Or more likely based on the rumors:
4) Your wife goes into a high-risk pool, your premiums go way up, and you go bankrupt.
And along with flat out refusal to cover people in that group, it was the entire reason the pre-existing condition clause was part of the ACA.
There is no way to paint it but anything but a huge step backward.
Really? I’m struggling to think of a complicated piece of US legislation whose details were discussed more in mass market forums prior to its passage. Certainly if you compare it to Dodd Frank, say, or even Medicare Part D.
ACA has been attacked for many reasons. Some of it has to do with the “lies” told about it when it passed. Some of it has to do with the fact that it did absolutely nothing to control costs. Some of it had to do with the individual mandate, even millennials realized they couldn’t afford the insurance they were mandated to have. ACA was almost designed to fail.
I don’t pretend to know the answer though. I do know you need to include pre-existing conditions, you need some type of cost controls, you can’t squeeze individual doctors to save money. You need to cover everyone. And you can’t give it free to the poor while you force increases on the middle class.
Question…and I ask this not knowing the answer and being to lazy to look it up myself, but did Nancy Pelosi actually say the line about “You will find out what is in it when we pass it”? Or did the GOP/Fox News?somebody make that up?
While it is clear that she didn’t intend it as a ‘we can’t tell you until it passes’ and more ‘once it passes it will be easier to get people the message of what it does, away from partisan bickering’, she did say something to that effect.
Eliminating medicare might cause enough pain to get a real backlash against Republicans from their base- which will make a real healthcare fix more doable in 4-5 years.
While possibly true, and probably the only thing that could break through the wall of ignorance FOXites have, that doesn’t mean I want this to happen.
Sure, sometimes there are pains in progress, but these pains are literally people’s lives.
Also, Ryan et al. will try to do some sneaky bullshit like “grandfather” in current and very near future Medicare-eligible patients while hanging everyone else out to dry.
I know that Social Security First is getting some money from me this year for sure. 50 dollars of which I can take right off the top of my Oregon Income Tax (we have a 50 dollar per year political contribution tax credit).
The fundamental problem we face is their is chasm between the level of healthcare we expect and the amount we are willing to pay for it. On average we spend $800/month per person in this country. While there is is huge pushback for paying more than $200-300/month for a young person and $500-600 for middle age person.
We need to either get use to pay $2k/month/person for those making over $100K to help subsidize the poor people or we need to accept that there are limits to how much healthcare we are willing to provide.
So no $50K/month cancer treatments that will extend life by another year. No hip or knee replacements for obese people, no private rooms in the hospital, and no 1/'2 dozen surgeries for infants born with severe birth defects.
The current approach put it on our credit card, sell the debt to the Chinese, and leave it to our kids to pay off, I find immoral
Well there is also the fact that prices are arbitrary and capricious. A year or two back Medicare released a portion of their database showing pricing for something like 100 common procedures in several metro areas. The variance, within a city even, was astounding.
But [quote=“Strollen, post:309, topic:73916”]
no private rooms in the hospital
[/quote]
Wouldn’t be a bad thing. Sure people like the privacy, but good lord do we not see how much this costs us?
Which… is going to be policically impossible because then you get ‘death panels’ rhetoric, like was leveled against the ACA. Remember that? People lost their shit.
Again,a politically tough sell. However I am generally in favor of things that would cut down on excessive medical procedures. People are generally in poor position to judge these things, and the cost/ benefit analysis gets short circuited. But having a way to manage care across the system more efficiently allocating resources (doctors, money) can be a good thing.
If done carefully.
There are several ways we could talk about cutting the cost to the system. Limiting end of life care treatment options is the tough one, but one we do need to tackle. Putting more reasonable caps on malpractice suits, rationalizing the pricing systems, and all that are things we need to discuss as a nation though.
The boomers seem to be a pretty selfish generation so I’m sure they’ll see no problem with this.
In all seriousness, the boomers also don’t have much time to change. I personally plan on having little to no support when I am old. I am pretty sure the generations ahead of me intend to suck the government, and potentially the planet, dry with little regard to anyone else.
The following is tangential to the general conversation on health care and reform, but:
Re: the national debt-- it is in fact denominated entirely in US dollars–not gold, not diamonds, not oil, not anything that’s not under control of the federal government. Also, the federal government never ever has to pay it off all at once. If it did ever do that, there would be a crisis–why? Because US debt instruments are the safest place to hold savings denominated in US dollars, period, end of story, and this will continue to be the case as long as the Freedumb Caucus in the House doesn’t force the government to start defaulting on the debt.
Now as long as people and businesses around the world continue to accept US dollars in payment for goods and services, they will need a place to park their excess dollars.
Why do people accept US dollars in payment–presumably because they find them valuable, right? You know what will make the US dollar less valuable? Yes, wild overspending vs. revenues to the point of causing high inflation, that one we all know about–we’re truly not in danger of that. The one that not enough people know about is if the central government is too frugal and too obsessed with reducing/eliminating yearly deficits, to the point of letting the country’s physical infrastructure and human capital degrade until we’re a third-world country, with income and wealth inequality and a general standard of living to match. We used to understand that in the US but we’ve let the Right own the conversation on this question since the Reagan Administration, and their ownership has only gotten worse, to the point that wackos are actually contemplating not increasing the debt ceiling as necessary and thus defaulting on US debt.
Why would all that happen in the US when it doesn’t happen in any developed world public system???
