The "Afordable" Health Care Act??

[rushmc 23]

Yea right

As many here stated years ago, this bill was NEVER about HC. It still isn't

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Study estimates Obamacare could raise individual claim costs 32 percent

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By 2017, the estimated increase would be 62 percent for California, about 80 percent in Ohio and Wisconsin, more than 20 percent for Florida and 67 percent for Maryland. Much of the reason for the higher claims costs is that sicker people are expected to join the pool, the report said.

Guess we got to vote it in to know what is in it


http://www.washingtonguardian.com/study-health-overhaul-raise-claims-cost-32-pct-1

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[wmw999 2,588]

Those people who will be driving up the cost of insurance are getting their care somehow today, and it's not free. It's just not being hidden any more. That might just make it easier to manage. Consider your BB training -- if you can count it, you can manage it. But when health care is paid for by anonymous hospital district taxes, then it's harder to count, isn't it?

One possible good thing is that some states are looking at offloading Medicaid onto private insurers. That will very likely lead to some more focus on preventive and maintenance rather than curative care.

One real issue is our current way to pay for medical care -- fee-for-service. Here is an opinion article contributed by a decent number (20) of cancer care specialists on the topic.

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[rushmc 23]

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Those people who will be driving up the cost of insurance are getting their care somehow today, and it's not free. It's just not being hidden any more. That might just make it easier to manage. Consider your BB training -- if you can count it, you can manage it. But when health care is paid for by anonymous hospital district taxes, then it's harder to count, isn't it?

One possible good thing is that some states are looking at offloading Medicaid onto private insurers. That will very likely lead to some more focus on preventive and maintenance rather than curative care.

One real issue is our current way to pay for medical care -- fee-for-service. Here is an opinion article contributed by a decent number (20) of cancer care specialists on the topic.

Wendy P.

ACH was "sold" as lowering or stabalizing HC costs

That was a lie from the start

And many people are still buying that lie despite the trends and evidence

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[wmw999 2,588]

HC costs are all of them, not just what individuals pay out of their pockets. It includes ER care for people who walk in off the streets, ER care for frequent fliers, doctor visits, end-stage care for cancer victims who will live another 2 weeks with a new treatment

all of it, not just the co-pay.

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[rushmc 23]

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HC costs are all of them, not just what individuals pay out of their pockets. It includes ER care for people who walk in off the streets, ER care for frequent fliers, doctor visits, end-stage care for cancer victims who will live another 2 weeks with a new treatment

all of it, not just the co-pay.

Wendy P.

Rates are going up faster than before the ACH
These increases were supposed to slow or go down

This law is not about HC. Never was

What was sold to us was and is a lie

This is not debatable anymore

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[rushmc 23]

Also, the piss poor bill, was passed using the reconciliation process. Which is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate rules. This was NO budget bill

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[kallend 2,148]

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Also, the piss poor bill, was passed using the reconciliation process. Which is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate rules. This was NO budget bill

You should pay attention to Wendy. She knows what she's writing about and you don't.

...

The only sure way to survive a canopy collision is not to have one.

[rushmc 23]

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Also, the piss poor bill, was passed using the reconciliation process. Which is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate rules. This was NO budget bill

You should pay attention to Wendy. She knows what she's writing about and you don't.

So you are saying this process was NOT used?

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[doorgirl 0]

Wendy, the first point in the article you linked refers to Accountable Care Organizations.

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First, over the next few years, the payment system needs to move away from fee-for-service toward a system of bundled payments, in which doctors are paid one fee for all the treatments involved in caring for a cancer patient. This would remove the incentive to prescribe more expensive drugs when older generics are equally effective.

ACO's don't remove the profit motive, they just shift it. Instead of making money by doing everything possible, they will make money by doing as little as possible. This is made even worse by the fact that costs of providing care have increased so much that many doctors (especially oncologists) and even smaller hospitals are joining up with big hospital systems to be able to keep the doors open. Their new employers (the hospitals and their accountants) are unlikely to look favorably on those doctors who spend the most money on each indication. Sure, there will be studies of outcomes and some data on who provides good care. But those data are available today for some disease states and the data are woefully inadequate. Check out the scores for some of the hospitals you would run from to see for yourself.

