Health Care Hell

Discussion in 'West Mall' started by Mr. Deez, Mar 13, 2017.

  1. Mr. Deez

    Mr. Deez Beer Prophet

    I'm surprised nobody has commented on this, but of course, the GOP has introduced its replacement for Obamacare. It is being almost universally panned. A good article discussing it by a staunch Obamacare critic who believes it's in some ways worse than Obamacare. It has a lot to hate in it almost regardless of your leanings. If you're a libertarian conservative, it largely leaves the government in a strong regulatory position in the insurance market (forces them to cover preexisting conditions, has price controls, etc.), reshuffles the mandate but doesn't really get rid of it, and continues to subsidize insurance, though it reshuffles that to make it less generous. If you're a liberal, you're not going to like it because it dramatically scales back the Medicaid expansion and will almost surely increase the number of uninsured people.

    I really don't see how the bill passes. If you're a conservative from a safe district or state like Rand Paul, you have no reason to roll over for Paul Ryan or for Donald Trump and vote for this. Furthermore, if you're from a state that expanded Medicaid (as several Republicans are), you're taking a major risk supporting anything that kills off or weakens the expansion. And of course, it's highly unlikely that the bill gets a single Democratic vote. With some vicious arm twisting, I could see it barely getting through the House, but with a 2-seat majority in the Senate, I don't see how it passes there.

    So why push this piece of garbage? There's no way in hell Paul Ryan actually likes it. However, there are problems. First, healthcare reform is a nasty issue to take on. A large number of people get screwed almost no matter what you do. That just goes with the territory.

    Second, there is no political mandate for a free market-oriented/conservative reform. The GOP has defined itself by its opposition to Obamacare rather than by its support for a free market-oriented reform, and frankly, it didn't run on a free market-oriented reform. It ran on keeping the parts of Obamacare the public tends to like and replacing it with something - the specifics of which were never explained. Trump basically ran on what I might call "platitudes of bigliness" - "we'll cover everybody," "it'll be big and beautiful," etc. That doesn't provide any details, but it also doesn't suggest any kind of conservative plan. It suggests government involvement and guarantees. Effectively, we've conceded the argument that the government should largely control the financing of healthcare in the United States.

    Third, the new Trump coalition wouldn't be receptive to conservative reform even if the case had been made. People forget that while Obamacare had plenty of losers, it had winners. If you're poor but weren't previously Medicaid eligible, have a pre-existing condition, are older but not yet Medicare eligible, Obamacare was mostly good for you. It provided you coverage where it didn't previously exist, doled out subsidies, and capped what insurance carriers could charge you. And here's the other problem - plenty of those people likely voted for Trump in key Rust Belt states. The Ryan plan is almost surely going to be worse for these people than Obamacare was. Medicaid will be less generous. The subsidies will be replaced by less generous tax credits that are allocated differently. The insurance carriers will be allowed to charge more. It'll be extremely easy for Democrats in those key states to say that the GOP made things worse for you rather than better. Will they screw it up? Perhaps, but under this plan, they'll at least get the opening they're looking for.
     
    Last edited: Mar 13, 2017
  2. Musburger1

    Musburger1 2,500+ Posts

    I'm skeptical that the health care system can be replaced or reformed. The combination of aging demographics, lifestyle, and government capture by various cartels will surely result in implosion at some point in the not so distant future. I see the end result being decreasing life expectancy as the aging and sick die without access to medication and treatment. The silver lining may be that when insurance "goes away," costs will plunge and much of the treatment that is priced in the thousands and tens of thousands will fall to the hundreds where people can pay out of pocket (as they did prior to the 70's when insurance coverage expanded and costs began to soar).
     
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  3. Mr. Deez

    Mr. Deez Beer Prophet

    There's a lot of truth to this. I think the fundamental problem is that we want a competitive market to hold down costs but also don't want anyone denied care. I think those concerns are in conflict. The latter concern is what prompted us to encourage reliance on insurance (both private and government), and that insulates and undermines the competitive market that we wish we had.

    We could see a collapse, but I think some kind of government system is what will ultimately show up. It may not be a full blown single payer system, but it'll be a government-dominated hybrid system like exists in Western Europe.
     
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  4. nashhorn

    nashhorn 5,000+ Posts

    I can't see Paul Ryan supporting this unless they promised him they would eliminate the IRS. Fat chance.
    They are blowing this big time. Should have admitted they needed to 'amend' and not replace and gone from there. Overall this plan sucketh.
     
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  5. I35

    I35 5,000+ Posts

    I've been taking a wait and see approach. Anybody here knows how I felt about Obama Care. It was a complete disaster and I had a very bad experience because of it. I'm for going back to what we had before Obama came into office. Just repeal it! Many if not most didn't have health care because of the decisions they made. Now I'm paying $1500 monthly to help them out due to their bad choices in life. I'm all for helping the ones that are not capable of taking care of themselves be it from physically or a mentality stand point.
     