Is the US that special (in a ba way)? I doubt it.
They would have to implement some kind of system to subsidize insurance while unemployed to continue your coverage, I’d think.
I don’t believe the market is capable of efficiently deteriming prices in this kind of situation, due to the fact that consumers and producers are not entering into a voluntary transaction on even footing.
I’m not sure what the solution is though.
I’m not sure what your question is. Other nations already ration their medical care. For instance an English friend, (US citizen) is quite obese but he was able get a hip replacement with no question,while his twin sister also obese was told she needed to lose 50 lbs before having the same operation in England.
The US also has higher structural costs for than the rest of the world, and finally the US is the driving force for innovation, which for a variety of reasons burdens the US citizens with having to pay for this innovation.
I’m sorry if this is a silly question and I don’t mean any disrespect to anyone. It’s just that I’ve seen it mentioned a couple of times in this thread but I didn’t know getting a hip replacement was a thing for overweight people. Is this due to some sort of work or activity-related injury? Or is it complications due to being overweight? I’ve got a dear friend who has put on some weight for various reasons and, at her request, I’ve been helping her keep active in an effort to lose some of it. I certainly don’t want to put her at risk, however. We do brisk walks, we’ve incorporated some bike riding and she takes a yoga class on her own from time to time. Should I be more mindful on how much activity we do? Oh, and sorry for the off topic post.
Being overweight–even fairly modestly–puts strain on your body. Organs encased in layers of fat, working harder. Muscles, straining to hold limbs and back at the proper angles. Bones, slowly distended, trying to support the extra, often unevenly distributed weight.
In short, it’s sort of a whole-body disease, and yes, it absolutely can limit what activities are entirely safe. I’m not saying the overweight should be wary of talking a Sunday walk or anything, but it’s always good to consult a doctor on a workout plan before diving into it. Nobody wants shin splints from too much treadmill usage, but I can’t imagine they’re more fun at 400lb than 200.
Yeah, we’ve been careful with the types of activities we do. My friend has been extremely thin for all of her life until just recently. She’s working towards her doctorate in cyber security and having moved away from a more active job into one that is in her field as well as taking classes and teaching, all of which leads to a much more sedentary lifestyle, has led to some rapid weight gain. She hasn’t expressed any real discomfort due to the exercises other than the occasional muscle soreness so I believe we’re doing alright. But I got a little worried reading about hip replacements here!
[quote=“Strollen, post:315, topic:73916, full:true”]I’m not sure what your question is. Other nations already ration their medical care. For instance an English friend, (US citizen) is quite obese but he was able get a hip replacement with no question,while his twin sister also obese was told she needed to lose 50 lbs before having the same operation in England.
The US also has higher structural costs for than the rest of the world, and finally the US is the driving force for innovation, which for a variety of reasons burdens the US citizens with having to pay for this innovation.
[/quote]
In Spain there’s no rationing of medical care for high priority treatments. Hip replacement, cancer treatment, everything serious is prioritized first. The only rationing comes at low priority stuff (regular checkups, second opinions, non essential treatments) where there are waiting lists.
It’s the same in France and Japan, at least. I think the UK is in the midst of a heavy public healthcare crisis due to semi privatization, so it’s maybe not the best example of what a public system is. But actually what I think it’s happening is that without losing those 50 pounds the operation in question you talk about would be too risky, offer no discernible benefit. Remember the US overtests and overtreats, often to the detriment or significant risk of the patient’s health. I have heard people being forced to lose weight before an operation, but it has nothing to do with rationing, but with not putting the patient at significant risk. Of course, in public systems it’s the doctor who decides what an acceptable risk is (not the patient). This is a feature, not a bug (patients are most of the time not equipped to make those decisions).
Tl,dr: the notion that public health care systems ration important, life saving or life extending healthcare is utter bullshit in general. The idea of “death panels” is ridiculous, and it shows a very poor understanding of how functioning and efficient public health systems ration their healthcare. A closer image would be the “waiting lines to get a minor operation panels”.
PS: As for the driving force for innovation: A lot of Pharma and medical discoveries come form the “public health waste of Europe”. The US is not the only driving force of innovation in the medical field, not by a long shot. That’s also nationalistic drivel. For example, just today there was an article in the local newspaper about this: http://www.bbc.com/news/health-24524027
PPS: Sorry if I come harsh on this, but my father probably did several hundred hip replacements in Spain under the public system. It’s bad for a doctor is for a patient to die at the operation table.
It’s even worst for the patient. It’s a dangerous operation and patients are rejected for risks very often. The reason public systems work is because people like my father earn (used to) around $3k a month. It’s price controls (professionals and pharma) as well as a client health first/client wishes second mentality that makes public systems viable.
Replacement type surgeries are just become more common as people live longer. Older people get hip replacements all the time, and it’s not a minor thing mind you so there’s some consideration about how well the patient will do after the surgery. You’d be surprised about not only how much a hip costs but the freaking screws… anyway though. I know a young lady who’s had surgeries on both knees in her twenties, she was a soccer player, and i suspect when she reaches a ripe old age she’ll need to address those again. She’s very fit and active now, but between her knee surgeries, her fertility treatments, and some other issues, this very lovely and attractive woman has probably cost the health care system, specifically the insurance plans she’s been on, more in her twenties than some people will ever cost in their lifetime. You just can’t see it. It’s easier to target old and overweight people though.