I agree that the system is too expensive and could benefit from quality and access improvements, but changing the system to provide financial benefit to doctors who do the least is a really risky move.

We will soon be paying far more money for far less care. A basic study of the bill and the way our healthcare system and insurance industry makes that quite clear. Sadly, those of us who could clearly and coherently put together these arguments in 2009 were shouted down as kooks, even when analyzing these things is our day job. It is and was painfully obvious, but the burning desire to "do something" caused most people to stop thinking before getting to the consequences of the bill.

Instead, we should have looked to when healthcare costs jumped with the introduction of HMOs and realized that continuing down that path was a bad idea. Instead people were so out to get the insurance companies that they forced a bill that will make them even more money.

[kallend 2,148]

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Also, the piss poor bill, was passed using the reconciliation process. Which is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate rules. This was NO budget bill

You should pay attention to Wendy. She knows what she's writing about and you don't.

So you are saying this process was NOT used?

No, that isn't what Wendy wrote. Do try to pay attention.

...

The only sure way to survive a canopy collision is not to have one.

[rushmc 23]

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Also, the piss poor bill, was passed using the reconciliation process. Which is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate rules. This was NO budget bill

You should pay attention to Wendy. She knows what she's writing about and you don't.

So you are saying this process was NOT used?

No, that isn't what Wendy wrote. Do try to pay attention.

I read what she wrote

To agree with her would indicate that the bill is about HC

It is not

Never was

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[lawrocket 3]

It's the Affordable Care Act. Affordable to whom?

It takes the cost of health care and spreads it, making it more expensive to those who don't use it and less expensive for those who do. That is, it was specifically designed to give insurance to the really sick. It mandates that everyone get health insurance so that the healty will cover the costs.

By design, the healthy population would be taxed for being in good health and the unhealthy population would be the beneficiary.

My wife is hotter than your wife.

[Andy9o8 2]

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It's the Affordable Care Act. Affordable to whom?

It takes the cost of health care and spreads it, making it more expensive to those who don't use it and less expensive for those who do. That is, it was specifically designed to give insurance to the really sick. It mandates that everyone get health insurance so that the healty will cover the costs.

By design, the healthy population would be taxed for being in good health and the unhealthy population would be the beneficiary.

That doesn't win the day in and of itself. Speaking generally, there are lots of examples of tax revenues from everyone being used for various things which, individually, benefit only a sub-population. E.g., the childless, privately-educated person whose tax dollars fund public schools. The rural southern-Illinoisan whose state taxes fill potholes in Chicago. Lots of examples. We're all in this together, and we all benefit from society. Even the random unabomber living off the land in Montana still benefits from the security umbrella the government provides in the airspace above his cabin, paid-for by everyone's taxes.

[wmw999 2,588]

I do think there is a limit to what health care should be provided as part of the public good; yes, having money will buy you more health care. I don't, however, think that the option for people too poor to afford a doctor is to just die.

But right now, it's totally fucked up. It's "just growed," kind of like Topsy in Gone with the Wind. And, just as we ended up needing an interstate highway system when the roads that evolved all along eventually proved inadequate to new faster cars and trucks, I think that the health care delivery system that has evolved is inadequate for the cost and scope of health care that can be delivered.

A few years ago Tom Aiello posted something about having a universal high-deductible limited policy for Americans, with poor people having their deductible supplemented (or paid for) on a needs basis. That addresses the system, and might have been a pretty good start.

ACA is not the desired end result. What we have been doing is unsustainable, and it's better to change it to something unloved before it breaks us (the collective us, not the individual us's who pay insurance). Because then there won't be nearly as much fighting over changing ACA, since everyone wants to change it. We'll just have another data point of something that doesn't work, rather than a single data point that doesn't work, but we don't know any better because it's all we know.

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[rushmc 23]

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I do think there is a limit to what health care should be provided as part of the public good; yes, having money will buy you more health care. I don't, however, think that the option for people too poor to afford a doctor is to just die.