  6. iatrogenic

    iatrogenic 2,500+ Posts

    Hopefully the proposed AHCA gets blocked and Obamacare fails.
     
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  7. Mr. Deez

    Mr. Deez Beer Prophet

    I agree, but it's pretty pitiful when that's the best case scenario.
     
  8. iatrogenic

    iatrogenic 2,500+ Posts

    The free market isn't so bad. It is actually the best option available. If the country was formed with the idea of health insurance being a "right" that all citizens should have it would have been in the Constitution. Forcing a centralized decision maker's idea of health insurance on the populace doesn't work very well (see Canada, England). Like other giveaways, the libs never concern themselves with the enormous, unsustainable costs involved. Centralized decision making should be reserved for the military, but even the military relies on local commanders to make decisions in battle.
     
  9. Mr. Deez

    Mr. Deez Beer Prophet

    The free market would work great in health care if someone would actually go for it. Unfortunately most people expect guarantees imposed by government. Once you go there, the free market is out the window.
     
  10. iatrogenic

    iatrogenic 2,500+ Posts

    Yep. Same old story;

    "Let's buy votes by offering free stuff" and "let's vote for politicians offering free stuff".

    The ghost of Christmases past will always come back to haunt us.
     
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  11. Joe Fan

    Joe Fan 10,000+ Posts

  12. Joe Fan

    Joe Fan 10,000+ Posts

  13. Seattle Husker

    Seattle Husker 10,000+ Posts

    We are in a worst case scenario. You have a Republican controlled Congress that cannot agree on how to remedy the ACA and an administration actively ensuring it's failure.

    This is quickly turning to not being an ACA failure but rather a failure to govern appropriately.
     
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  14. I35

    I35 5,000+ Posts

    They need to just repeal it and then get out of the way. Right now we are paying for coverage that's only good for catastrophic. So unless you have something major happen to you like cancer or a bad wreck, you will be paying super high premiums that won't benefit you for anything less than that. It's time we give the people their choices back. If they don't want insurance then that's their choice. The old way is 100% better than Obamacare. 2007 my family paid $521 monthly, and right now we pay $1496 monthly and we had way better care with a much lower deductible. So we tried to help a small portion (compared to the population) of people that only really hurt the majority.
     
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  15. iatrogenic

    iatrogenic 2,500+ Posts

    The ACA is a failure because it was flawed in its design. It has never worked, and will never work. The government failure was when the law was passed by Democrats and signed by a Democrat in the White House. I do understand your desire to blame someone else, however. That is the greatest desire of all Democrats- blaming someone else for their problems.
     
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  16. Brad Austin

    Brad Austin 2,500+ Posts

    Even worse is it was intended to fail, but carefully crafted to self-destruct after BO left office. Then HRC was supposed to valiantly pick up the dimming torch and push through single payer as our only saving grace.
     
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  17. nashhorn

    nashhorn 5,000+ Posts

    *^^^^^*. Exactly correct!!!
     
  18. Crockett

    Crockett 5,000+ Posts

    Obamacare was poorly written and not especially innovative. It was a response to health care costs escalating at double digit rates in an economy growing in the low single digits. In my lifetime, health care delivery has always been a hybrid, public/private/non-profit that has never been price transparent or cost competitive. I'm slightly more optimistic than Musburger1 about the future of health care delivery in the US. There is a lot of energy for it ... not as much imagination or cooperative spirit.
     
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  19. iatrogenic

    iatrogenic 2,500+ Posts

    The best way to deliver healthcare, milk, or any widget is to get government out of the mix, and let the market work its magic. The cooperation will be through willing buyers and sellers using a price determined allocation of scarce healthcare resources in accordance with their own incentives and constraints. Taaa Daaaa! Problem solved.
     
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  20. theiioftx

    theiioftx Sponsor Deputy

    It is really hard to watch today's political process due to the hypocrisy of both establishment parties. How anyone identifies with either is amazing.

    On the surface, the senate's latest bill looks like a revised version of ACA, not anything that actually addresses the real problems. The Dems reaction is hilarious because it seems to give them everything they want except single payer. The CBO will give it a bad score. Rinse and repeat seems to be the new way to legislate.
     
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  21. mchammer

    mchammer 10,000+ Posts

    Like education, only path forward for improvement lies in innovation.
     
  22. theiioftx

    theiioftx Sponsor Deputy

    And personal responsibility. Those days are over though in America.
     
