So there has been a lot of people up in arms about the ACA (Affordable Care Act), and I just wanted to give my thoughts on it, and what I think the biggest problem with it is. First off, I want to be up front and say that I didn't support this law from the start. I believe that healthcare should be left up to the states, and while one of the biggest "strengths" of the ACA is that it is modeled after a state run system that worked, that is not an indication that it will work in 49 other states. I am not a Democrat or Republican, I would probably consider myself "libertarian" on most issues (although I like to talk about issues independently of any kind of political party or ideology). That being said, the fact is, the ACA is a law that affects every single American, and so I am therefore going to approach it as the law of the land, and not as something I simply don't like or think will work. The biggest problem, I believe, with the Affordable Care Act, is the name "Obamacare" that has been attached to it. This is the fault of both parties (the Democrats and Republicans), and it is one of the main reasons I believe the law is going to do far more harm than good. You may notice that I have been very careful not to call it "Obamacare" and it is because that is not what the law is called. Thanks to this name, we have a stalemate in Washington. On the one hand, you have Democrats who want the law to work out because it will mean that they can use it to leverage more votes, have a stronger majority in congress, and in the end, have more power. The Republicans DON'T want the law to work for the exact same reasons. This has created a stalemate in Washington, and I truly sympathize with both parties for their actions (both of these action plans are perfectly rational), but the cost of this is the well being of Americans. On the one hand, I look at the frustration of Obama and the Democrats, who are sick of Republicans doing anything they can to destroy the law, and I can feel their frustration. They tried to force Obama to keep the time schedule for certain provisions (such as the employee mandate) JUST so that the American people wouldn't like it. Republicans have tried to force Obama to keep the law rigid in order to prove a point, even if the cost is to the general welfare of Americans. I understand Obama's frustration with the fact that he knows the law isn't perfect, and is willing to listen to ways to improve it from both sides of the aisle, yet Republicans continue to do anything they can to undermine the law and make it even HARDER on Americans so they can point to it this November and say "this OBAMACARE is what is causing your problems". It would be really nice if Republicans would stop fighting the law and start working with the other side of the aisle and actually try to improve the law so that it serves it's purpose which is to help Americans. At the same time, why should the Republicans help improve the law? Suppose they did try to improve the law, and came out with some great provisions to improve it. Do you really think they are going to get any credit? The law, after all, is called "Obamacare" by most Americans, and it is seen by most as Obama's "legacy" as president (and is 100% linked to liberals). If the Republicans do ANYTHING to improve the law, that is just going to be chalked up as a win for Democrats, as liberals will go around patting themselves on the back saying "I knew it would work...we're just so freaking smart aren't we" (don't worry, this is ALL politicians, not just democrats...but in this case, it would be just democrats). How do you think the political commercials would run for the next election? Do you think that Republicans would be able to take ANY credit for improving the law? Of course not. Democrats would run smear campaigns on Republicans for rejecting the law, even if they eventually came around to support it. For those of you that don't know the story, I will give you a brief history of the ACA. First off, the law started in the House of Representatives (as all revenue based laws must start in the House according to the constitution). The law passed with a vote of 416-0!!! That's right, not a SINGLE member of the house, democrat or republican, voted against the law. It's hard to believe that any law, especially a healthcare law of this magnitude, could ever get through a branch of congress on a unanimous vote. Then Harry Reid, the Senate Dems, and the White House, decided that they didn't like what was in the bill, so they basically just rewrote it (they even changed the name from . This pissed off all the Republicans (and several democrats), but the Democrat majority didn't care because they had a majority in both houses, a supermajority of 60 in the senate, and the White House. They basically ran the country. This allowed them to pass the law through the senate without a Republican filibuster. When the law went back to the house, many democrats were not impressed with the new law, but were afraid of sending it back to the senate, as they had lost a supermajority in the senate at that time. So they passed the bill with many democrats conceding to