You may not need 2,700 pages of legislative text. But you can’t blow up the health-care system and replace it with a series of piecemeal measures. Any real plan to provide even crappy coverage — let alone the better, more affordable coverage Trump has repeatedly promised — is going to need to be paid for. Making those trade-offs means figuring out some big-picture strategy for where the money will come from.


The reason health-care reform is done by assembling a big bill with a high page count is that all the stakeholders want to know beforehand whether the final product will be acceptable to them. Hospitals or insurers or doctors or drug makers might be willing to accept provisions that hurt their bottom line if there are other provisions that help them. But they won’t support passing a bill that hurts them on the promise of getting help in a future bill, because they don’t know whether the future bill will pass. Going step by step is a talking point, not a plausible way to actually write laws.

Step-by-step changes could work if they leave the current system in place and alter it incrementally. But if you blow the market up, you need comprehensive changes to rebuild something in its place.

Several Senate Republicans have expressed severe reservations about repealing Obamacare without having a replacement. Now the House is admitting there isn’t going to be a replacement. So now the choice falls to Republicans to either defeat repeal, or allow the system to hurtle toward chaos.

Offline El Barto

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Re: The ACA/Obamacare Thread
« Reply #89 on: January 27, 2017, 03:49:52 PM »
The problem with repeal and replace, and I'll borrow from Stadler's not quite as entertaining as the Prisoner analogy, is that what we keep hearing is "I'm going to turn the TV off as soon as possible and then we'll all frolic in Eden with unicorns, Pegasus, mermaids and the Stay-Puft Marshmallow Man." That's the sort of promise that makes reasonable people want to call bullshit.
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Offline pogoowner

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Re: The ACA/Obamacare Thread
« Reply #90 on: January 27, 2017, 05:14:11 PM »
The Trump team has reportedly backed down and the ACA ads will continue to air now.

Offline jsbru

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Re: The ACA/Obamacare Thread
« Reply #91 on: January 27, 2017, 09:47:46 PM »
These people just don't have a clue:

https://www.washingtonpost.com/politics/behind-closed-doors-republican-lawmakers-fret-about-how-to-repeal-obamacare/2017/01/27/deabdafa-e491-11e6-a547-5fb9411d332c_story.html?utm_term=.b98bc9b33943

Republicans have made the promise to repeal Obamacare before they have any idea whether they can even come up with a viable replacement.
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Re: The ACA/Obamacare Thread
« Reply #92 on: January 28, 2017, 12:50:34 AM »
It's NOT a death wish.  It's not WANTING people to die.

It's not really caring if they die or not.  That's a different thing.

You're splitting hairs.  It's still something else to accuse someone of not caring if someone dies.   Especially when you're not really talking about policy (the "WHAT") but just the "how".

https://www.washingtonpost.com/politics/behind-closed-doors-republican-lawmakers-fret-about-how-to-repeal-obamacare/2017/01/27/deabdafa-e491-11e6-a547-5fb9411d332c_story.html?hpid=hp_hp-banner-main_goptapes-138pm%3Ahomepage%2Fstory&utm_term=.ae731aa58c91

Republicans.  Doing and saying all the things some of you are saying they don't give a crap about.  Again, it's not as if "political party" is indicative of whether one is human, with human feelings.

Stadler, there's exactly one quote in that entire article that mentions "pulling the rug out from people" while the rest are about the political ramifications they might face.

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Re: The ACA/Obamacare Thread
« Reply #93 on: January 28, 2017, 12:39:05 PM »
Interesting.  I didn't even realize Stadler posted that same article on the previous page.

I read that article, and my takeaway was about how reckless their promise to repeal the ACA was when they have absolutely no idea if they can come up with something better.  Seems like they don't have a plan at all.  They've had 7 years now, and all they could figure out was "screw Obama."
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Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #94 on: January 30, 2017, 07:37:35 AM »
Quote
If you're so right about the evils of "profitability", it would make far more sense to have as many healthy, insured people as they can; with the premiums, that's virtually an annuity.  Not JUST the healthy, but get everyone healthy. WELLNESS!  You can't scream "PROFIT!" like it's screaming the "n-word", then ignore all the behaviors that belie the profit motive.

