The PPACA Thread Part IV - Repeal & Replace, or Something...

[St. Clown]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

The national growth rate for health insurance premiums slowed with the ACA. So while anecdotally someone's tripled, that was no where close to the norm. Maybe his costs would have quadrupled if not for the ACA? And it is not attributed to higher deductibles either, growth in deductibles was higher before the ACA than it was after as well. Facts and data simply don't back up the ACA driving up costs.

http://www.commonwealthfund.org/publ...ce-cost-growth

The rate of premium increases were also declining prior to the ACA. Things were not static in the medical insurance field.

All that said, this is purely a game of political optics. Up to the point of 2016, the Republicans were winning that game on health insurance. Now that they've released their plan, the pendulum has started to swing back to the Democrats.

[Deutsche Gopher Fan]

Premiums had been going up 8-10% per year for the country on average prior to the ACA. It would've taken a long, long time for them to triple.

When you're arguing about the details behind the law that formed the ACA, the Average Joe was looking at his pocketbook and focusing on how he was going to afford his insurance. The details of the bill mattered little to him at that point. And the Average Joe saw who was in power when it passed, and thus the blame was set and the 2016 vote was cast.

A study recently came out that showed Obamacare lessened the premium hikes. I'll try to find it.

[Handyman]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

But you strip the Obamacare lite parts of it out, and their voters will like it. An even more horrible bill which would get passed.

But they arent doing that. You can keep moving the goal posts to try and make your post make more sense but the truth is it doesnt. This is the bill, this is what Trump said was coming and this is what Ryan put forth. No major change will come to it because Ryan and his cronies cant allow that to happen. (he might as well resign as Speaker if he does) What you see will pass with little opposition.

Oh and even if they did strip the Obama Lite stuff...only the super Righties (the one that think even this is Socialism) would back it. The Team Party would only support it until they realized 3/4 of their membership are going to be prison raped by it.

[ScoobyDoo]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

The people most hurt by the Republican plan are people like me. People aged 50-64. At this point just blow the whole ****ing thing up. Thanks Democrats and Democratic voters.

[Kepler]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

No, the solution is to stop the bleeding the GOP induced when it gutted the bill, repeatedly. Or single payer. I'm ready to give it a shot.

We will eventually have single payer. Remember Churchill's quote: "You can always count on Americans to do the right thing after exhausting all other possibilities."

The opposition to single payer, except for the obvious rice bowl excuses by the insurance industry, just boils down to a blindly obstinate ideological objection to a government solution regardless of the merits. Ryan et al. have to start from the axiomatic grunt "gubmint bad, private profit sector good" because their entire philosophy of life is anchored on that unthinking reflex. But the rest of us can weigh the merits of the choices, and the GOP simply can't come up with anything more competitive on coverage and cost because there isn't anything.

The only reason this is even an issue is the GOP has yoked their economic philosophy (a sop to their 1% paymasters) to a bunch of social prejudices that are very popular to lower and middle class whites who are particularly anxious right now as their racial privilege recedes. It's like shooting fish in barrel, particularly because the Dems have been for the most part bought off and won't argue for genuine liberal economic policies that their donors don't like.

Without campaign finance reform, this just goes on for another generation until demography finally buries the GOP for us.

[alfablue]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

We will eventually have single payer, just remember Churchill's quote: "You can always count on Americans to do the right thing - after exhausting all other possibilities."

Maybe this will play out just like gay marriage did? As soon as states started to ban it, it was clear that the SCOTUS would be forced to make it universally legal.

So after the first attempt to cover everyone, and then a pretty universal restriction on it AND other cuts- we will be forced to go single payer.

I'm pretty sure a government black box can't do much worse the the corporate black boxes that dole out our money at the moment. I think it's funny that people CONTINUE to pretend that for profit companies are actually looking out for them. As opposed to their shareholders.

[Kepler]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Maybe this will play out just like gay marriage did? As soon as states started to ban it, it was clear that the SCOTUS would be forced to make it universally legal.

I don't think so. For one thing, the Court has been severely retrograde on economic issues during its period of Conservative Captivity, which was just extended by the GOP's clever (albeit cynical) seat steal. Even as social rights have expanded to meet cultural realities, GOP appointees have rigorously enforced Neofeudal economic preferences. That doesn't change until the levy breaks a la 1929.

And for another, this isn't the sort of thing where it matters when public attitudes and political ideology is misaligned. On social practices, the people lead the Court. (This was the big problem with Roe.) On economic and political issues, the Court is the creator and guardian of the rules which actuate reality. It's not like you and I can set up our own single payer system in the privacy of our own bedroom. The Court iimposes economic and political realities on us, which is why for example Republican voter suppression is such a lethal threat to the republic. They are the secular business end of Matthew 16:19: And I will give unto thee the keys of the kingdom of heaven: and whatsoever thou shalt bind on earth shall be bound in heaven: and whatsoever thou shalt loose on earth shall be loosed in heaven.

[alfablue]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

I don't think so. For one thing, the Court has been severely retrograde on economic issues during its period of Conservative Captivity, which was just extended by the GOP's clever (albeit cynical) seat steal. Even as social rights have expanded to meet cultural realities, GOP appointees have rigorously enforced Neofeudal economic preferences. That doesn't change until the levy breaks a la 1929.

And for another, this isn't the sort of thing where it matters when public attitudes and political ideology is misaligned. On social practices, the people lead the Court. (This was the big problem with Roe.) On economic and political issues, the Court is the creator and guardian of the rules which actuate reality. It's not like you and I can set up our own single payer system in the privacy of our own bedroom. The Court iimposes economic and political realities on us, which is why for example Republican voter suppression is such a lethal threat to the republic. They are the secular business end of Matthew 16:19: And I will give unto thee the keys of the kingdom of heaven: and whatsoever thou shalt bind on earth shall be bound in heaven: and whatsoever thou shalt loose on earth shall be loosed in heaven.