the senates demands on the grounds that they change the bill later. This is a blatant abuse of power, and in my opinion, a disgrace to this country and the law that was passed. Democrats continued to laud the law as something that will save us all from modern healthcare, while Republicans, who weren't given any say or opinion in the writing of the law, continued to undermine the law in an attempt to write a new law that would be more appealing them (and maybe both parties as the original law was). So how do we solve this problem? Well the primary solution would be to stop associating the law with democrats and republicans anymore, and start associating it with America, because that is what the law is governing. This association of the law to Democrats has created an intense divide in Washington that every American is paying for. The second solution, and this one is something that can be done immediately, is to STOP calling the law "Obamacare" and START calling the law the Patient Protection and Affordable Care Act (or ACA if you want to shorten it). It seriously bothers me when people insist on continuing to call it "Obamacare" when that isn't even the name of the law. What really grinds my gears is when I hear Democrats call it "Obamacare" because that does nothing but show their own ignorance (in my opinion), and it also throws the healthcare feud in the face of Republicans, leading to more animosity in Washington (I will explain the origin of this deep political division about the ACA below). Finally, and this is going to be the libertarian speaking in me, hopefully this will show Americans why it is extremely stupid to give the people in Washington this much power over something this important, such as healthcare. Because they care more about themselves and getting reelected than they do about the Americans, every one of us suffers as the politicians continue to profit at our expense. They are clearly not competent enough to run a system like this, and since they are unwilling to work together, it seems extremely foolish to let them pass ANY law that affects every single American. So who is to blame for the law? Well hopefully I have convinced you that both parties are largely to blame. We as Americans are also largely to blame for our political dichotomy. Our ability to have rational discussions about how to improve our healthcare systems has turned into polarized political fights. In this case though, I am largely blaming the SENATE Democrats. Not for the content of the law, for the way they used their political power to bully the law through congress rather than work to make it a law that both sides could come to support.
I agree. This is both sides fault. Both sides in 2008 wanted to reform the system, and now it's to the point where we can't do anything about it without setting off a fire storm. We need to reform the system, not wreck it. Despite what we do have, it's not enough. Why a corporate version of something that is supposed to be socialist seems to impress the Dems is beyond me but then again I'm not really surprised. It's nothing more than another bad sign of how everything is being run in Congress.
The problem with the ACA is the mandate, the regulations, and the taxes. Abolish all of em and what you're left with is A-okay to me. Although, what you're left with is pretty much nothing.
I would do this give each state a chunk of money including Medicaid funding from taxes based on population and say okay you get this money but must provide medical care that is affordable to every resident of your state and if you opt out we will maintain Medicaid but you get not that money or any other funding to your state unless an emergency or is required this includes government contracts. Your choice opt in or not. Then see what states do.
Had the Left installed an experienced national level politician in 2008 instead of a green-as-grass to national level politics not-yet-ready-for-prime-time newbie as president then SHE would simply have told the Legislature "Hammer out a decent compromise bill people, and then present it to me. If it's good then I will sign it. If it stinks or has major flaws then I will veto it and ask you to return to the drawing board. But I will NOT sign into law any bill passed over the unified objections of the opposite party just to mark down a win in the political column. Now get to it!" In other words, President Hillary Clinton would have done just fine in 2009 . . . because she WASN'T some gormless political newbie. Moral of the story? Beware of over-hyped Political Rock Stars and absolutely ANYONE that the Mainstream Media intimates is a Political Messiah.
How about using Bush's attempt to reform Social Security as a model . I didn't think so! Our government is becoming totally dysfunctional and both sides are to blame.
You'll get no argument on that point from me. I am not actually a huge fan of the GOP, because after all they did sod-all to put a halt to Bush letting the national debt rise another four trillion dollars on his watch, up to a revolting 8 trillion of national debt in total. So they do not have clean hands or get a free pass from me!
