Repealing Obamacare

Discussion in 'West Mall' started by Hollandtx, Jan 13, 2017.

  1. Hollandtx

    Hollandtx 250+ Posts

    OK, people of West Mall, I need help.
    As I have mentioned I belong to a Facebook group, with women who sobbed when HRC lost, who cried "what will I tell my 10 year old daughter?", and have knitted hot pink "p*ssy cat" hats to wear in the Women's march in D.C.
    Right now, they are clutching their pearls over the repeal of Obamacare, posting comments such as, "my 15 year old nephew has diabetes. I guess his college fund is out the window", or, "My aunt has cancer. What do I tell her? That she will wake up in a week and have no insurance?" "Can you believe they did it in the dead of the night?"

    It is my understanding that the whole repeal/replace is in a bit of flux, but I do recall reading that if it were to be repealed, it wouldn't happen until a year or so. However, there are 2 lawyers that love to troll around and argue with anyone who dares post anything that isn't a total trashing of anything anti-Obama/Hillary. I usually lay low, and make no comment as I don't enjoy arguing on Facebook, or being ganged up on.
    But, I did share that if it happened it would most likely take a year while people had time to tweak the negative portions. I do believe in pre-existing conditions, and allowing children up to 26 to be covered, but, I also feel that it has raised premiums in many cases (I-35, for example) many major insurance companies are opting out, which shrinks the already thin number of GPs an FPs. I also don't think younger, healthy people are thrilled to be paying for the older and sicker people, and don't have the facts to back this up.

    So, I am expecting to get piled on by these women...particularly on "Trump is stupid and Rs don't care if people die", "why should women have to pay more than men?" (not a bad question) and stuff about Medicaire that I honestly don't keep up with.
    So, who among you is willing to give me your non-partisan thoughts about repeal and replace. I have scoured the internet to find fair articles, but no luck.
    I know there are quite a few lawyers on this site, and some very smart people. I would love to stick it to one lawyer who lives in DC, went to a non-tier law school, isn't even a partner, yet acts as if she is the end all, be all, on all things election oriented.
    Would someone be so kind as to give me the simple version of what is going on (so I won't sound stupid) and possible ideas to make this work.
    I promise I am not being lazy, I am having a hard time separating fact from fiction. My bottom line is there is some good in the ACA, and more not so good. I don't think it can survive in it's current state.
    I just need some eloquent talking points that sum up what the heck is going on, if it is not too much trouble.
    Thanks, if anyone gives this a try!
    UPDATE:
    13 minutes, and I have gotten slammed. One of the kindest comments: "I realize you're exiting the discussion but they could have just amended the law if the wanted to fix it. They want to eliminate coverage for folks. Shrug." said by DC attorney, who works checking out mortgage loans. So she is the penultimate expert on all things political.

    Please, give me a comeback to this wench. I read it isn't even a done deal yet. Gah, she bugs me.
    And of course, the old, "why does universal healthcare work in other countries? I lived in Germany for 3 years and had great healthcare". Could it be that we have an enormous population of poor, out of work, mentally ill, food stamp taking, welfare taking, people who are obese, (just one example) and due to their obesity they have a ton of medical problems. Aren't European countries a bit more healthy than the US?
     
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    Last edited: Jan 13, 2017
  2. iatrogenic

    iatrogenic 2,500+ Posts

    This may help a little:

    http://www.marketwatch.com/story/7-obamacare-failures-that-have-hurt-americans-2016-03-24
    http://www.forbes.com/sites/scottat...ndalous-national-health-service/#582194c2364c

    By the way, under the ACA employers can purchase plans that qualify as "minimal essential coverage" but do not cover hospitalization. Those plans only cover "preventative services", and that is not insurance at all.
     
  3. Hollandtx

    Hollandtx 250+ Posts

    Thanks, iatrogenic. Do you have any thought on the comment, they could have just amended the law if the wanted to fix it. They want to eliminate coverage for folks. Shrug."

    Did they not amend the law because they want to "bundle" it with the whole replace package? I know the answer isn't they "want to eliminate coverage for folks". I just don't want to respond when I don't know the correct answer, or I don't know if I am interpreting what I am reading correctly about why the law wasn't amended.
    Shrug. Makes me want to punch someone in her pink p*ssy covered head.
    I'm in a salty mood today. Sorry!
     
  4. towersniper

    towersniper 100+ Posts

    I'll see your propaganda, and raise you: https://www.publicintegrity.org/201...d-or-not-britains-health-care-system-superior
     
  5. Sangre Naranjada

    Sangre Naranjada Winebibber

    Never, ever, ever talk politics on facebook. That is an exceptionally dangerous undertaking unless you are one who simply cheerleads for whatever the mob happens to think.
     