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  23. Musburger1

    Musburger1 2,500+ Posts

    There's been plenty of innovation. The biggest problem is corruption. Health care in the US has become the company store. Monopolistic practice, fraud, collusion via political bribery, and failure to enforce laws are bankrupting Americans.

    The next biggest problem is lifestyle (the western diet). Foods are laced with chemicals, sugar, and derivatives of corn. Over time feedback mechanisms within the body deteriorate leading to obesity, diabetes, heart disease, and cancers in ever increasing rates. The food system is based on creating profit and does so at the expense of public health.

    I guess a third problem is escalating opioid abuse. Part of the epidemic is personal choices but much can be attributed to greed and exploitation within the pharmaceutical industry. And perhaps some more blame can be tied to the US presence in Afghanistan which rather than decreased the production of opium, resulted in a 40+ fold increase.
     
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    Last edited: Jun 24, 2017
  24. OUBubba

    OUBubba 5,000+ Posts

    59 attempts to repeal and 8 years to come up with something better and this is it? The ACA is going to die a slow, painless death. I'd be curious how things would have gone if all of the states would have cooperated.
     
  25. theiioftx

    theiioftx Sponsor Deputy

    It's not been slow or painless. The problem with entitlement programs is that they are incurable cancers. The only way to cure it, is death.

    The narrative has been changed that this is now a right and that somehow insurance is the same as healthcare. Just listen to any democrat and now even establishment republicans, and they equate repealing ACA to killing Americans.
     
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  26. I35

    I35 5,000+ Posts

    I agree. Just repeal it. The MSM pretty much dictates of congress. One day maybe they will not give a F what the media reports and just do what's best for America. The media reports how many people will be without insurance. Really? We're without insurance right now for the common use. We're paying high premiums and only getting a disastrous insurance.

    Both sides of the Establishments are just useless. Anytime they vote for a health care for the people, but not for themselves then you know it's crap.

    Obamacare should have never been passed in the first place. Nobody read it. You have a majority leader at the time say "You have to pass it to find out what's in it." Not touching healthcare in the first place would have been 1000% better.

    Exactly! The Govt just needs to get the hell out of the way. Everything they touch goes to sh$t. For some reason Libs want Govt to have more control. Are they blind to what happens when Govt gets involved? Just unbelievable!
     
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  27. huisache

    huisache 2,500+ Posts

    Letting market forces forge health care will work just like it has in education. No government involvement will cure all and cure all, just like keeping government out of education at any level has made American education great. Well, maybe that is not a good comparison.

    If we really want the market to work its magic we need to get the government out of all aspects of medicine. No more federally funded research. All those now treatable diseases would have discovered their own cures without federal funding. Who needs government hospitals, med schools, etc?
     
  28. iatrogenic

    iatrogenic 2,500+ Posts

    Government has screwed up education just like everything else.

    You are blind to the absolute disaster that government has created in our healthcare system. Just the fraudulent claims they have paid alone is astronomical, and that doesn't touch the cost of the regulations they have enacted. Tell me one government program that has worked in a cost efficient manner, and you will have discovered something no one else has ever seen.
     
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  29. Seattle Husker

    Seattle Husker 10,000+ Posts

    [​IMG]
     
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  30. Mr. Deez

    Mr. Deez Beer Prophet

    It's not "Western" as much as it's American. Also, these are actually two separate issues - lifestyle and diet. I see the contrast between how Americans and Europeans eat and live, and it's remarkable.

    Junky fast food is everywhere in the US. You'll see some of that in Europe, but it's far less common. What you see more of is small cafes and food stands that serve food that's usually better quality and tastes better. I also notice less prepared frozen food in grocery stores. It exists, but it's less common. Furthermore, I don't see people buying it a lot. The crowded sections at the grocery stores seem to be the fresh meat areas and especially produce, which get a little crazy at times. That makes sense because the quality of European produce is much higher. It's easier to get people to eat fruits and vegetables when they actually taste good. Overall, the food seems less sugary (even sweets) but fattier (more cream, butter, and cheese) and sometimes saltier.

    Their lifestyles are far less sedentary. Americans drive everywhere. Europeans walk and take public transportation far more often. I'm fact they walk for relaxation. When Americans get home from work, they flop in front of the TV and eat. When Germans get home from work, they work in their gardens for an hour, then eat (usually at a dinner table), and then go for a leisurely walk.

    The key factor is free time. They have a lot more of it. That means they can sit down for a real lunch during the day rather than driving through a Wendy's and then scarfing down their food in their cars. They get home at 5 or 5:30 pm, not 7pm or 7:30 pm. That means they can actually prepare real food when they eat at home, and they can do something physical. It's not overly strenuous. In fact, I rarely hear about people hitting the gym and see far fewer people who are noticeably muscular. It's just something other than sitting on their asses.
     

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