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Obamacare repeal/replace (or 2.0, or Obamacare "lite")


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Well that's pretty much it, Jacen, well said. People think they can skirt the system and get someone to pay for them when they are sick when they've paid nothing into said system.

 

I think a lot of it comes from the youthful denial of responsibility, the false pretense that you never have to save or prepare for the future. I know plenty, some of whom are in my family. Those are the ones that eventually come begging for handouts.

 

It's fine if you want to chase your dreams and live free, but if you don't prepare for the future you will eventually have to accept the consequences.

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This is going off topic here, so out of respect to the actual topic, I will put this into spoiler tags for people like Tex who want to see my response. Those who don't want to see it, can choose not

...well I guess it doesn't matter. Cancer is generally slow moving and Nuclear war with N Korea will be much quicker.

Because that is the entire fucking point of insurance of any kind. That has always been the case and always be the case. You don't buy insurance after you need it, but before hand in case you ever d

Because that is the entire ****ing point of insurance of any kind. That has always been the case and always be the case. You don't buy insurance after you need it, but before hand in case you ever do need it. The fact that people don't get that speaks volumes about the lack of education, proper or otherwise, people have about the entire concept. You pay into the system in case you ever need to make a claim. In the meantime, that money pays for other people's claims. Then, eventually, if/when you make one, the money other people have paid in covers your claims. It's not a hard concept at all, which speaks volumes about people who don't get it.

 

That's exactly right. Insurance and warranties are essentially a gamble on bad things happening. If you get sick or if something breaks, you win and the insurance company pays money.

 

My point that you appear to have missed, is that Obamacare removes the gamble feature with the ban on preexisting conditions. It essentially says that insurance companies must treat these two buildings the same:

 

 

Obviously, if you can wait to buy insurance until your house is currently on fire, the incentive to pay into the system before the fire is eliminated. The gamble has gone away. It's like being at a roulette table and the casino giving you the option to bet on black either before or after the ball has settled into its slot. Whether you pay in advance or wait until you need it, the return is the same, so only a fool would bet in advance of the outcome. If you proactively buy the insurance, you're not investing in a safety net in case something bad happens, you're just paying an insurance company for the privileged of subsidizing other people's burning buildings.

 

That's not rational behavior. And, even though I simplified things a bit, it's essentially why a hard ban on preexisting conditions is simply not compatible with the whole concept of insurance as you yourself just defined it.

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But the ban on preexisting conditions is negated by the mandate. If everyone buys into the insurance pool as intended, then it all works out. Additionally, if everyone gets insurance, then over time, there will be fewer and fewer preexisting conditions because they will have been already covered by the time they get insurance. If people are educated enough into seeing the point of buying into the system and then do so, it works out in the long run.

 

People expect for a system that is put in place to work immediately, but nothing on this scale is ever as simple as just throwing a switch and having the system work perfectly. There is always an adjustment period with complex systems. How long that adjustment period lasts for is dependent on a tremendous number of factors and we have very much still been in that adjustment period. Adding in a huge shock to the system by trying to completely reverse course is just going to make it take even longer for the system to reach an equilibrium.

 

Even still, despite whatever academic debates we may be able to have about the economical and mathematical behavior of this complex system,. we all have to bear in mind that there truly is a huge human cost to all of this. It is very easy to speak of all of this in abstract terms, but these decisions have a huge impact on the lives of so many people living in this country. Trying to make quick decisions to score political points on an issue like this when there hasn't been time to properly study the human and economic costs of a plan is truly despicable behavior. The congressional system is built to go slow on things like this and it should go exactly that slow. I am all for further reforming the healthcare system, but it needs to be done carefully and thoughtfully. What happened here is neither.

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There are people that would say that implementing Obamacare was a quick decision that got us into this mess. And worse at that a partisan decision. Yes, if there was complete buy in then this might not have been a mess. But let's be honest, when do insurance premiums on anything ever go down? If you threaten to go to the other guy it can happen, but in a system when the other guys are dropping like flies it's less likely. I'm for government helping to reform the health care system. It should never have gotten into the health care business. Like you said thought Jacen, it takes time to get these things right. Look at the post office. Poor service, lack of shipping options led to the next rise of DHL, Fed Ex, UPS, and other delivery and express services. After losing business and having to layoff many postal employees, the USPS had to retool. Now they offer a better product at a competitive price.

 

Of course if all of this is dependent on people buying into the system then this will most likely never work. Millions of people didn't have insurance before Obamacare, and there were still millions after that didn't. They can talk about the poor that couldn't afford insurance, but there were just as many that didn't want to pay for it. And ten there are those who resent being forced to pay for it.

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But the ban on preexisting conditions is negated by the mandate.

 

In theory, yes. In practice, the mandate is too low to accomplish the goal. The pool of newly insured people is actually rather low if you take out people pushed into Medicaid. There has been no gusher of income. The young, healthy, and invulnerable are just paying the penalty. The only group that's really grown are the kids who stayed on their parents' plan a few more years and those who just miss out on Medicaid and have enough tax credits that they get the insurance for free or a highly discounted cost.

 

For everyone else, if health insurance cost too much before Obamacare, it's likely to still too expensive. They just have to eat a penalty on top of their other expenses.

 

 

 

If people are educated enough into seeing the point of buying into the system and then do so, it works out in the long run.

