Affordable Care Act (AKA Obamacare)

[Joe Shlabotnik]

Of course this is all a calculated game by politicians to shepherd us into a single payer system.

I'm just saying, lets not gloss over the fact that what we have stinks.

I won't disagree that it stinks. I do think it's also hyperbole to say it's a calculated game though. The ACA is based on a Nixon era Republican plan. It's also built with the existing insurance industry in mind. I think some in government would like single player, but I think there are plenty who don't want to go that far. Upending the insurance industry (many thousands of jobs) is a big deal and just from a practical standpoint not something that should be done lightly or quickly.

But, to be fair, many of those jobs would just move to the government sector from the private sector. The rest - well, like they tell us old programmers - now is the time to unleash that entrepreneurial spirit and enjoy the adventure of self-employment!

Sure, but that's still not a small thing. Indianapolis has a couple major insurance companies with a big presence here. Are those jobs staying here, moving to DC or some Federal complex in another state? Probably some smaller towns that would hit even harder.

The IRS, SSA, and Veterans Affairs are all over the country - no different with health care.

[Arthur Dent]

Personal ACA experiences

As I recall, you live in a rural area, right? The ACA has not been good in rural areas at all as the insurance industry doesn't see the profit in them and, as a result, there is little or no competition. There was some discussion of this a few pages ago. The marketplace portion of Obamacare essentially assumes insurance company competition to provide decent options but does little to ensure this actually happens.

That said, I'm curious what your experience was prior to the ACA and what you see it having taken away.

With regard to your lower middle class brothers being soaked to fund subsidies, I'm not sure what you're referring to. Were they getting health insurance through work? I can't think of an ACA provision that transferrs away from the lower middle class other than maybe the requirement for minimum coverage, but that isn't about covering lower incomes.

I personally think expanded public provision of insurance is the obvious solution to these serious problems. The Medicaid expansion, though never the centerpiece, is the part of the law that's worked best, which, to me should be as lesson. But if Congress wants to get serious about getting more people better, less expensive heath insurance, there are certainly other options. Some combination of subsidies and coverage area rules to require networks to better cover rural areas would be a possibility, for example. I really have not heard anything proposed outside the ACA to single payer spectrum that would do anything to correct these problems.

[Tim]

So let me this straight, we want the same folks who run the VA, to run the health care for the entire country?

[Joe Shlabotnik]

So let me this straight, we want the same folks who run the VA, to run the health care for the entire country?

Yup, like every other First World country on earth. Like the way we entrust those folks with every other piece of crucial infrastructure. My health or lack thereof should never be anyone else's profit center.

[Tim]

So let me this straight, we want the same folks who run the VA, to run the health care for the entire country?

Yup, like every other First World country on earth. Like the way we entrust those folks with every other piece of crucial infrastructure. My health or lack thereof should never be anyone else's profit center.

And I'd argue that my health or who provides my health care should never be determined by someone in Washington DC.

[Tim]

Joe, if you want the government as opposed to insurance companies to determine your healthcare, that is your right and I support that. What I don't support is being forced to purchase government mandated healthcare.

[Socnorb11]

So let me this straight, we want the same folks who run the VA, to run the health care for the entire country?

Yup, like every other First World country on earth. Like the way we entrust those folks with every other piece of crucial infrastructure. My health or lack thereof should never be anyone else's profit center.

And I'd argue that my health or who provides my health care should never be determined by someone in Washington DC.

You've entrusted your country's defense (military) to the folks in Washington, among other things.

Who do you think is determining your health care now? The health care industry is the biggest fraud in America, by far. Someone needs to reel them in. I'd love it if my government at least tried to.

[thrill]

So let me this straight, we want the same folks who run the VA, to run the health care for the entire country?

Yup, like every other First World country on earth. Like the way we entrust those folks with every other piece of crucial infrastructure. My health or lack thereof should never be anyone else's profit center.

And I'd argue that my health or who provides my health care should never be determined by someone in Washington DC.

You've entrusted your country's defense (military) to the folks in Washington, among other things.

Who do you think is determining your health care now? The health care industry is the biggest fraud in America, by far. Someone needs to reel them in. I'd love it if my government at least tried to.

It seems like a lose-lose. We're dependent on capitalist corporations that want to profit off our healthcare or were dependent on the government with all of the red tape and inefficiencies that entails.

What it comes down to for me is that the first world countries that have socialized healthcare (pretty much all of them), wouldn't want to get rid of it.
Second, even if the checks and balances are extremely inefficient and mostly ineffective, at least there is some accountability for politicians that doesn't exist in the corporate world. I can't even try to vote out the Board of Directors at Pfizer. I can try to vote out a politician. That's probably the illusion of agency more than actual power, but it's something.

[pioneer98]

The thing I keep coming back to is the Postal Service. It is a great example of a business-like government entity that has very little corruption and is highly efficient. It just shows that it's not impossible for government to do something pretty efficiently. I have a small side business where I have to ship small things often. I can ship pretty much anywhere in the continental US for between $2.50 and $3.00. To ship the same thing via UPS would cost like ~$12. Granted, UPS guarantees delivery within 2 days. It's a nice option to have UPS if I need something urgent, but it's not a "need" since the $3 USPS option still gets it there within 3 to 5 days usually.

Health insurance truly is a "need". If rich people want some other more premium option for health care, I'm sure that would still be available one way or another.

[Socnorb11]

So let me this straight, we want the same folks who run the VA, to run the health care for the entire country?

Yup, like every other First World country on earth. Like the way we entrust those folks with every other piece of crucial infrastructure. My health or lack thereof should never be anyone else's profit center.

And I'd argue that my health or who provides my health care should never be determined by someone in Washington DC.

You've entrusted your country's defense (military) to the folks in Washington, among other things.

Who do you think is determining your health care now? The health care industry is the biggest fraud in America, by far. Someone needs to reel them in. I'd love it if my government at least tried to.

It seems like a lose-lose. We're dependent on capitalist corporations that want to profit off our healthcare or were dependent on the government with all of the red tape and inefficiencies that entails.

What it comes down to for me is that the first world countries that have socialized healthcare (pretty much all of them), wouldn't want to get rid of it.
Second, even if the checks and balances are extremely inefficient and mostly ineffective, at least there is some accountability for politicians that doesn't exist in the corporate world. I can't even try to vote out the Board of Directors at Pfizer. I can try to vote out a politician. That's probably the illusion of agency more than actual power, but it's something.

+++

What we've done for the last 50 years clearly isn't working.