The only real problem with ACA is that it doesn't go far enough in bringing about total reform and the fact that the GOP created death panels because of their failure to promote and expand the law's coverage to the poor: [video=youtube;6mD7iYFovdk]https://www.youtube.com/watch?v=6mD7iYFovdk[/video]
There is a lot of problems with the ACA but it did create one fundamental change in health care that is making a big difference no matter if it is repealed or not. It brought the transparency of the open market to health insurance through its health care exchanges. The private sector is rapidly moving away from the long standing regime of tedious and expensive secret negotiation for employee health insurance coverage to the ACA model of open exchanges where any insurer that agrees to their coverage requirements is allowed to participate in their private exchanges, some of which are expecting to have hundreds of private companies with hundreds of thousands of employees within a few years. It was impossible for companies to get insurers to do this before the ACA created health insurance exchanges, after the ACA there was no way for insurers to refuse them in the private market. The next step to bringing health care costs under control is to get price transparency from the providers, many of whom consider their pricing to be proprietary, a trade secret protected from public scrutiny. Massachusetts has had an equivalent to ACA for six years. An investigation accomplished only through subpoenas from the state attorney general uncovered a huge disparity in pricing for routine procedures by the same doctor paid by the same insurer in the same provider network. The exposure of a ubiquitous pattern of arbitrary and capricious health care provider pricing generated massive public outrage which has moved the state legislature to threaten the imposition of price controls through legislation if providers do not adopt a more reasonable and transparent pricing regime. They have already established a board to oversee health care provider capital expansion and empowered them to reject any proposed capital expansion that they deem to be unnecessary or redundant to the needs of the people of the state. This is because there are already enough MRIs and PET scanners and other hugely expensive and vastly underutilized high tech medical machinery for more than ten times the current population. As more and more MRI machines and other expensive diagnostic machines were built the prices went up and the price of every other hospital procedure went up as well as their utilization rate dropped into the single digits. There are 48 MRI machines within 20 miles of Boston. Their average utilization rate has plummeted from 24% to 6.3%. Every facility with an MRI is paying for it by raising the price of everything else. A reasonable person would think how could this possibly happen. GE was thinking how can we sell MRIs and had the finance arm to do it. What GE did was tell the hospitals and doctor groups that they did not have to put any of their own money up to get an MRI, GE would finance the whole thing and the increased revenues from having an MRI in their facility would more than pay for it. The only problem was that the market was already saturated and the only way to pay for these machines was to increase the price of everything else, which was easy to do because US health care was not an open competitive market but a conglomeration of secretive cartels and monopolies that could hide their inefficiencies with front men enablers, the health care insurers.
My spouse and i agree. That is equally features problem. Both features in 2008 desired to change the machine, and now it is to the issue exactly where all of us can not accomplish whatever about this without leaving some sort of fireplace storm. We should change the machine, not really destroy the item.
I agree that these are huge problems with our healthcare system, but at the same time, forcing all 50 states and over 300 million Americans to follow thousands of pages of bureaucratic BS is not the most effective way to solve this problem. I always say that I am a libertarian, but I am not a "Ron Swanson libertarian" in the sense that small state and local governments are a good size for government regulation. If you look at the models of other healthcare systems that most hardcore liberals wish to emulate, they are implemented in SIGNIFICANTLY smaller countries. One of the largest is German, which only has a population of about 90 million (about a third the size of America), and many will agree that Germany's system is far from perfect. That being said, I do agree with the liberal argument that in many European countries, the state can act as somewhat of a union for the people to collectively bargain for healthcare. Under the American system, it is every man for himself, which doesn't give any citizen adequate power to control healthcare costs (see this video...a great video, much of which I disagree with, but he makes a solid argument). This kind of collective bargaining (aka single payer) system may work well in some states, and totally destroy the economy of other states. The problem with most liberals is that they want EVERYBODY in the country to conform to ONE system, which is a terrible idea. Why are you (and every other liberal) so opposed to states running healthcare? Do you think the federal government will be more effective? Do you have ANY evidence to support that the federal government would be more effective than state government?
The states are free to devise their own plans whose coverage exceeds the federal guidelines. Let's see the "independent" minded Southern and Republican states do any of that without federal dollars.
The biggest problem with ACA is that it doesn't go far enough: http://www.dailykos.com/story/2014/...ansion-becomes-issue-in-Georgia-governor-race More than 409,000 Georgians fall into the Medicaid gap—they make too much or don't meet the benefit guidelines for traditional Medicaid, make too little to get a subsidy to buy private insurance—because Republican Gov. Nathan Deal refused Medicaid expansion for the state. Expand Medicaid and save lives!