It's not evil, its just not well suited for solving certain types of problems, in particular ones that require protection for all people regardless of individual ability to fund it, hence why capitalist societies still have core services like Police, Firefighting etc funded publicly. This is my main point of contention with most right wingers I have met:  the market does not always solve the problem well.

Ignoring the "right wingers" for a moment (not all "right wingers" - in the full sense of the word - are ardent capitalists and vice versa), you're right, the market DOESN'T always solve the problem well, but that's not to say that it NEVER does, or that when it doesn't it's because of "free market!" and not "poor execution".   Police and fire are not appropriate analogues to healthcare, because the rationales are somewhat different.   We don't "not pay" for police and fire because of "free market" issues, but because of the compelling state interest that there be some arbitrary standard enforced - by government, thus government pays - and because allocation of costs would be brutal.   How do you assess the fire department fees for a condo complex, or an apartment building?  You don't.   Were those two solely attributable to a single person every time, there would be no issue with a free market fire protection scheme.   

The problem with "healthcare" is not the free market (or not entirely; there are some areas where it doesn't work.  That miracle drug that is made from the distilled semen of the Australian aardvark and only helps the 18 people with that particular strain of flu).  The problem with "healthcare" is the framework is messed up.  You don't have responsibility and accountability in the same place - or even in the same ballpark - and the opaqueness of the layers is ridiculous.   I've told this story before:  my daughter went in for what turned out to be a routine infection - OTC for a week, and GONE - and during the discussion the doctor asked about a certain symptom, and she said "no, haven't had that, that I recall", and the doctor said, "well, have you had a [certain blood test] lately?" and she said "no, because I haven't had that problem".  And he said, essentially, "well, let's do it.  Insurance is paying anyway, and then you can say next time "had that test!"".    That's not how "driving out costs" ought to work.  If the doctor was paying for it, it wouldn't have happened.  If my daughter - or I - was paying for it, that wouldn't have happened.   

There are almost 1,000,000 doctors in the U.S. right now (last count I saw was about 970,000).   If that $500 test happens even ONCE a year, for HALF of them, we're talking about $250 MILLION dollars of waste.    A quarter of a BILLION dollars.  We have this idea that "insurance will pay! F the insurers!" and yet, it's NOT the insurers that pay.  At the end of the day, after the next rate cycle YOU pay.  And you had no input into the cost, no ability to control it, and no accountability for the spend itself.   THAT'S why the system is not working.  Not "free markets" (because without a free market, that test is perhaps $750, or $1000, and the mechanism is still the same, and the waste is 50% or even 100% higher).   

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #95 on: January 30, 2017, 07:49:59 AM »
ON the subject of REPEAL AND REPLACE TM:

The history of the development of the Republican alternative to Obamacare since the beginning of the health-care debate, in 2009, has been an endless loop of loud promises that a full plan will be announced soon, followed by quiet admissions that it will not. Seventeen days ago, Donald Trump promised a vote to repeal the law “probably some time next week” with a vote for a replacement “very quickly or simultaneously, very shortly thereafter.” At a meeting in Philadelphia yesterday, Trump and his House Republican allies produced no agreement on a plan. If there is a consensus, it is that there will be no replacement plan at all.

Representative Greg Walden, a key leader of the House Republican efforts on health care, tells Julie Rovner, “There’s no single fix. There’s no single plan.” Representative Marsha Blackburn touted bills to limit medical malpractice lawsuits and to allow the sale of state-regulated insurance across state lines. Neither of these proposals would have any significant impact on insurance coverage. If Obamacare is repealed, this would leave the individual-health-insurance market a smoldering crater.

Republicans are portraying the lack of a plan as a philosophical aversion to lengthy legislation. “If you’re waiting for another 2,700-page bill to emerge, you’re going to have to wait until the sun doesn’t come up, because that’s not how we’re going to do it,” says Walden. You may not need 2,700 pages of legislative text. But you can’t blow up the health-care system and replace it with a series of piecemeal measures. Any real plan to provide even crappy coverage — let alone the better, more affordable coverage Trump has repeatedly promised — is going to need to be paid for. Making those trade-offs means figuring out some big-picture strategy for where the money will come from.