I meant more the inevitability as opposed to the courts deciding it.

[Kepler]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

I meant more the inevitability as opposed to the courts deciding it.

OK, then yes, I agree, though "inevitable" shouldn't suggest that it's a near-term solution. The various ox gored interests against it, and of course the Potemkin village of the Republican obtuse glorification of the profit motive, are immensely well-funded. It will probably take a decade to reach the obvious end state.

The most valuable thing Obamacare did was force this onto the table. TPTB would have been happy to just let it sit in the corner for decades while they lapped up their profits. You can see they are still gamely trying to put the genie back in the bottle on clean energy, and they have so far managed to embargo the entire subject of guaranteed minimum income. All of these things are obvious solutions to problems which the private sector is incompetent to solve, and they will all come to pass, after of course untold wasted dollars and lives so the 1% can each have a 12th vacation home.

[Kepler]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

"The worst system... except for these others."

[dxmnkd316]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

We will eventually have single payer. Remember Churchill's quote: "You can always count on Americans to do the right thing after exhausting all other possibilities."

The opposition to single payer, except for the obvious rice bowl excuses by the insurance industry, just boils down to a blindly obstinate ideological objection to a government solution regardless of the merits. Ryan et al. have to start from the axiomatic grunt "gubmint bad, private profit sector good" because their entire philosophy of life is anchored on that unthinking reflex. But the rest of us can weigh the merits of the choices, and the GOP simply can't come up with anything more competitive on coverage and cost because there isn't anything.

The only reason this is even an issue is the GOP has yoked their economic philosophy (a sop to their 1% paymasters) to a bunch of social prejudices that are very popular to lower and middle class whites who are particularly anxious right now as their racial privilege recedes. It's like shooting fish in barrel, particularly because the Dems have been for the most part bought off and won't argue for genuine liberal economic policies that their donors don't like.

Without campaign finance reform, this just goes on for another generation until demography finally buries the GOP for us.

Or how about this? We offer the public option. Since there's no need to make a profit, the government can offer lower rates. Since Medicare has historically run less than half the cost for overhead compared to health insurance companies, even better yet!

Insurance companies should need to compete with someone who has the public's interest in mind and not the shareholders' interest. More competition, lower rates. Everyone wins except the GOP's medieval ideology.

[mookie1995]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Or how about this? We offer the public option. Since there's no need to make a profit, the government can offer lower rates. Since Medicare has historically run less than half the cost for overhead compared to health insurance companies, even better yet!

Insurance companies should need to compete with someone who has the public's interest in mind and not the shareholders' interest. More competition, lower rates. Everyone wins except the GOP's medieval ideology.

don't utilities need to go before local boards and ask for increases?

if we move that way (should), who gets squeezed? insurance co? hospitals? dr welby? pfizer?

again for the upteenth time, cost has got to be tackled (first).

[dxmnkd316]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

if we move that way (should), who gets squeezed? insurance co? hospitals? dr welby? pfizer?

Yes.

again for the upteenth time, cost has got to be tackled (first).

Agreed. But insurance companies don't care if costs go up for health care. They just pass it on to the consumer. They negotiate on our behalf, but it's for whatever best suits their shareholders, not the patients. Insurance companies negotiating with the health care providers don't prioritize lowering the cost of care. It probably doesn't even show up on their radar. They just want their reimbursables to be as high as possible and then pass the rest on.

The government, on the other hand, is a much bigger stick and negotiations would be for the patients, not the shareholders.

I don't see why we can't tackle the relatively higher overhead of insurance companies, coverage, and access at the same time we tackle cost of health care.

[Deutsche Gopher Fan]

Yes.



Agreed. But insurance companies don't care if costs go up for health care. They just pass it on to the consumer. They negotiate on our behalf, but it's for whatever best suits their shareholders, not the patients. Insurance companies negotiating with the health care providers don't prioritize lowering the cost of care. It probably doesn't even show up on their radar. They just want their reimbursables to be as high as possible and then pass the rest on.

The government, on the other hand, is a much bigger stick and negotiations would be for the patients, not the shareholders.

I don't see why we can't tackle the relatively higher overhead of insurance companies, coverage, and access at the same time we tackle cost of health care.

They do care if costs go up, to a degree. I've spent some time working with our contracting specialists.
It's pretty complicated.

[Rover]

Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

if we move that way (should), who gets squeezed? insurance co? hospitals? dr welby? pfizer?

again for the upteenth time, cost has got to be tackled (first).

I always thought that bahstid was overcharging for his services.

I know my fellow lefties want single payer. I can see its benefits. What I would say is we need to prove it, and that's relatively simple to do. Expand Medicaid to cover everyone in the country like it does the 30 states that signed on. Next offer a Medicare buy in for those 55 and older. IF those two things lead to a continued lowering of the projected increase in growth rates, you pretty much have your answer. At least from a political standpoint.

It goes back to what I was telling the knucks' years ago when they tried to come up with a different standard of success for the ACA. Success was measured by 1) Are more people insured, and 2) are we spending less than we thought we would overall than what was projected before the law was enacted. Yes and yes to both questions as we now know. Same standard applies here and its not exactly a huge sea change vs the laws we have now.

Also, while I realize this will get me kicked out of the Bernie Sanders Fan Club, I wouldn't change employer coverage right now. Concentrate on the people who aren't insured.