If you take the EU as a whole it is about the same size as the US in population, territory and GDP. I am not opposed to states running their own programs but I also believe that because the Federal government pays for almost half of all the health care provided in the US, and some 60-80% of what states spend for health care, it has a compelling interest to set some minimum requirements for how the entire health care system in the US is operated and how Federal funds are deployed. That said I think that the implementation of Romenycare in Massachusetts 6 years ago was better than the ACA to some extent. Vermont is in the midst of implementing a single payer plan. States have a lot of flexibility under the ACA, which basically sets a floor and opens a public market for health care insurance, something that the US has never had. I think that the biggest legacy of the ACA, and the thing that will be written about in the history books is that the ACA was the first step in turning US health care into an actual market. It was the ACA that was the enabling step towards the provision of care as an open and competitive market for the US health care industry. The next step is coming fast, Massachusetts is moving to require all health care providers to publicize their prices on the Internet. Not the overblown charge master prices that are secretly discounted for insurers and subject to negotiation, but a single price that they must charge for all comers. Secretly discounting or rebating publicized prices will be illegal racketeering subject to criminal penalties. The state has also created a board to oversee provider capital spending and reject any capital expansion that is considered wasteful and unnecessary, like the $200Million one hospital recently spent to build a fancy new maternity ward that has averaged six births a month since it opened three years ago, which caused the hospital to raise its prices across the board to pay for this hugely wasteful investment in a state with a birth rate in serious decline and a very low maternity ward utilization rate already. The days of completely uncontrollable hair brained willy nilly hospital expansion are coming to a close in Massachusetts. To put it simply, the people have finally figured out how much it is costing their pockets for the completely overbuilt state health care system. They have been putting such enormous pressure on the legislature to do something about it for so long that the legislature is acting despite the massive lobbying power and wealth of the health care providers. The state is acting as the union of the people, which is what states are intended to be.
Well, here in Texas, the plans offered through the State are far less costly and offer access to more providers than those plans offered to us through the Federal Insurance Exchange. Plus, since my husband is a surgeon I have first-hand knowledge of how well the insurance plans purchased through the Federal exchange are benefiting their insureds. We have had more patients forced to cancel needed treatment and surgery than ever before. These patients are upset and confused, as are we. Why? Because both the patient and our staff were told the treatment, surgery, hospital admission would be covered. Only to find hospital admission denied the day of surgery. Plus, too many times, the day of treatment, hospital admission, and the like; the patient is surprised to find the deductible is so high they are unable to pay it. Hence, their surgery, admission or medical care is cancelled. I suggest that the insurance offered in the State of Texas already had exceeded the Federal Guidelines. I also will tell you the it was the failure of the Federal Government to regulate Health Insurance Companies that contributed to the problem of pre-existing conditions, un-controlled premium increases and the like. They expempted Health Insurance Companies from regulatory laws such as the Sherman Act and others for far too long. So blame the Doctors, Surgeons, Hospitals as much as you like but it was the Federal Government and their support of Private Insurance companies that caused and continues to cause the premiums to increase.
It was the failure of the government to regulate spending by providers that has created a crises in the entire health care system. Doctors and surgeons and hospitals are the ones to blame for this, after all they are the ones who decided to spend $100Billions on new equipment and facilities every year. Hugely expensive new facilities and equipment that, with each new one built, reduce utilization and increase the costs that hospitals and doctor and surgeon groups need to recover through their fees. To do that they just raise their prices. Insurers try to bargain them down in negotiations but only a dominant insurer can get a discount and that is shifted onto everyone else. The hospital or doctor group will have its profits regardless of poor business decisions that saddle them with huge debt from embarking on completely unnecessary capital ventures. In Texas providers have recently spent $10Billions on upgrading facilities, building new ones and purchasing new equipment and have plans to spend even more $10Billions in the future. The population of Texas is growing but not nearly at the rate that these expenditures warrant, or the state or its people can afford. It is a trend that has been going on for decades. The average family health insurance plan is more expensive in Texas than in Massachusetts now. Ten years ago it was half as expensive. Average incomes in Texas are far lower than in Massachusetts. There is no way that Texans can afford those increases so more and more Texans lose their health insurance every year. A larger and larger part of increasing insurance rates is because hospitals are required to treat everyone who comes to their emergency room and every year more and more of them are uninsured. To recover their costs the hospitals raise the rates for those who can pay, which means everyone who has insurance. The government provides some reimbursement for indigent care but not nearly enough. Texas has the highest uninsured rate in the nation, close to 40%. It is entirely probable that many insurance plans offered in Texas exceeded Federal guidelines, after all, the federal guidelines were designed that way. The coverage in all the plans on a Federal exchange is exactly the same and explicitly described. The only differences are in the rates, deductibles, co-pays and total out of pocket expenses for the various plans offered by private insurers on the exchanges. I find your claims about patient denials extremely dubious for any patient with insurance they purchased on the federal exchange. Over 875,00 Texans have signed up on the federal exchange out of a population of 27million. This does not mean there is no confusion because you are perhaps confusing people who believe they purchased their insurance on the exchange but did not, or people with employer provided insurance whose terms have changed or maybe you are just making things up out of thin air.