The reason health-care reform is done by assembling a big bill with a high page count is that all the stakeholders want to know beforehand whether the final product will be acceptable to them. Hospitals or insurers or doctors or drug makers might be willing to accept provisions that hurt their bottom line if there are other provisions that help them. But they won’t support passing a bill that hurts them on the promise of getting help in a future bill, because they don’t know whether the future bill will pass. Going step by step is a talking point, not a plausible way to actually write laws.

Step-by-step changes could work if they leave the current system in place and alter it incrementally. But if you blow the market up, you need comprehensive changes to rebuild something in its place.

Several Senate Republicans have expressed severe reservations about repealing Obamacare without having a replacement. Now the House is admitting there isn’t going to be a replacement. So now the choice falls to Republicans to either defeat repeal, or allow the system to hurtle toward chaos.

What was the point of that Op-Ed piece?   I don't see any specific reference to the headline in the body of the article (at least that part of the article that is quoted; I couldn't get the link to work).  It just sounds like one of the anti-Trump posters here making the same assertions and drawing the same conclusions, but just a little longer, a little better researched (quotes! taken out of context to demonstrate something that wasn't said!), and a little better written (though I'm willing to concede that one).

I'm pretty sure that no matter what the Republicans offer up, it's going to be lambasted, not because it's "bad" but because it's "Republican" and/or "Trump".  They're actually doing it RIGHT, doing it the RIGHT WAY - the way Obama should have, instead of trying to cram 10 pounds of shit into a 5 pound bag because it was "HIS LEGACY!" - by looking at all options, weighing all possibilities, and considering all sides of the equation.  Had this been "Hillary" doing this, most of you would be celebrating.  MASSIVELY. 

At least for me - who has no doubt whatsoever that the current system will continue unless and until something better comes up - it's fun to watch people's partisanship and bias overwhelm reason and fact.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #96 on: January 30, 2017, 07:59:07 AM »
Interesting.  I didn't even realize Stadler posted that same article on the previous page.

I read that article, and my takeaway was about how reckless their promise to repeal the ACA was when they have absolutely no idea if they can come up with something better.  Seems like they don't have a plan at all.  They've had 7 years now, and all they could figure out was "screw Obama."


Repeating it over and over doesn't make it true.   No one said it was easy.   80% of Americans - EIGHTY; that's well more than both parties COMBINED, so this ISN'T "screw Obama", this is "HOUSTON WE HAVE A PROBLEM" - have said that they do not like Obamacare and want something done about it.  The Republicans are not in "screw Obama" mode, they're actually in "hey, we have to do something" mode, and are figuring it out.    Better than the alternative; ramming it through with almost no thought whatsoever - except that legacy-building deal with Pharma to make sure they get their profits, to the tune of $80 BILLION dollars - but it doesn't matter does it?   The Republicans could cure cancer, double everyone's salary, and get the Kardashians to go away, and some of you would still find a way to say "yep, the GOP.  All of them want to see people die and "screw Obama".   

It's getting sickening now, and any credibility of argument against what is happening is dissipating rapidly.  This is how the process SHOULD work, left or right.   They've identified the problem - and it is a problem - and they've set a commitment, to which they can be held accountable, to fix it.  And that's the part that is in process now. 

Offline hefdaddy42

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Re: The ACA/Obamacare Thread
« Reply #97 on: January 30, 2017, 07:59:41 AM »
At least for me - who has no doubt whatsoever that the current system will continue unless and until something better comes up - it's fun to watch people's partisanship and bias overwhelm reason and fact.
You keep saying that, but there has been no evidence put forth that I have seen to support that.  I haven't even seen it mentioned as an option by anyone or reported as an option by anyone, no matter which news outlet.

Hef is right on all things. Except for when I disagree with him. In which case he's probably still right.

