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Orange Blooded [2133]
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Health Care.....show of hands....
Feb 26, 2024, 2:34 PM
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How many people were aware that the ACA (and its precursor in Massachusetts, aka RomneyCare) were based on the same framework as a proposal from the Heritage Foundation given in 1989?
https://www.heritage.org/social-security/report/assuring-affordable-health-care-all-americans
There are differences in the ACA and what Heritage was proposing. But a few things were very much the same or similar:
1) A Medicaid Expansion.
2) An Individual Mandate to buy insurance.
3) Subsidies for people who were too sick or too poor to afford it.
It's not fashionable to say that the ACA was based on a fairly conservative proposal. But it was. The heritage plan had a three-legged stool, where everyone had to buy and where there was always something that would be available and finally subsidies for people who couldn't afford it.
I admit that when the ACA was signed into law, I thought it might collapse, and I didn't support it. But that collapse hasn't happened. It's actually done better than I thought. The individual mandate was done away with. So, getting to Universal healthcare won't be possible under the ACA. But it has been a positive step in that direction. Due to the ACA, the ranks of uninsured in this country has been roughly cut in half from 15-20% to about 7-9%...
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Oculus Spirit [83197]
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Yep. That came up quite often when ACA passed.***
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Feb 26, 2024, 2:36 PM
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Orange Blooded [2133]
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Heisman Winner [112115]
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Re: Health Care.....show of hands....
Feb 26, 2024, 2:45 PM
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My understanding is that a lot of these ideas go back to the Nixon administration, which was probably on par with Obama's from a policy perspective.
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Orange Blooded [4024]
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Re: Health Care.....show of hands....
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Feb 26, 2024, 2:53 PM
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This is why MAGAts have no replacement for Obamacare. It's a conservative idea that they pretend is woke. Obama checkmate them and they are forever stuck on this. 😆
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110%er [5712]
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Re: Health Care.....show of hands....
Feb 27, 2024, 4:26 PM
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the replacement for Obama care is natural selection. Get a job, earn money and buy insurance or don't.
You should like that because it reduces the carbon footprint of humanity.
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Orange Blooded [4024]
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Re: Health Care.....show of hands....
Feb 27, 2024, 9:46 PM
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That was working so well prior to the ACA. LOL. Why do you hate small business and the people who worked for them?
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Associate AD [819]
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Re: Health Care.....show of hands....
Feb 27, 2024, 10:05 PM
[ in reply to Re: Health Care.....show of hands.... ] |
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NC Tiger, huge props for comedy, thanks shedding for sharing your comically ridiculous naive proposals.
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All-TigerNet [13266]
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Every bill since the ACA has passed includes more funding for the ACA
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Feb 26, 2024, 2:54 PM
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It is an absolute failure and has been funded 5000% more than budgeted.
"But that collapse hasn't happened. It's actually done better than I thought."
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Orange Blooded [4024]
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Re: Every bill since the ACA has passed includes more funding for the ACA
Feb 26, 2024, 3:03 PM
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By what measures is it an "absolute failure"?
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All-In [47955]
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"You like your doctor, you can keep your doctor."***
Feb 26, 2024, 4:18 PM
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Orange Blooded [4024]
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Re: "You like your doctor, you can keep your doctor."***
Feb 26, 2024, 8:12 PM
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That's all your googling efforts could come up with?
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Orange Blooded [2133]
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The vast majority of people did keep their doctor....
Feb 28, 2024, 9:00 AM
[ in reply to "You like your doctor, you can keep your doctor."*** ] |
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Most people were not affected by the ACA in terms of their doctor & keeping their health insurance they already had at work.
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Orange Blooded [2133]
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The problem with the ACA....
Feb 26, 2024, 4:36 PM
[ in reply to Re: Every bill since the ACA has passed includes more funding for the ACA ] |
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is that it didn't fail. The hard right desperately wanted it to fail. But it wouldn't comply with their wishes. The death spiral that was predicted by the hard right never occurred.
Not only did it cut the uninsured in half, but it did so without costs going up as a % of gdp. We actually slowed healthcare cost growth while insuring more people.
To get to full UHC though, more has to be done. The ACA wasn't nearly enough.
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All-TigerNet [13266]
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JFC . Is everyone brain dead today
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Feb 26, 2024, 8:19 PM
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What part of that it can’t sustain itself by a factor of 5000, means it’s not an abject failure. Every year billions of additional funds are needed to keep it afloat. The mandate was the only thing that raised a couple of dollars for it.
FAIL!!
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All-In [34144]
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Re: Health Care.....show of hands....
Feb 26, 2024, 3:02 PM
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Yes, and not only that, but McCain favored the individual mandate while Obama did not. What was passed was as much or more the Heritage Foundation/McCain/Romney version than it was Obama version.
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Orange Blooded [4851]
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Re: Health Care.....show of hands....
Feb 26, 2024, 3:43 PM
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So more people are covered but we are all paying out the wazoo compared to what we paid before this boondoggle was passed. Only pointing out half of the equation and using it as some kind of proof of success is disingenuous at best and an outright lie at worst. And who cares who thought up this terrible idea first fifty years ago? What a bizarre and completely irrelevant defense of a horrible piece of legislation.
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Orange Blooded [2133]
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All-In [26428]
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Orange Blooded [2133]
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This is true....
Feb 26, 2024, 6:45 PM
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There are still people who are uninsured and people who are underinsured. More reform is needed. Biden's IRA bill allows for drug price negotiations, and increased subsidies for policies that are bought on the exchange. It's incremental improvement. But much more is needed.
