The Sad Case of the Patient Protection and Affordable Care Act

[ScoobyDoo]

Re: The Sad Case of the Patient Protection and Affordable Care Act

les you're trying to reason with idiots. Rule #1 in life: There's no reasoning with idiots. Inevitably somebody will spout some libertarian nonsense about repealing the law that hospitals have to treat everybody which has zero chance of getting enacted. Someone else will post some handy platitudes about "we all need to be responsible" blah blah blah. Finally you'll get the ol' "tort reform will solve all the problem" argument.

But, and the end of the day, the "Repeal and Replace" chant suffers one fatal flaw. What exactly is the "Replace" part going to be?

Let people die. Or, if you're Mittimous Romney, use the Emergency Room.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

les you're trying to reason with idiots. Rule #1 in life: There's no reasoning with idiots. Inevitably somebody will spout some libertarian nonsense about repealing the law that hospitals have to treat everybody which has zero chance of getting enacted. Someone else will post some handy platitudes about "we all need to be responsible" blah blah blah. Finally you'll get the ol' "tort reform will solve all the problem" argument.

But, and the end of the day, the "Repeal and Replace" chant suffers one fatal flaw. What exactly is the "Replace" part going to be?

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Serious question- They repeal the law. We also do what a lot of people want to do- cut the cost/reimbursement rate for providers/ hosptitals, decrease the number of people who qualify, make the requirements more stringent, allow people to not pay into the system, do not cover people until 26 yo on parents insurance, create a voucher system, no longer require preventitive well exams, screening.

In an ideal/ fair world there should be a consequence for not doing the right thing. No one should be forced to buy coverage, they should be allowed to take a chance they will be healthy. People should be responsible for their own actions- if you eat a poor diet, drink to excess, smoke etc you need to take the medical consequences. If you don't wear your seatbelt you suffer the consequences in an accident. If you don't take your medicine you get sick. If you don't save enough then you can't afford your care.

I agree with many of these premises wholeheartedly but the thing I struggle with is what do you do with the aftermath of non-care. This is not an ideal world. The system is required to take care of what presents to them regardless of irresponsibility of the patient or the bad gamble as far as assuming they will be well (stuff happens - trauma, sudden illness). We do not have a little section of the ER that we put people who don't have $ and wait for them to die. No one is going to pass a law that people will be allowed to die if they don't have cash. People cry out that abortion isn't right and there isn't a face attached. There is no way they are going to be OK with a 'real' person dying.

Making the assumption that people will change behavior when they know they won't get care is not realistic. Anyone in medicine can regale you with endless stories of people who have been told do not drink, to take meds correctly, to test their blood, etc, etc or they will die/ be very ill. They will also tell you that these people, despite being clearly told of the possible consequences, are legitimately shocked when they occur. You can argue all you want about the lack of logic but it is the reality of the beast.

In the real world medicine is forced to care for the patient whether there is reimbursement or not. There is a cost to care no matter what plan is proposed. If we follow through with removing the current coverage, by necessity, it will leave a large number of people without coverage either by choice or not. We have a population top heavy with aging people who will present in time with some sort of medical malady. Some may be healthy and be so for a long time. Some will have illness that is not treated. Some of the latter will go undiagnosed until sx occur (diabetes, renal disease, cancer, etc). All of these things eventually need treatment when someone is in extremis.

It seems like the proposals relabel the problem as not the government's but that doesn't deal with the impact to the medical system. The bills will not just go away because they are inconvienent or not the government's. Saying the person shouldn't need care does not remove the fact that we still have to provide it.
Currently there are allowances that take into consideration for these costs and attempts to fund things to prevent pts presenting late in disease when it is more costly to treat. If we remove all these nets is there a plan to cover the aftermath? Has anyone commented on what the financial impact will be and what the plan would be to address it?

The reason I ask this is I heard an amazing show on the radio which talked in detail about the possible financial costs of repeal being staggering now the system is in place- unfortunately I can't remember where I heard it so no link.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Romney's solution? On 60 minutes he touted the Emergency Room solution.

The only real solution is to start letting people die. The private sector has failed to bring Health Care costs down and Obamacare tries but evidently has failed.

You don't have insurance, you don't have money, you can bleed out on the sidewalk.

Congratulations, you have found yet another reason why I won't vote for Romney. There is no difference between the emergency room and Medicare, as both involve rationing based upon ability of funds.

I'm not sure if you're speaking in jest or not, but you pretty much have the best solution. Could you finally be starting to grow a brain?

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Somebody said a National Speed Limit would destroy the country? Who? (Besides, I dunno, the trucker lobby.)

No, the trucker lobby is saying that 85 MPH in Texas would destroy the country. If anything, they were for it.

The biggest issue is that we are falling into this single point of failure issue once again. Everything is becoming inefficient.

[ScoobyDoo]

Re: The Sad Case of the Patient Protection and Affordable Care Act

According to Obama, through cutting administrative costs and getting better research going, families would save $2500 per year on insurance premiums with Obamacare.

