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The PPACA Thread Part III - Let's have a healthy debate!

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FreshFish said:
FYP.

No one single plan will work for everyone. The states should be sole regulators of insurance, the feds cannot handle regional variations. They are just too arbitrary and heavy-handed. PPACA is full of disguised pork and contradictions. It is unworkable in its current form.

Community free clinics can be really effective in some cities. that doesn't mean they will work just as well in rural areas.



PS you also make the (typical, unfounded) assumptions that health savings accounts can only be funded by one's own money. I guess you conveniently forgot (again) the possibility of pre-paid healthcare debit cards, eh?


You should meet Daniel Kahneman sometime. I'm sure he'd love to include you in his next study of how willful blindness affects otherwise intelligent people.
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Yes, the person who reads nothing but News Corp. publications is trying to call someone else willfully blind. That's hilarious.

Here again, folks, is an opportunity to witness the Rovian strategy of accusing your adversary of having your own faults. That's a bold strategy, Cotton. Let's see how it works.

And until you can buy an MRI at your local Wal-mart, I don't see the food stampifaction of health care being a realistic solution to anything. Pre-paid debit cards. That's gotta be a joke, right? Probably run by a private insurer who takes a 5% fee off the top everytime you use it in addition to fees every time you log in to the website to check its balance.

You are probably also in favor of fast food workers getting their paychecks on those fee-laden cards, as is the new trend.
 
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Re: The PPACA Thread Part III - Let's have a healthy debate!

Jimjamesak said:
I've said it once and I'll say it again, there are two solutions to health care in this country: 1. A socialized single payer system. Or 2. Repealing the law that forces hospitals to treat people even if they can't pay.
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I agree 1,000,000%.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

jerphisch said:
I hope you're not implying they'd be funded by your employer. Mine has an FSA that went from a company contribution of $1,000, to $500 to $0 over the last 3 years for a family.
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I am saying we need multi-pronged, multi-faceted solutions, each tailored to different categories, adjusted to fit local needs and circumstances. There is no sane, sensible way to have a comprehensive, national, healthcare program that will satisfy everyone. Healthcare delivery solutions should all be developed at the state and local level. The federal government requires non-discrimation and uniformity, while "discrimination" in the sense of using discerning judgment is what is needed most. The two are fundamentally incompatible.


Single-payor can not deliver satisfactory results. There is always rationing, either by money or by time. It is inevitable and inescapable. That's just how life works. Grow up and face reality as it actually exists, not as you wish it would be. Single-payor is merely a big invitation to massive fraud. We see it every day with Medicaid and Medicare. I wish it were not so.

The best solutions are innovation, local adaptability, and a much stronger emphasis on preventative care and wellness.
 
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Re: The PPACA Thread Part III - Let's have a healthy debate!

FreshFish said:
I am saying we need multi-pronged, multi-faceted solutions, each tailored to different categories, adjusted to fit local needs and circumstances. There is no sane, sensible way to have a comprehensive, national, healthcare program that will satisfy everyone. Healthcare delivery solutions should all be developed at the state and local level. The federal government requires non-discrimation and uniformity, while "discrimination" in the sense of using discerning judgment is what is needed most. The two are fundamentally incompatible.
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Because tonsilectomies in Iowa are different than the ones in New Jersey? I'm not buying this "local needs and circumstances" angle. Seems like cover for "local ideologies and biases" to me.
 
LynahFan said:
Because tonsilectomies in Iowa are different than the ones in New Jersey? I'm not buying this "local needs and circumstances" angle. Seems like cover for "local ideologies and biases" to me.
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I stopped after "massive fraud like we see everyday with Medicaid and Medicare." That's all they see, welfare queens as far as the eye can see.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Jimjamesak said:
I stopped after "massive fraud like we see everyday with Medicaid and Medicare." That's all they see, welfare queens as far as the eye can see.
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The fraud isn't usually perpetrated by those in need, rather by those who are simply looking to game the system.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Interesting.

(S)ingle-payer has made it onto the ballot in Colorado. This will be the first ballot initiative to be voted on that would create a single-payer healthcare system in a state.
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First I have heard about it. All my thinking re: single payer has been for a federal system. State-based would have the advantage that it would only happen with state buy-in. We could have single payer in blue states and gilded age neglect in red states. People sincerely concerned about federal overreach could still support it.

If these start popping up all over we would also have the benefit of a lot of different experiments, since they would all probably vary.
 
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Re: The PPACA Thread Part III - Let's have a healthy debate!

FreshFish said:
I am saying we need multi-pronged, multi-faceted solutions, each tailored to different categories, adjusted to fit local needs and circumstances. There is no sane, sensible way to have a comprehensive, national, healthcare program that will satisfy everyone. Healthcare delivery solutions should all be developed at the state and local level. The federal government requires non-discrimation and uniformity, while "discrimination" in the sense of using discerning judgment is what is needed most. The two are fundamentally incompatible.


Single-payor can not deliver satisfactory results. There is always rationing, either by money or by time. It is inevitable and inescapable. That's just how life works. Grow up and face reality as it actually exists, not as you wish it would be. Single-payor is merely a big invitation to massive fraud. We see it every day with Medicaid and Medicare. I wish it were not so.