While the pro death Republicans are crying over Obamacare success, ACA signups continue to grow: http://www.dailykos.com/story/2014/...s-Hello-Mr-President-and-Goodbye-Mr-McConnell So, yesterday I posted an item about how the ACA has cut Kentucky's uninsured rate by at least 50% since last October. This is significant news, but I also posted similar items about impressive uninsured rate drops in New Jersey (38%), Minnesota (40%) and especially Massachusetts (a good 86% or so, down to nearly zilch). All four posts received various levels of retweets on Twitter. However, the Kentucky one in particular apparently caught the eye of one David Simas, aka the "Assistant to the President and Deputy Senior Advisor for Communications and Strategy." Truly amazing ACA news. Kentucky cuts uninsured rate in half!! More ACA success!!!!!!
more health care expansion: http://www.dailykos.com/story/2014/06/12/1306559/-Medicare-cost-growth-still-very-very-nbsp-low more coverage, more lives saved = that's a great TRUTH
Okay lets say Mr. Smith comes into the ER, your husband is on call and its a dangerous infection area that needs surgical draining and removal of dead tissue so he does it then later he can't pay being poor and your state didn't expand Medicaid so there is not even the ability to get that income for the work - is that better than no insurance or the ACA exchange plan since they would bill usually after the threat is tended to. The ACA is not perfect but having someone unable to pay at all is likely worse to your husbands bottom line. I know he likely would have done a surgery for free all doctors say that the truth is they deserve to get some income for their work, not get shafted with unpaid bills, which is largely the case now.
You are so delusional. The cost of providing care has continually increased since the early 1990's while reimbursements have continually decreased. And, due to Government regulation our costs have tripled. And, hospitals and providers must keep up with advancements in equipment in order to offer the best diagnostics. It is the Federal government via more costly, unnecessary regulations, failure to properly administer the Medicare program and insurance companies that went unregulated for far too long that have caused overspending. By the way there is a huge difference between over spending and simply rising costs for providing treatment. My husband is now pay less than $200.00 to amputate a gangrene diabetic foot where he was paid $600.00 in the mid 1990's. We paid 4000$ to have our dogs spine operated on with no insurance. As many pet owners are willing to do. You and people like you are delusional! Read my other posts on health care and Obama care. I am all for health insurance reform and the "Patient Protection" part of the PPACA the rest is BS
Obamacare doesn't work. My premiums went up 50% and deductive tripled. My new insurance the premium is 25% more double the deductible and the flexible spending account was eliminated. I should be allowed by law to punch every liberal in the face.
Remind me again, which political party is it that fights tooth and nail against regulating businesses?
Your husband is a healer, a vocation, if he didn't want to treat any who were sick regardless of the means to pay he should have entered another profession. I have Medicaid if I ,hopefully not, needed something amputated in an emergency would he refuse to treat me what about the professional ethics of his profession money should not determine if he does a life saving procedure or not.
Apparently both parties as the President wants to bail-out insurance companies that lose money by providing insurance plans through the Exchanges. And it took both parties decades to hold health insurance companies to the Sherman Act and to regulate their activities. Health Insurance was the only insurance that went unregulated. So what is your twisted point?
