4162

But you have no room for compromise. Despite the left and right mentality, the majority of the population resides in between the two, mostly in the middle with a leaning left or right. Despite my presence on this board, I have some conservative views that don’t mesh with the left at all. Socially I am left, economic and financially speaking, probably more to the middle. Your approach doesn’t just eliminate the hard right it destroys the middle too, not just the independents but people in the party who are not as left leaning as you are.

To dismiss ACA in it’s entirety discredits that good it’s actually done. Pre-existing conditions were the bane of almost everyone in healthcare. I absolutely support the idea that the for profit, not for profit and non profit groups should be able to exist and in many cases make a profit (this is not a statement against a SP system though). The 300 page health insurance guidelines of what is covered, what is not covered, what you need a pre-auth for and the ability for them to reach back and see if you sneezed once in your past to deny a claim due to a 20 year old pre-existing condition was out of hand.

ACA got some things wrong but also a lot of it right. I think you’re naive if you think the ACA getting thrown out would lead to any sort of single-payer result. More likely it would throw us decades back and even further away from your goal. ACA needs to be tweaked and fine tuned and the supply side in health care also looked at.

I think in your scenario, no one wins. And while I know the public isn’t always right and doesn’t have to be on board (civil rights and other issues like it prove that), it’s better to have the public on board. A lot of people are terrified of the government being in control of their healthcare… as they wait to get access to Medicare (yeah I know weird right?).

4163

Hence, “Theirs might not be the only way.” Even I recognize the inherent issues with scorched earth political tactics, for all my furious rhetoric. You asked if I thought they were successful, and I do. From their own perspective, I’d wager they definitely think so, too (except when stabbed in the back by their own weak Republican brothers, of course!).

Personally, I think what your arguing is based more on frustration and emotion, rather than effectiveness.

A truer thing has likely not been said in this thread. It’s why I tried to resist the siren song of P&R for as long as possible! :)

4164

To be fair, it wasn’t supposed to address costs, except in some minor tweaking kind of ways (limiting administrative percentages, refunding excess admin percentages, establishing a better market to allow market forces to keep costs down, limiting pre-existing condition denials/booting, etc.).

4165

Not to mention getting people health care so that health issues can be looked at immediately, instead of festering and getting worse. I believe I’ve mentioned before how my wife’s uncle had an individual policy, had health issues, ignored them due to fears of raising rates, and nearly died for it. Now he is effectively disabled, has chronic health issues, and no longer able to contribute to society due to this. Short term his health care costs were shorter (due to not getting treatment), but long term the costs are far higher.

This is the kind of thing that takes years to manifest. In the short term there was always, and honest appraisement admitted, going to be an increase, as people who previously would not have gotten health care did. But long term we should expect there to be a reduction in costs as long term health issues and the like are treated sooner, when they are cheaper.

Now there is also the issue of over reliance on emergency rooms for treatment, but that is a public awareness campaign issue, not a health insurance failure issue.

4166

Wait…

You want political leaders with courage who will tilt at windmills. Okay, I can see that.

However, you’re not willing to go out and vote because you think your vote won’t make a difference if you can’t vote for Bernie? Really?

Change in our political system is almost always incremental. When you have sweeping change, it typically comes at great cost in lives and/or treasure (or as the result of events which have a great cost). While single payer may be an admirable goal, a significant portion of the electorate thinks it’s a terrible idea. Right or wrong, the only way you get single payer is to either convince those folks otherwise or marginalize their voices. In a democracy, we’re not supposed to do the latter, and, well, if anyone had a chance to do the former, it’s our current president, rather than any of the folks running for President on either side.

4167

All apologies (in this case only) to Barbara Boxer? :) (FWIW, I went to High School with her daughter, and as part of my High School Social Studies Current Event course, worked her (Barbara Boxer’s) House Campaign in 1984).

4168

Believe 96 law of HIPAA eliminating pre-x problems in group market if you had continous coverage. Better option would have been broadening HIPAA instead of overreaching. You need a look back period on pre-x if you don’t have continous coverage rule.

New paper on high cost for the u26 provision. Hurt particularly large employers and average $1200 salary lost per Harvard and Standard researchers Usin a diff in diff model.

4169

Pre-existing conditions was a big push by the ACA not HIPAA. HIPAA may have limited how the insurance companies collected that information, but it certainly didn’t eliminate it… and it started in 2014 I believe. I think the lifetime maxes might have been address by 2010…

4170

As I’ve tried to convey (and clearly failed–this isn’t on you or Oghier, but my own inability to communicate it well), it is exceedingly likely that in 2016, my state is going to go red. Hard. At almost every level and in almost every race of any import. It’s been trending down that line, and our present set of gerrymandered districts are encouraging that trend to continue unabated through at least 2020. While we’ve technically been a close state before, my understanding of state politics as they stand now leads me to believe that 2016 will go cleanly to the Republicans unless they wind up picking an extremely divisive candidate like Trump (though he’d do better here than many places) or a lackluster one like Bush.

As such, when I say that my vote here is unlikely to matter, I mean that in a very literal sense, as opposed to something broad and philosophic. If current trends in NC continue unabated, the Democratic Presidential candidate will lose the state and most blue candidates down the ticket will only succeed in extremely gerrymandered districts that they’ll win in landslides, since their entire base have been crammed into a handful of crazy-shit puzzle piece-shaped strips of land.

Voting in an election like that is deeply disheartening for someone living through the effects of our state’s ongoing political climate. A candidate like Clinton inspires virtually no additional passion or hope on my part for the state of affairs here. A candidate like Bernie does.

My original statement was, in essence, that I’d have a lot more motivation to go vote for a losing candidate that I actually approve of and believe in than a losing candidate that was the lesser of two evils.