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  6. ProdigalHorn

    ProdigalHorn 10,000+ Posts

    From the article:

    "The article begins by relating the experience of Scottish-born David Gray, now living in Brooklyn, who was recently given the unfortunate news that his doctor was no longer in his insurance company’s network of providers. He was turned away."

    Ummm.... you get why that happened, right?

    Frankly if both are propaganda, the Forbes article did a better job of it. It actually cited stats and used logic aside from "this one guy I talked to had this experience."

    Ultimately, it seems you've got people who are willing to accept inferior results and longer wait times in order to avoid paperwork and more complicated decision-making. Some like that trade-off, some don't. It'd be nice if we could figure something out that addresses both. Of course, to do that, you'd need to remove both the government and insurance from the equation altogether.
     
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  7. towersniper

    towersniper 100+ Posts

    I truly did not want to get into a debate on the US system versus the world. I just found it amusing that the OP wanted ammunition to support his preconceived opinion, and you complied with the usual propaganda. Very few people really want to analyze data and arrive at "the truth." They want to root for their team, ignore tough questions, and insist that our system (is the best in the world/needs to be replaced with the Canadian system), and back it up with an advocacy piece masquerading as an inforation piece. I suppose that is what the West Mall has become, though, primarily from a right wing perspective, with a few intrepid lefties. I guess that is why I rarely hang out here anymore. It used to be much more interesting.
     
  8. towersniper

    towersniper 100+ Posts

    In re-reading that, it looks like I was slamming you, Prodigal. That was not my intention. Your response was actually pretty interesting and on point. Thanks, and sorry if I came across as dismissive.
     
  9. ProdigalHorn

    ProdigalHorn 10,000+ Posts

    No worries - it's a valid observation in general. Frankly I'd love to see more actual addressing of some of the issues brought up by both sides.
     
  10. Mr. Deez

    Mr. Deez 10,000+ Posts

    TS,

    If you hung around here very long, you'd know that probably no one on West Mall fits your characterization less than the OP does. She leans Right and has sincerely-held opinions like anybody else, but she is not a partisan hack by any means. She is specifically asking for real analysis on the issue, and she consistently listens to both sides on issues and is always kind and respectful to others regardless of their views. In short, she doesn't deserve your criticism. Some here do, and they know who they are. She is not one of them.
     
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  11. NJlonghorn

    NJlonghorn 1,000+ Posts

    Additionally, the OP is very knowledgeable on some issues, and isn't reluctant to talk about those issues in depth and with an open mind. The fact that she is reluctant to talk about issues she is less informed about is refreshing. I know I could learn from that example.
     
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  12. NJlonghorn

    NJlonghorn 1,000+ Posts

    Yes, the ACA has been a godsend for some people, especially those with preexisting conditions. And yes, repealing the ACA will have devastating consequences for those people.

    That said, hurting people isn't the Republican's reason for wanting to repeal the ACA. If you are confronting knee-jerk liberals who think it is the reason, or even that the Republicans don't care, then there probably is no talking to them.

    A more balanced discussion would require weighing the huge benefits to some against the smaller (but still significant) costs incurred by everyone else. Most agree that the costs of the system as it is are too high, such that what we have right now is worse than what we had before. But is that because the concept is inherently flawed and can never work, or because no serious effort has been made to fix it? Most on this board would say it is inherently flawed. I'm not so sure.
     
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  13. Mr. Deez

    Mr. Deez 10,000+ Posts

    I'd like to pitch into this discussion, but I've got guests flying in tomorrow morning. Furthermore, Monday is Nigel Farage Day for me, so I've got a lot on my plate for the next few days and won't be able to give you some great analysis.

    However, I will say this. These people are engaging in speculation. If your DC lawyer friend is so smart, then she should know that there isn't a consensus in the GOP about what to do. They have some ideas on which I have varying degrees of enthusiasm and some criticism, but they're still working out a comprehensive plan. That means she doesn't know what they're actually going to end up with. Furthermore, the public, frankly, didn't care and never demanded specifics from Trump or from congressional Republicans. All they knew is that they wanted Obamacare gone and voted accordingly. (I think that's a bad thing, but my view on that is irrelevant.)

    Second, don't let her trip you up over the semantics of repealing a law or amending it. That's a matter of legislative draftsmanship that's she's needlessly making an issue of. Repealing a federal law means deleting it from the United States Code. Amending a law means making changes to what's in the United States Code. However, you can repeal a law and substitute another law that has some of the same provisions that were in the repealed law. For example, Trump says he wants to keep the preexisting condition provision from the ACA. Well, he can repeal all of the ACA and then put the relevant provision back into the law. He could also simply not repeal that portion of the law but get rid of the undesirable parts. That would technically be an amendment as a opposed to a repeal, but did anyone really take him that literally? I didn't.