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Re: The ACA/Obamacare Thread
« Reply #98 on: January 30, 2017, 08:01:21 AM »
At least for me - who has no doubt whatsoever that the current system will continue unless and until something better comes up - it's fun to watch people's partisanship and bias overwhelm reason and fact.
You keep saying that, but there has been no evidence put forth that I have seen to support that.  I haven't even seen it mentioned as an option by anyone or reported as an option by anyone, no matter which news outlet.

Yeah, if that's really the case then what the hell is this kabuki theater they've been doing?

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Re: The ACA/Obamacare Thread
« Reply #99 on: January 30, 2017, 08:06:23 AM »

 80% of Americans - EIGHTY; that's well more than both parties COMBINED, so this ISN'T "screw Obama", this is "HOUSTON WE HAVE A PROBLEM" - have said that they do not like Obamacare and want something done about it.

But that statistic is so vast as to be almost meaningless.  80% means it uncludes both people who want to get rid all health insurance and just pay as you go AND people who want a universal system.   
« Last Edit: January 30, 2017, 08:23:43 AM by XeRocks81 »

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #100 on: January 30, 2017, 08:17:09 AM »
At least for me - who has no doubt whatsoever that the current system will continue unless and until something better comes up - it's fun to watch people's partisanship and bias overwhelm reason and fact.
You keep saying that, but there has been no evidence put forth that I have seen to support that.  I haven't even seen it mentioned as an option by anyone or reported as an option by anyone, no matter which news outlet.

Except for one thing: there's no evidence that they WON'T, yet that's not stopping a bunch of us from jumping to conclusions.  At least I have top elected officials - who will presumably be held accountable for their actions - confirming my position.  You don't even have that.  Why can you jump to conclusions and it's valid, but we can't?  Because of "party"?    You know that's nonsense, or at least partisan.

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Re: The ACA/Obamacare Thread
« Reply #101 on: January 30, 2017, 08:18:26 AM »
 ???  I have no party.  I am making no assumptions based on party.  I am making no assumptions at all.  YOU are.

Hef is right on all things. Except for when I disagree with him. In which case he's probably still right.

Offline jsbru

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Re: The ACA/Obamacare Thread
« Reply #102 on: January 30, 2017, 08:31:53 AM »
Better than the alternative; ramming it through with almost no thought whatsoever -

There's just no evidence at all that the original bill was "rammed through" with almost no thought whatsoever.

This bill was exhaustively debated with industry experts, revised, and debated again.  The only reason it had no "input" from Republicans is because they announced that they would oppose the bill no matter what because Obama.

Well, now they have their chance.  And it appears to me that they have no clue as to how to actually improve it.  Tort reform isn't going to do jack shit...almost every study shows that.  Selling insurance across state lines is going to create chaos and fraud.
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Re: The ACA/Obamacare Thread
« Reply #103 on: January 30, 2017, 08:36:28 AM »
Better than the alternative; ramming it through with almost no thought whatsoever -

There's just no evidence at all that the original bill was "rammed through" with almost no thought whatsoever.

This bill was exhaustively debated with industry experts, revised, and debated again.  The only reason it had no "input" from Republicans is because they announced that they would oppose the bill no matter what because Obama.

"Congress "[has] to pass the bill so you can find out what's in it, away from the fog of controversy.""

Nancy Pelosi in regards to ACA bill.  I'm sure many people went through and debated the bill, but it seems pretty clear at least some of our politicians didn't.

Offline El Barto

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Re: The ACA/Obamacare Thread
« Reply #104 on: January 30, 2017, 08:41:02 AM »
Better than the alternative; ramming it through with almost no thought whatsoever -

There's just no evidence at all that the original bill was "rammed through" with almost no thought whatsoever.

This bill was exhaustively debated with industry experts, revised, and debated again.  The only reason it had no "input" from Republicans is because they announced that they would oppose the bill no matter what because Obama.

"Congress "[has] to pass the bill so you can find out what's in it, away from the fog of controversy.""

Nancy Pelosi in regards to ACA bill.  I'm sure many people went through and debated the bill, but it seems pretty clear at least some of our politicians didn't.

[[sigh]]

Perhaps that's true, but there's nothing in your quote that supports that. I give you props for actually including the second part of it, most don't, yet you still use it to imply something it doesn't.
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