Real Affordable Healthcare Can Be Accomplished

So you think the Dems should introduce legislation improving Obamacare...do you?

Is that because you think they are so powerful right now in the congress...or because they have so much influence over the signature of the president?

 

You are arguing semantics, basically We should replace the current system with something that works better and just keep calling it the Affordable Care Act. It needs to replaced for a multitude of reasons, not the least of which are the failures to fully fund and fully implement medicaid expansion, the exemption of the people who it is supposed to help from the mandate by waiving their penalties, the mandated coverage provisions that were focused solely on appealing to women, the skyrocketing premiums, and policies with outrageous out of pockets making them worthless to have.

 

I do not think the ACA is going to be replaced. I think the ACA will form the base of a program that will finally bring the US into the modern era of healthcare.

If you think it has to be replaced...fine with me.

 

The problem IMO.. is that its a bit like rearranging deck chairs on the Titanic. Until we go to single payer private delivery, get rid of the VA and get the insurance companies out of healthcare we will be forever upset and quarreling about healthcare.

I don't see any willingness of the part of Trump and the Freedom Caucasus to address the issues.

 

I've not suggested anything other than the Republican lay this ACA at the doorstep of the DNC, ring the bell and run like hell never to look back

 

I suspect you are also hoping that Donald Trump and the congress do everything it can to help destroy the ACA.

But I understand. Pettiness is part and parcel of the American conservative agenda.

I'm hoping the ACA will survive the attacks...and that this country finally comes into the modern era with the rest of the industrialized world.

 

I truly get where you are coming from, Margot...but for the next four years, our focus has got to be on preserving the ACA. It is not going to be improved...and if the right manages to get it repealed, it will NOT be replaced with anything that helps the common folk. As you noted, there doesn't seem to be any willingness on the part of these other guys to address the issues...at least, not realistically.

 

Frank, I am not hung up on what they call it.. I should have made that clear. But, we are in agreement. .. and fixing it is do-able.

 

Not universal

 

As the proportion of Americans in senior ages has increased, that figure has increased as well. I've seen figures in the 38% range.

By 2006, 38 percent of inpatients were aged 65 years and over, with those aged 75 years and over comprising 24 percent of all inpatients.
http://www.cdc.gov/nchs/data/nhsr/nhsr005.pdf page1

It is probably higher now.

Could you provide backup for these assertions? The rest of your analysis is based on these facts. Thanks

Why would be need to eliminate individual premiums?

 

I found them.

Some data:

In 2015, total Medicare outlays were $632B, net outlays were $540B.

That was funded by 37% payroll taxes, 42% from general tax revenue.

http://kff.org/medicare/issue-brief/the-facts-on-medicare-spending-and-financing/

21% of all Medicaid spending was for seniors as well (2011).
http://kff.org/medicaid/state-indicator/medicaid-spending-by-enrollment-group/?currentTimeframe=0&sortModel={"colId":"Location","sort":"asc"}

Total Medicaid spending in 2015 was $545.1B. So about 114.5B of Medicaid spending was on seniors.

So the total cost to the government of Medicare and Medicaid to cover seniors in 2015 was about $750B.

In 2015, total health care spending was $3.2T.
https://www.cms.gov/research-statis...enddata/nationalhealthaccountshistorical.html

Now, if seniors use roughly a third (or more) of all health care, then, extrapolating Medicare/Medicaid expenditures on seniors ($750B) for 1/3 of all health care, to a universal coverage yields a total Medicare/Medicaid outlay of about $2.25T to cover the entire population.

Versus the $3.2T total cost with our private insurer system.

Why would making Medicare universal be a bad idea again?

 

If the US were not crippled by rabid ideologues, partisan fanaticism, and rapacious, entrenched, "special interest" parasites, it would adopt a pragmatic, practicable approach to healthcare by looking to the actual examples of nations' providing coverage to all citizens at around half the cost of the US.

Cutting out the all the superfluous middle men that insinuate themselves between provider and consumer, eliminating the monstrous annual federal subsidy that sustains employer-administered plans, advantaging economies of scale, and maximizing the risk pool as an actuarial imperative is a common sensical approach for which their are multiple extant examples - the most advanced nations on earth all arriving at variations on the same approach to achieve relative success. No, none is perfect, which provides the opportunity for the US to refine the winning formula and do it even better.