    I've got more, but I've gotta run some errands.
     
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  14. Mr. Deez

    Mr. Deez 10,000+ Posts

    Ditto and Amen. In other words, she just flat out rocks, and everybody should try to be more like her. The internet would be a much better place to be and talk politics.
     
  15. iatrogenic

    iatrogenic 2,500+ Posts

    That's funny!

    Regardless of what language is being used ("repeal" sounds good from the Republican perspective because the Dems passed the law alone, and "amend" sounds good for the Dems because their candidates passed the law), the result will be the same. It is probably easier to just let them have their descriptive term, keep the label Obamacare, and change/amend/repeal/replace with something that works.

    Note: Didn't see Deez' post before posting this
     
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  16. Horn6721

    Horn6721 10,000+ Posts

    Nj
    when you posted, "Yes, the ACA has been a godsend for some people, especially those with preexisting conditions. And yes, repealing the ACA will have devastating consequences for those people."
    It has been reported all long that it is not just repealing it but replacing it. Has anyone who will be involved in putting forth new health care plans said preexisting conditions would no longer be covered? That would be dreadful and unacceptable.
     
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  17. NJlonghorn

    NJlonghorn 1,000+ Posts

    Fair point. It certainly is possible that whatever the Republicans come up with will retain this aspect of Obamacare. If they do, it will be interesting to see what they come up with to control premiums. At the end of the day, the problem is that covering preexisting conditions is the ACA's best feature, but also its biggest cost driver. You can't keep the upside (covering preexisting conditions) but avoid the downside (paying for it).
     
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  18. Seattle Husker

    Seattle Husker 10,000+ Posts

    That's the challenge in front of Republicans. They are promising better and cheaper. We know a large part of the cost driver is covering pre-existing conditions. I'd also add that there are 11 million more people insured than before. A portion of those get subsidies too that must add to the cost somewhere.

    To Hollandtx, the Democrats have been open the past 6 years to "fixing it". They haven't had the majority that led to the ACA to do that. Since then the Republicans haven't open to amending it and instead chosen the route of many many votes to repeal it knowing that the POTUS would continually veto any repeal. That's there prerogative. Now they no longer have the impediment of a POTUS that would veto any significant changes.

    As has been pointed out, it's not likely that the Republicans would be willing to rollback the pre-existing conditions and the 26yr old parental coverage. Add in 11 million more Americans covered and like any "entitlement" program there are very difficult constraints to work around.
     
    Last edited: Jan 13, 2017
  19. NJlonghorn

    NJlonghorn 1,000+ Posts

    Ah, the dreaded ratchet. Democrats are always looking to expand the reach of the welfare state. Republicans oppose creating new benefits, but are loathe to roll them back once they are created. Hence, benefits go up, but they never come down.
     
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  20. Seattle Husker

    Seattle Husker 10,000+ Posts

    Yep. The legacy of Obama may be that he's changed healthcare forever in the US.
     
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  21. nashhorn

    nashhorn 5,000+ Posts

    If this were easy it wouldn't be hard.....did Yogi Berra say that? He should have.
    Don't get into arguments about ACA. You cannot win, either way. Healthcare costs are something we all have issues with in some form or fashion. Me, as every human being will say I think preexisting conditions ought be covered. Only the CEO of an insurance company will disagree and he/she would not do so publicly. Then again I think young adults should stay on their parents too, but I think 26 is absurd. Get them thru college, trade school, whatever till they can get their own but 26? Good grief. Would love to have had that for my kids, even to 22, or 23, but I think 26 is a stretch.
    Didn't the ACA also provide the changing employer 'can't drop' clause? That is also a plus imo.
    What I don't like were all the switches, with Drs, plan coverages, forced inclusions, etc. You see, there is something to like and dislike for everyone. You just cannot win an argument on the topic. How the Pubs get out of this is going to be quite amusing. The Dems will make sure they pay a huge price no matter how incompetent or brilliant their solution.
     
  22. Crockett

    Crockett 5,000+ Posts

    There are some areas of low hanging fruit in controlling health care costs. The medical billing system in the US is a morass of complications, incomprehensible to health care consumers and a massive and costly pain in the butt for providers. We can negotiate on pharmeceuticals and substitute older less costly drugs that are good but maybe not optimal. We can create price transparency for providers and give consumers a greater stake in costs (high deductibles, health savings accounts, co-pays) that will make them more aware of costs.
     