But right now, it's totally fucked up. It's "just growed," kind of like Topsy in Gone with the Wind. And, just as we ended up needing an interstate highway system when the roads that evolved all along eventually proved inadequate to new faster cars and trucks, I think that the health care delivery system that has evolved is inadequate for the cost and scope of health care that can be delivered.

A few years ago Tom Aiello posted something about having a universal high-deductible limited policy for Americans, with poor people having their deductible supplemented (or paid for) on a needs basis. That addresses the system, and might have been a pretty good start.

ACA is not the desired end result. What we have been doing is unsustainable, and it's better to change it to something unloved before it breaks us (the collective us, not the individual us's who pay insurance). Because then there won't be nearly as much fighting over changing ACA, since everyone wants to change it. We'll just have another data point of something that doesn't work, rather than a single data point that doesn't work, but we don't know any better because it's all we know.

Wendy P.

Socialism

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[ryoder 1,590]

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Socialism

Where I live we have:
- Socialized law enforcement.
- Socialized courts.
- Socialized water and sewer.
- Socialized fire department.
- Socialized road maintenance.

"There are only three things of value: younger women, faster airplanes, and bigger crocodiles" - Arthur Jones.

[rushmc 23]

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Socialism

Where I live we have:
- Socialized law enforcement.
- Socialized courts.
- Socialized water and sewer.
- Socialized fire department.
- Socialized road maintenance.

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From Each According to Their Abilities, to Each According to Their Needs

Much different than the examples you gave

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[wmw999 2,588]

That's certainly short and to the point -- I just have no idea what point it's to?

Is it the thought of actually thinking about health care delivery that's socialism? The interstate highway system? TomAiello's thoughts on a universal plan? Limiting what's available as a part of public health? Or just the thought of admitting that people who are poor are treated?

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[Andy9o8 2]

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Socialism

Marc, that's a buzz-word, not a position, and certainly not an argument or a rebuttal. It's like a preacher intoning "Satan!" - it appeals to base emotions, but does little to advance a productive conversation. All taxation and publicly-provided services are a form of socialism; and that has existed since the US was founded.

The only debate is over how much, and whose ox gets gored.

[rushmc 23]

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That's certainly short and to the point -- I just have no idea what point it's to?

Is it the thought of actually thinking about health care delivery that's socialism? The interstate highway system? TomAiello's thoughts on a universal plan? Limiting what's available as a part of public health? Or just the thought of admitting that people who are poor are treated?

Wendy P.

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I do think there is a limit to what health care should be provided as part of the public good; yes,

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From Each According to Their Abilities, to Each According to Their Needs

HC is not a right

But people keep redefing rights to get more of other peoples work

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[rushmc 23]

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Socialism

Marc, that's a buzz-word, not a position, and certainly not an argument or a rebuttal. It's like a preacher intoning "Satan!" - it appeals to base emotions, but does little to advance a productive conversation. All taxation and publicly-provided services are a form of socialism; and that has existed since the US was founded.

It is what is being sold to us

Roads, police, ect are things the people decided they wanted to work together to pay for.

HC is not about health. It is about control of the gov which equals less freedoms

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[wmw999 2,588]

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HC is not about health.

If you're poor and you have asthma (or any other health problem), health care is about health.

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[rushmc 23]

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HC is not about health.

If you're poor and you have asthma (or any other health problem), health care is about health.

Wendy P.

The ACH is not about HC

Never has been

It is the story line given that many have accepted

The people you post to get treatment when they need it.

There will always be inequities

The liberals think a heaven can be created so they go along with crap that is the ACH.

One good thing may come of this however

This is the Dems bill and only the Dems

When it fails (and it is already) they will be hung with it

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[airdvr 210]

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We're all in this together

You don't really believe that do you?

Please don't dent the planet.

Destinations by Roxanne

[airdvr 210]

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HC is not about health.

If you're poor and you have asthma (or any other health problem), health care is about health.

Wendy P.

Wendy, why has congress opted out of this wonderful program?

Please don't dent the planet.

Destinations by Roxanne