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All-TigerNet [12681]
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Market forces
Feb 26, 2024, 7:30 PM
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might be something to consider. There is essentially no competition on price between hospitals or physicians.
More government intervention which is already considerable will only lead to a least common denominator product.
It will not be any cheaper if the California model of offering MediCal to ALL illegal aliens is adopted by more states. The Medicaid budget will explode.
It’s a problem Solomon would struggle with, but leaving it all up to politicians is unlikely to produce a good result.
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Orange Blooded [2133]
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There's a limited amount of "market forces"....
Feb 26, 2024, 10:17 PM
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that can assist us with healthcare costs in the US. I think markets apply quite well in areas where treatments & surgeries are optional, and customers have choices. It's not easy to apply market forces when the customer is the victim of a heart attack or a stroke or a serious injury from a car accident.
Now, when we compare the US to other countries, our system is far more private and profit-driven than those other countries. We have mostly private doctors/providers, in private clinics or private hospitals, serving a customer base that is largely using private insurance or insurance that their private employer self-insures or has negotiated with a private insurance entity. And even when people have Medicare or Medicaid, they're often using private entities in Medicare Advantage or private administrators in Medicaid HMO plans. For some people, around 20 million or so, who buy their insurance on the ACA exchanges, they're buying from a private insurer and often choosing between various plans that are offered by more than one insurer.
Compared to other countries, we are much more "market-based" and/or private-based than any other country. However, those other countries, which are all supposedly socialist hellholes, cover their entire population and spend far less money on healthcare than we do, and they typically have longer lifespans, too.
I'm not advocating that we copy another country. But I am advocating that our system needs changes, and that we can look at what other countries are doing better than us, and occasionally borrow an idea or two from them.
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All-TigerNet [12681]
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Re: There's a limited amount of "market forces"....
Feb 27, 2024, 7:25 AM
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that can assist us with healthcare costs in the US. I think markets apply quite well in areas where treatments & surgeries are optional, and customers have choices. It's not easy to apply market forces when the customer is the victim of a heart attack or a stroke or a serious injury from a car accident.
Now, when we compare the US to other countries, our system is far more private and profit-driven than those other countries. We have mostly private doctors/providers, in private clinics or private hospitals, serving a customer base that is largely using private insurance or insurance that their private employer self-insures or has negotiated with a private insurance entity. And even when people have Medicare or Medicaid, they're often using private entities in Medicare Advantage or private administrators in Medicaid HMO plans. For some people, around 20 million or so, who buy their insurance on the ACA exchanges, they're buying from a private insurer and often choosing between various plans that are offered by more than one insurer.
Compared to other countries, we are much more "market-based" and/or private-based than any other country. However, those other countries, which are all supposedly socialist hellholes, cover their entire population and spend far less money on healthcare than we do, and they typically have longer lifespans, too.
I'm not advocating that we copy another country. But I am advocating that our system needs changes, and that we can look at what other countries are doing better than us, and occasionally borrow an idea or two from them.
Well roughly 90% of surgeries are elective, not necessarily optional, but not emergent. There is essentially no price competition among surgeons. Insurance pays at a fixed rate. Medicare or Medicaid pays the surgeon at a fixed rate within the same state.
For the most part, hospitals are likewise paid the same amounts.
Heart attacks are common admissions. There is a lot of standardization on treatments. If market forces were in play I'm sure the hospitals and Cardiologists would compete on cost.
Of course we need a safety net for those who can't pay.
Furthermore, it is a ridiculous myth that people are turned away for treatment of heart attacks, strokes, cancer or injuries due to a negative wallot biopsy.Those with no money are treated.
I totally agree that we can do better and all options should be explored, but before we jump on a nationalized health care system, encouraging competition among doctors and hospitals with full transparency of pricing would be a help.
The current system where the patient typically along with the doctor is clueless about costs since 3rd payers are involved does nothing to lower costs.
A pure market driven medical system is probably not feasible, but let's at least try it in some low risk areas such as with primary care. What does Dr A charge for a routine checkup vs Dr B? What does Dr A Ortho charge for a knee arthroscopy vs Dr B Ortho?
Alas, lower price doesn't necessarily equal better quality, but as long as Dr's and patients are at multiple arm's lengths away on the costs of healthcare, costs will never be reigned in.
If the Feds totally take over health care, there will ultimately have to be rationing.
Much of the problem is us. We are a nation of fat people who do little in the way of exercise. That is a huge problem that perhaps could be better incentivized even now more than it is by Insurers.
It's a very difficult problem, but I feel market forces need to be expanded rather than reduced further.
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Orange Blooded [2133]
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I think more price transparency is a good thing....
Feb 27, 2024, 9:41 AM
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I think some laws were passed during the Trump years that helped with that, although more is needed. I agree with alot of what you're saying, at least to a point. I also thinking giving medicare bargaining power with big pharma will help lower costs for seniors.
Rationing already occurs, btw. Emergency rooms have to treat people when they show up. But bureaucrats will deny coverage for this or that treatment or prescription all the time. And people without health insurance will put off check-ups & treatments due to inability or perceived inability to pay. Some doctors don't accept Medicaid patients. Rationing is already part of our system that is so private based.
I don't think America needs a nationalized system like the UK or "Medicare for All". I think we need to build on the system we have in place already, which uses private insurance for more than half the country. But we will need a stronger government hand in order to get to full UHC.
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Orange Blooded [4024]
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110%er [5712]
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How many people know if
Feb 27, 2024, 4:25 PM
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the gov't gets involved in anything, it gets effed up?
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Orange Blooded [4024]
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Re: How many people know if
Feb 28, 2024, 7:19 AM
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How does the free market work for healthcare? 😆
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