The best solutions are innovation, local adaptability, and a much stronger emphasis on preventative care and wellness.
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This is all nonsense with no actual proposals in it. In short, a typical Fishy post!

Kep, I too am interested in the possible single payer experiment in Colorado. The benefit of the ACA was that it had already been tried and implemented successfully in Massachusetts, where without setting up death panels the state 1) had the lowest uninsured rate, 2) could afford the program without going bankrupt, and 3) had lower unemployment than than that national average.

A lot of my fellow lefties want to see single payer and while I might be on board I'd sure like to see it actually working in practice somewhere. I know Vermont tried it and scrapped it recently although I confess I don't know why they felt the costs were going to be unaffordable.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Rover said:
A lot of my fellow lefties want to see single payer and while I might be on board I'd sure like to see it actually working in practice somewhere. I know Vermont tried it and scrapped it recently although I confess I don't know why they felt the costs were going to be unaffordable.
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I'm not so much on board with single payer as I am looking for a solution which ensures everyone has high quality coverage, where the "universality" doesn't come with the proviso "may not be available in your social-economic status.". My ideal would be universal coverage with a deductible based on wealth: the super-rich would never reach the deductible, the middle class would reach it well under the costs they pay now, and the poor would have no deductible and would be paid in full from the first dollar. Birth control would fall under health care. Medicaid, Medicare, Obamacare and all other state and federal plans would end. The health insurance industry would be limited to pools of very rich individuals trying to protect themselves from being wiped out by catastrophic emergencies. Insurance beyond this would cease to have meaning since the shared risk would be the entire population and the premiums would just be a portion of non-dedicated government revenue. The money would come from the general budget -- there would be no specific tax associated with health care in the same way that we don't have a "National Defense Tax."

That's what I want. First party to get there gets my vote. If the states want to do it individually out of their general funds rather than having the federal government do it out of the HHS budget, as long as the outcomes are the same I don't care.
 
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Re: The PPACA Thread Part III - Let's have a healthy debate!

Kepler said:
I am looking for a solution which ensures everyone has high quality coverage.
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I'll bet everyone in your world is above average too!

The fact that it is a mathematical inevitability that there will always be variance doesn't exist in your world???

Unless by "high quality" you mean "sufficient quality to ensure access to fundamental basic health"....there will always be lazy people who drink too much, over-eat, chain-smoke cigarettes, etc. There is a really big difference between having access to adequate quality coverage, and then using that access in a responsible manner.

We might be able to bridge the gap on the latter. "Access" does not necessarily mean people will then use it effectively. If you can agree that giving people access to coverage of adequate quality is enough, fine; if you think that somehow "coverage" is also supposed to protect people from their own destructive behaviors, we'll just have to agree to disagree.
 
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Re: The PPACA Thread Part III - Let's have a healthy debate!

Jimjamesak said:
I stopped after "massive fraud like we see everyday with Medicaid and Medicare."
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I guess you don't read the newspapers at all then. Every month there is a new prosecution for Medicare or Medicaid fraud running in the millions, overall annually nationwide in the billions. As Unofun stated, it is usually doctors running the scam, not the patients, so wherever you came up with the "welfare queen" denigration, it was your imagination, not reality as it exists.

The government has little incentive to stop the fraud, compared to people who actually are accountable for how the money is spent. The prosecutions merely try to go after the fraud once it has been committed. The way budgets work, one department then runs a deficit while a different department pockets whatever it recovers.
 
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Re: The PPACA Thread Part III - Let's have a healthy debate!

LynahFan said:
Because tonsilectomies in Iowa are different than the ones in New Jersey? I'm not buying this "local needs and circumstances" angle.
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Some states and communities have a lot of older people compared to others, they'd need more gerontologists. Some states and communities have a lot of young married couples, they'd need more obstetricians and pediatricians. The way the feds run things, every locale would have to have the same number of practitioners in each specialty per capita regardless of actual demographics.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

A major health insurance company considers whether to withdraw from offering PPACA-Exchange policies at all.

UnitedHealth Group Inc. said it expects major losses on its business through the Affordable Care Act’s exchanges and will consider withdrawing from them, in the most prominent signal so far of health insurers’ struggles with the health law’s marketplaces.

....

The Obama administration has said it aims to have about 10 million people with paid-up coverage on the state and federal health-law exchanges by the end of 2016. But that falls well short of some earlier projections: the nonpartisan Congressional Budget Office earlier this year estimated that at least 20 million people would buy policies under the law for 2016 coverage.

....

A recent analysis by McKinsey & Co. found that in 2014, the first year of the exchanges, health insurers lost a total of $2.5 billion, or on average $163 per consumer enrolled, in the individual market.
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Re: The PPACA Thread Part III - Let's have a healthy debate!

Can anybody find out if Fishy still thinks the SCOTUS is going to rule his way on the ACA? I know he has me on ignore after some tough but accurate comments I made about what Roberts did to his backside, but its a worthwhile question. :D
 
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