The Sad Case of the Patient Protection and Affordable Care Act

[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.

 

[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.

 

[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

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.

 

[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.)

 

[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.

 

[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.

 

[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?

 

[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.

 

[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?

 

[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]

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

Presumably they could just borrow money off their parents, ala his solution to the student loan debt problem.

 

[ScoobyDoo]

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

Presumably they could just borrow money off their parents, ala his solution to the student loan debt problem.

That's ****ing awesome. He's a machine the way he rattles off those easy solutions to so called complex problems.

 

[walrus]

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

Charlie Summers, repub in Maine running for Snowes seat, will repeal Obama care if elected. What a joke that is. I realize he can fool alot of people saying that but the ones he can't sure as heck know he doesn't have a clue

 

[unofan]

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

So after years of 10-15% premium increases, this year's insurance premiums for state of Iowa employees are set to remain flat or even drop by up to 7%, depending on the plan. We just got the spiel from our HR director since the open enrollment period starts monday.

But I'm guessing the ACA had nothing to do with that, amirite?

 

[joecct]

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?

Have no idea, but the new health care law should be thought out and not put together in the middle of the night. I think the 1099 requirement has already been struck. There are probably a few more that will be discovered as the law's provisions (and regulations) become effective.

Remember, "It seemed like a good idea at the time..."

 

[bronconick]

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

So after years of 10-15% premium increases, this year's insurance premiums for state of Iowa employees are set to remain flat or even drop by up to 7%, depending on the plan. We just got the spiel from our HR director since the open enrollment period starts monday.

But I'm guessing the ACA had nothing to do with that, amirite?

Why aren't you giving Steve King his proper credit for keeping your premiums down?

 

[leswp1]

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

Have no idea, but the new health care law should be thought out and not put together in the middle of the night. I think the 1099 requirement has already been struck. There are probably a few more that will be discovered as the law's provisions (and regulations) become effective.

Remember, "It seemed like a good idea at the time..."

Until the 'new' Healthcare law is put together what is the plan. It took decades to get any Bill passed. The legislative branch has no interest in working on anything together. I want to hear what the people who want to enact these changes predict will happen, not just blindly follow along and pretend there will not be a list of sequelae that will impact the entire health system. At this point I hear no foresight or consideration of what the impact will be. If they have a stopgap I might feel more comfortable

 

[joecct]

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

Until the 'new' Healthcare law is put together what is the plan. It took decades to get any Bill passed. The legislative branch has no interest in working on anything together. I want to hear what the people who want to enact these changes predict will happen, not just blindly follow along and pretend there will not be a list of sequelae that will impact the entire health system. At this point I hear no foresight or consideration of what the impact will be. If they have a stopgap I might feel more comfortable

Les -- we need Tip O'Neill or (waiting for the vomit) Newt Gingrich to lead the House and a Mike Mansfield to lead the Senate. But politics has changed a lot in the last 20 (or more) years. The middle grounders on both sides are getting tossed aside for the radicals.

That said -- if we could get Tax Reform in the 80's, we can get a better plan. We survived without one for many, many years. Why are many thinking that the PPACA is the cure all (pun intended) for everything that ails the health care industry? Could it be that too much regulation has stifled creative solutions? Somebody needs to be daring -- and creative.

I don't know, but the way the PPACA was passed left a bad taste in a lot of peoples' mouths. Surely they can do better.

Side thought -- I wonder what would happen if they turned the TV cameras off in the Congre$$ for a session? 99% of what is said is grand standing to the cameras. Maybe they'll think less with their mouths and more with their brains.

 

[leswp1]

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

Les -- we need Tip O'Neill or (waiting for the vomit) Newt Gingrich to lead the House and a Mike Mansfield to lead the Senate. But politics has changed a lot in the last 20 (or more) years. The middle grounders on both sides are getting tossed aside for the radicals.

That said -- if we could get Tax Reform in the 80's, we can get a better plan. We survived without one for many, many years. Why are many thinking that the PPACA is the cure all (pun intended) for everything that ails the health care industry? Could it be that too much regulation has stifled creative solutions? Somebody needs to be daring -- and creative.

I don't know, but the way the PPACA was passed left a bad taste in a lot of peoples' mouths. Surely they can do better.

Side thought -- I wonder what would happen if they turned the TV cameras off in the Congre$$ for a session? 99% of what is said is grand standing to the cameras. Maybe they'll think less with their mouths and more with their brains.

I don't think I know anyone who thinks it is the cure. Almost every one I know who approves of it thinks it is the beginning step. When they ask people about the components without asking about the bill the vast majority approve of the concepts in the bill. I truly do understand why people object.

I am baffled about the people who want to 'throw it out and start again'. I can't find anyone who wants the repeal who has actually thought of what consequences there would be to the action. The cost would be huge. Maybe I am not understanding this but why can't they adjust certain things? I thought that was the intent when it passed.