Well, the premiums did change by about $2500. The other direction, though.

The mandate is the issue.

Romney's solution? On 60 minutes he touted the Emergency Room solution.

The only real solution is to start letting people die. The private sector has failed to bring Health Care costs down and Obamacare tries but evidently has failed.

You don't have insurance, you don't have money, you can bleed out on the sidewalk.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I also see that you conveniently left out Prohibition and the National Speed Limit.

Somebody said a National Speed Limit would destroy the country? Who? (Besides, I dunno, the trucker lobby.)

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

If Obama wins it's permanent. Of course it will morph back and forth with the future hemlines of politics, but the basic principle will no longer be controversial except among the hard core nutbars, much like Social Security and Medicare now.

That is the basic flaw in reactionary movements that scare people by saying a given change will "destroy the country." When it doesn't, they are exposed as frauds.

Here is an incomplete list of all the things we have been told will "destroy the country" in American history:

National bank
Abolition of property qualifications for voting
Abolition of slavery
Irish Immigration
Labor unions
Direct election of Senators
Unemployment benefits
Italian immigration
Income tax
Women's suffrage
Eastern European immigration
Child labor laws
Chinese immigration
Repeal of Prohibition
Social Security
Peacetime standing army
Joining the United Nations
Desegregation
Nuclear arms limitation
Birth control
Women's rights movement
Mexican immigration
Universal health care
Gay marriage

As you can see, they were right every time.

We're a trillion dollars per year over-spending, $16T in debt, have countless expenditures not on the books because they haven't happened yet, but you want to tell me that Social Security hasn't destroyed the country?

Direct Election of Senators hasn't caused states to completely lose representation and allow for federal bullying.

I also see that you conveniently left out Prohibition and the National Speed Limit.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Read 'em and weep Fishy. Even [people I dislike] are starting to realize the ACA is here to stay!

yes, sadly, it looks that way, there are quite a few really terrible laws on the books that look like they'll remain there for awhile. Roberts' ruling makes it effectively impossible to amend PPACA as it needs to be to be viable in accomplishing its stated ends. [a medical devices tax? seriously? who thought that one up..."let's penalize innovation, yeah, that will really get healthcare costs down!" yeah, right...]

oh, well, at least I don't have to deal with Dodd-Frank or Sarbanes-Oxley. Those are even worse!

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

According to Obama, through cutting administrative costs and getting better research going, families would save $2500 per year on insurance premiums with Obamacare.

Well, the premiums did change by about $2500. The other direction, though.

The mandate is the issue.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

If Obama wins it's permanent. Of course it will morph back and forth with the future hemlines of politics, but the basic principle will no longer be controversial except among the hard core nutbars, much like Social Security and Medicare now.

That is the basic flaw in reactionary movements that scare people by saying a given change will "destroy the country." When it doesn't, they are exposed as frauds.

Here is an incomplete list of all the things we have been told will "destroy the country" in American history:

National bank
Abolition of property qualifications for voting
Abolition of slavery
Irish Immigration
Labor unions
Direct election of Senators
Unemployment benefits
Italian immigration
Income tax
Women's suffrage
Eastern European immigration
Child labor laws
Chinese immigration
Repeal of Prohibition
Social Security
Peacetime standing army
Joining the United Nations
Desegregation
Nuclear arms limitation
Birth control
Women's rights movement
Mexican immigration
Universal health care
Gay marriage

As you can see, they were right every time.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Read 'em and weep Fishy. Even knuckledraggers are starting to realize the ACA is here to stay!

A new Associated Press-GfK poll finds 72% of Americans think President Obama's health care law will go fully into effect with some changes, ranging from minor to major alterations.

Just 12% say they expect the Affordable Care Act to be repealed completely

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

If you like your health insurance plan, you'll be able to keep it.

-- Barack Obama

I'm going to retire at the end of this year; I don't want to put up with all the additional paperwork of PPACA combined with lower Medicare reimbursement rates.

-- My (soon-to-be former) physician.

Who are you going to believe, me or your own eyes?

-- the rat from An American Tail

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

http://www.independent.ie/national-news/senator-john-crown-defends-abortion-waiting-list-joke-3236119.html"] this started out as a satire of how long it takes to get health care under "universal" coverage in Ireland....

IF ABORTION was available in Ireland there would be a 10-month waiting list, Senator John Crown warned today

which actually is kind of funny....

Dr Crown was commenting on the latest figures from the HSE showing hospitals plunging further into financial crisis while over 300,000 wait to see a specialist

however, his timing was terrible since abortion is not yet legal there and the first law permitting abortion in limited circumstances is being debated (no one there has yet said "safe, legal, and rare")

[LynahFan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

There IS the story that when BHO spoke at Georgetown, the school (was forced/asked?) covered up the religious symbols behind the podium.

Temporarily, for a government function. I'm going to need a lot more than that before I lose any sleep over this.