Of course, if NC winds up being anywhere near competitive in the polls, I’ll be there dutifully tapping the screen for Hillary if/when she takes the nom. If Hillary’s projected at a 55/45 loss the morning of, I’m as likely to pencil in Stein (not even sure she’ll make it to the ballot here) as anything.

4171

If Bernie Sanders somehow finds himself in the Oval Office I would say that the dreams of single-payer healthcare might be possible. But it’d then take another landslide mid-term election in 2018 to get the House and Senate in line, and possibly also a few Supreme Court justices for good measure. Then of course you have to hold the Presidency for long enough to make sure the system is enshrined enough that the next Republican won’t just repeal it.

Not easy, and unfortunately there’s no middle of the road on this. As long as healthcare is private, it’s going to be terrible.

4172

Yes, it’s more convenient for them. Also, they probably don’t have to take a bus, and the line they wait in will be shorter.

Still, in the spectrum of things that people suffer for political representation, hopping a bus before or after work and waiting in a line does not rate as impossibly gruesome. And for those whose job truly prevents them from voting, you can generally get in via early voting, absentee ballots, etc. The number of people for whom voting is truly impossible (short of quitting their job) is, I would guess, quite small relative to the number of people who simply don’t bother.

This issue drives me a bit loopy. Sorry for the ranting tone.

4173

Sorry to hear that. I said that shit does happen. But how exactly did ACA doing anything to fix that. Also was your father insurance, company provided or privately purchased.

4174

Exactly. The Tea Party makes for a great insurgency. But governing requires the ability to compromise, and the willingness to see the rest of the country as fellow Americans, not “those people.”

4175

My employeer insurance had none of those limitation, admittedly it was from a megacorp, but it was pretty standard for Silicon Valley firms big and small. I agree people with pre-existing conditions generally benefit from ACA. The hidden cost is that it allows many of us to game the system.

What makes you think most people on QT3 gets their insurance through their employers. I thought we had a number of students on the board. They weren’t allowed to continue to receive their insurance through their parents until the law extended it to 26.

You mentioned no drug coverage. What did you plan to do if you wound up with a serious illness that has pills that cost a few hundred dollars per pill. Was your plan a managed-care plan, a preferred provider network or POS kind of set-up.

You don’t mention what wasn’t covered besides maternity, and yeah there were some pretty stripped down plans for young people that needed to be bolstered. You can’t have all the young healthy people in one plan and all the unhealthy people on another plan and expect the plan to be profitable. Say what kind of preventative care did your plan offer?

For people who had ongoing conditions, who were not in their twenties, that hopped jobs or pulled from the private market it was entirely possible to pay insurance premiums for years only to wind up with a huge bill where suddenly a 40% co-insurance for a 500k ED bill just led to other patients with better insurance fitting the bill.

The census department says that 55% of people insurance get it through their employeer vs only 15% buying it direct. I haven’t seen demographic info on QT3 for ages what makes you think it is so different from the rest of the US. Actually I don’t think we have a lot of college students.

Both the ACA plan and my old plan used the Kaiser system, and included one free physical. If I was woman there probably was some additional screening allowed under the ACA plan and off course free birth control. My plan has 50% co-pay vs $50 for lab test (most blood work is right around $100 so generally a wash). Now you are right if I ended up with expensive drugs than I’m screwed (hello Canadian pharmacies.) But the big difference was the maximum out of pocket expense of $2,000 vs $6,500($6850 now) and the $50/month additional premium. My drugs would need to cost ~$6K a year before I came ahead with the ACA plan.

For many people who’s ACA bronze plan don’t provide any benefits until the $6,850/$13,700 family out of pocket is hit. ACA provides little insurance $13,700 is a big chunk of change for most families. I’ve found that most of biggest supporters of ACA actually have employer provided insurance so they aren’t faced with paying many hundreds of dollars a month in premium and then have to fork out $13.7K like Scuzz has to get any benefits.

Personally, I’ve figured out away of gaming the system so I come out ahead with ACA, but I don’ t think it is sustainable.

4176

Really the Affordable Care Act, wasn’t suppose to address costs? You might want to go back a listen to the President speeches, or say an early SOTU speech.

4177

Maximum out-of-pocket of $2k is insanely low.

4178

It’s not just college students. Some industries have been moving toward more contractor use for more than a decade, including the one I am in (Management Consulting). Also, consider anyone who starts or joins a small business, if they can’t get covered through their spouse’s employer.

I’ve watched clients work to shed the burden of providing employee benefits for decades. Temps, contractors and the like are more of the work force every year. Insurance reform was absolutely critical to this group, simply to ensure they’re able to purchase insurance at all.

4179

I know plenty of people on my early-retirement forum who have seen their maximum out of pocket deductible from $2K, like myself to $6800/$13,700. Is that just a slight inconvenience? I suppose if you don’t get sick it is.

If you simply look at the increase of the number of insured, no existing pre-conditions, kids on parent policies, enhanced coverage, and other stuff, then I agree the winners outnumber the losers. That is because ACA front-ended all the goodies.

The bad stuff, ACA for large employers, tax on Cadillac plans, and medical devices, collecting penalties for individual who don’t get insurance, cost-sharing by states for expanding medicare, and eliminating the subsidies for insurance companies (aka risk corridors) is all ahead of us.

We have put several hundred billion of insurance on a credit card, with the no payments until 2018 option. So it looks just peachy right now. The scary thing is that even people like Megan McCardle who have written extensively on the subject freely admit we don’t have a clue what the bill will be.

4180

Actually, it is tad less than the average for ACA silver plans, and slightly below ACA goldplans. Pretty typical for large employers, I just checked Costco $1500 out of pocket max.

4181

This thread makes me very very happy to be Canadian.