WillardCare kowtowed to special interests, but acknowledged personal responsibility as an incentive for universal coverage:

Mitt Romney: “The idea for a health care plan [in Massachusetts] was not mine alone…The Heritage Foundation — a great conservative think tank — helped on that. I’m told Newt Gingrich, one of the very first people who came up with the idea of an individual mandate, did that years and years ago.”

“It was seen as a conservative idea to say, you know what? People have a responsibility for caring for themselves if they can. We’ll help people who can’t care for themselves, but if you can care for yourself, you gotta take care of yourself and pay your own bills.”

The Heritage Foundation  described Romney’s mandated plan as “one that is clearly consistent with conservative values,” that would eliminate the “uncompensated care pool.”

Gingrich supported Romney’s ultimate conservative idea":

“ Personal responsibility extends to the purchase of health insurance. Citizens should not be able to cheat their neighbors by not buying insurance, particularly when they can afford it, and expect others to pay for their care when they need it."

 

You're beating the hell out of the self employed/small business! In some cases one person can generate 200k solo but normally that about in a small business requires additional labor. So what's the results, don't hire and scale back, keep employee's and make less then they do. Small business is important to out economy and people take it for granted and fail to understand the fragile climb it is to success and keeping it solvent!

Starting a small business is a tier system, most start out as self employed, and as time passes they grow and make a descent wage but eventually they ALL need help, so they hire! At that point the Owners wages slips back until he can generate enough addition business to just to get him back to the point where he was making that decent wage again! But once again the increase business once again demands more labor and the owner hires and slides backwards again! Most small business men spend their entire lives in that small pocket of wealth, and people don't realize that although the Self employed shows he is making a million a years the common guy never takes in to account his overhead, labor costs, state, federal, unemployment sales and all the other taxes he must pay on himself and employees

Just something to chew on

 

A huge advantage to making Medicare universal would be it would relieve the health care cost (a huge cost) from businesses, making hiring employees less expenses and making our businesses more competitive.

 

Doesn't apply to small business bro. Your tax plan is based on total income and doesn't reflect anything else even remotely to do with what was spent out of that total.

 

I don't understand why you think "Medicare for all" would be universal but "Medicaid for all" would not be.

 

Can you elaborate? Why doesn't it apply to small businesses? Because they don't provide health care benefits?

I don't understand what you mean "Your tax plan is based on total income and doesn't reflect anything else even remotely to do with what was spent out of that total." The figures I posted were total medicare, Medicaid, and health care spending.

 

Nature of the program. Medicare is already a universal plan for folks over 65 -- there is just an age limitation.

Medicaid is a means based program. I'm not sure how you would make that universal without totally changing it. Why do you think it would be better than Medicare?

 

Both programs would have to altered radically to do what you want, but the basic benefits package under Medicare would have to be altered since there is no childbirth or benefits for kids and young people. Benefits wise, Medicaid is already set up that way.

But I was really referring to the consumer side. Medicare is an 80/20 cost share, but Medicaid is zero premiums, copays, or deductibles. It's truly free healthcare (at the consumer level). Plus, since Medicaid reimbursement rates are lower than Medicare (and far lower than private insurance), it should be cheaper on a per person basis.

But I only ever hear from the left about "Medicare for all" and never "Medicaid for all."

 

To put it simply, if you as a small business guy made a $100 that year and you paid out half to your helper, what are you going to tax the owner $100 or $50? See it's a little more complicated than just pulling a number from the air and taxing it!

 

Not sure what that has to do with your comments about Medicare providing universal coverage. I didn't pull any number out of the air and tax it.

What I said was that a universal Medicare program would be a boon to business which would be able to hire employees more cost effectively and be more competitive without having to shoulder the costs of employee health care.

 

It would be cheaper to the person, but maybe not to the Govt. I'm not totally against the idea. The goal is to make it universal, not necessarily free for all.

 

Yes but you still have not explained why Medicare would be universal but Medicaid would not.

 

I was referring to Seth's numbers and contribution, sorry! Man that was confusing, I was thinking, for a guy putting that much in to a presentation he sure isn't recognizing normal operations of small business and owners expenses LMAO, sorry about that

 

I did explain. See my post above. My recent comment was not that Medicaid couldn't be universal, but that if you make everything free its going to cost more.