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  23. Crockett

    Crockett 5,000+ Posts

    End of life care is another area of cost containment opportunity. This can be driven by consumer choice, not rationing of care. I don't know a single person who says "keep me alive no matter the cost, the quality of life and suffering involved." But if decisions aren't made in advance ... the family will be cautious.
     
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  24. nashhorn

    nashhorn 5,000+ Posts

    Dead on Crockett!!!
     
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  25. ProdigalHorn

    ProdigalHorn 10,000+ Posts

    This is an area where I think messaging really hurt early on. If it had been as simple as saying "We're going to emphasize that physicians have discussions with patients about end of life care and make sure they understand the cost associated with certain life-prolonging procedures" that would have been one thing. If I recall, the issue was that the question started coming up on "making recommendations" about whether certain things would be covered, and that led to the whole death panel thing. It's been too long and I can't remember the details, but I do remember some pretty ineffective explanations being thrown around.
     
  26. Hollandtx

    Hollandtx 250+ Posts

    Thanks for some good, fair and enlightening discussion. Also for the kind words. I needed them after my assault by the mob on Facebook!
    I never usually engage in arguing on-line, period. It doesn't change anyone's mind, just seems to make them dig in deeper to their way of thinking, often to the absurd.
    The last few days have been filled with gleeful "Trump urinates on hooker" stories as if they were all fact, or literally weeping about the Obamas leaving the White House and I have avoided Facebook. It is total doom and gloom all the time over there, and I like to--have to, think we will muddle through this and be ok. I didn't vote for Trump, towersniper, but now that we have him, I want him to succeed.

    I took the bait when the healthcare debate disintegrated into, "Republicans don't care if we die, they just want to win", "may all the idiots that voted for Trump rot in hell", "I hope their kids all get cancer" and worse, much worse. And a few people being (maybe) honestly scared this meant they would be without insurance next week. So, I read up, best I could, on what everything meant, and posted what I thought was a fairly innocuous statement that things were up in the air, and change would take a while. Also, that I believed the good parts would most likely be put back in. Well, the hounds were unleashed.
    I do worry about the costs, as I think the US has proven by the low enrollment rates that healthy people don't want/can't afford to pay a large premium to support the aged, very sick people. That's when the conversation swerved in to, "other countries do it".
    As mentioned, this is an incredibly complicated issue, and it will never make everyone happy. I hope that we can come to some type of plan that helps the most without hurting others too badly.

    Thank you Mr. Deez for taking the time to decipher the lawyer-speak. That is what this person does. She has cultivated a rep as being this huge expert on all things election oriented, to the point where people will post things like, "Suzanne, you have to stop this", and she will respond, "We're trying". Again, she works in the mortgage department at her firm . :facepalm: But she loves being the thought leader of the group. How she has time to post on Facebook freely throughout the day (and post endless videos of her working out, running, doing Barre, sneezing, etc.) is beyond me. All of my lawyer friends are super busy working and have no time for such foolishness, but I digress.

    I think y'all have mentioned some good ideas to start cutting costs, and I absolutely agree the end of life care is a huge issue. I think the Rs started the negative connotation ("death panels" seem to ring a bell) but we spend a huge percentage of our lifetime medical care costs in the last year of our lives. Usually, that last year has a very poor quality. We could cut a lot of cost, and more importantly end needless suffering if we let nature take it's course in many cases.
    So, no more Facebook for me for a while. I'm grateful that we can have genuine discussions in here, without defaulting (mostly) in to name calling and pettiness.
     
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    Last edited: Jan 13, 2017
  27. mb227

    mb227 2,500+ Posts

    And NOT for the better...
     
  28. NJlonghorn

    NJlonghorn 1,000+ Posts

    Whatever you say, *****. (oops, did I type that out loud???)
    ;)
     
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  29. Seattle Husker

    Seattle Husker 10,000+ Posts

    That depends on whether you have or ever will have a pre-existing condition that requires significant care, doesn't it?
     
  30. Statalyzer

    Statalyzer 10,000+ Posts

    We need to fix the preexisting condition crap, but I think we're not going to do that successfully as long as we're conflating insurance with healthcare charity. And we're also as a society conflating insurance with medical payments. So if you want to pay for something out of pocket, often the costs are needlessly high just b/c you're bucking the trend. You can find places that take you and even charge you less (often gladly so as they save tons of money avoiding red tape that way), but it can be really tough to do so.

    Bingo.

    There'd probably be a lot less calls to repeal it if not for the mandate too. If you can't afford insurance anyway, fining (or taxing, depending which legal loophole is being dodged) hundreds of dollars isn't going to help that situation. The people that fucks over are precisely the people the left tends to claim they care about and the right doesn't, too.
     

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