 

You can't expect the whole nation to act in an altruistic manner when such a large sum of money is involved each and every month. We're talking about one of the biggest items in a budget here.

 

 

 

People expect for a system that is put in place to work immediately, but nothing on this scale is ever as simple as just throwing a switch and having the system work perfectly. There is always an adjustment period with complex systems. How long that adjustment period lasts for is dependent on a tremendous number of factors and we have very much still been in that adjustment period.

 

But the adjustment is just getting worse. It's not a matter of flipping the switch and things settling down. The switch was flipped and here we are several years later and insurance companies are abandoning ship after losing billions and prices are going up for those that are sticking it out. The affordable part in all of this just isn't happening, if anything the bad is accelerating.

 

 

 

Trying to make quick decisions to score political points on an issue like this when there hasn't been time to properly study the human and economic costs of a plan is truly despicable behavior. The congressional system is built to go slow on things like this and it should go exactly that slow.

 

It's only passed one chamber of Congress and they've spent basically the whole term so far negotiating it. The Senate doesn't look like it'll even take it up until July where it's going to be incredibly difficult to get to 50 votes. And even if the Senate passes something, they still need to go to conference.

 

I don't see how this is breakneck speed. There's much sausage making left to witness and I think it's more likely than not that nothing gets to the president's desk this term and we'll look back on this and call it a complete waste of political capital.

 

 

 

Even still, despite whatever academic debates we may be able to have about the economical and mathematical behavior of this complex system,. we all have to bear in mind that there truly is a huge human cost to all of this. It is very easy to speak of all of this in abstract terms, but these decisions have a huge impact on the lives of so many people living in this country.

 

Yes they do. But the underlying market and economic issues can't be wished away with good intentions. In the end, the results are the results and you need to deal with them as they are and not what you hoped they'd be no matter how sympathetic a cancer patient might be.

 

We don't have to speak in abstract terms anymore, we have the system in place and are watching the results. As I mentioned, the only thing really working to provide insurance is expanded Medicaid. If that's where we're going, let's talk about that. But ignoring reality and making the insurance market dysfunctional because it's difficult to face up to the limits of government's ability to decree a positive outcome is just going to hurt people more in the long run.

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The whole pre existing condition aspect of all of this is one of the most polarizing points of these Healthcare reforms. Morally it seems like the right thing to do. Not charging more for people that already have health issues seems only right. Right? This is insurance were talking about. Should I have to pay the same for car insurance as the guy who has a couple a DUIs, an accident, and a few speeding tickets? Should my home owners insurance be the same as someone who lives in a high crime area? These are high risk situations that usually require higher premiums. So is it fair? Older people pay more for insurance because they are at higher risk of needing medical care. Most people have a problem having to pay more for someone else. Parents lament the fact that their insurance goes up grealty when they put their teens on their policy. The biggest difference is that people's rates won't go down when others get older, and won't eventually drop off their policy when they pay for their own.

 

It's hard to argue whether it's moral to help the poor, the unfortunate, and those that don't want to help themselve, when you're asking people who were forward thinking and responsible to pay for them.

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But the ban on preexisting conditions is negated by the mandate. If everyone buys into the insurance pool as intended, then it all works out. Additionally, if everyone gets insurance, then over time, there will be fewer and fewer preexisting conditions because they will have been already covered by the time they get insurance. If people are educated enough into seeing the point of buying into the system and then do so, it works out in the long run.

That's not actually what ended up happening though, and I don't see why any amount of education or I guess, what you call 'critical thinking skills' would change that.

 

The problem was the mandate penalty was lower than the price of insurance. Thus, there was never any incentive to actually buy insurance until you got sick, since the ban on denying pre-existing conditions and guaranteed issue meant you couldn't be denied. For the system to work, a large portion of the 26-35 year old 'healthy' group had to pay in, but there simply was no reason for them to do so. This was the loophole that myself and many others identified back when the original act was passed. I knew it was a ticking time bomb, and just like clockwork, insurers started dropping out of the market and premiums went up.

 

Not sure why any increased education would change this. You can scream at a healthy 26 year old til you're blue in the face that he's screwing over the whole plan by not buying in, but why would he listen? Assuming he has a job, which may be unlikely given how high unemployment is in that age group, and further assuming his employer doesn't provide insurance, he sure as sh-t isn't going to buy insurance that costs more than the penalty, when he can spend that money on other things like beer.

 

Quite frankly, neither would I. I have insurance through my employer, and I'm rich enough to just afford anything out-of-pocket anyway... but assuming I wasn't, I'm in my early 30s and healthy. I am very unlikely to need health care for probably at least 30 years, so why in the world would I spend money on insurance instead of paying the penalty and buying it later in life when I need it? Because it's raising premiums for everyone else? Why do I give a f-ck about that? This is completely rational behavior. Not sure exactly why you jumped on poe for this by the way- he's accurately describing what people are doing in the market, whether we like it or not.

 

This is why premiums were rising under Obamacare and it was never going to work. Now, whether the new GOP plan would work or not- separate question. It depends on whether states actually end up waiving the ban on denying pre-existing conditions (I assume probably about half of the states would). If someone lives in a state that keeps the ban, then no, they're still not going to buy insurance. If they live in a state that lifts the ban... maybe they'll buy insurance. They would be subject to a 30% surcharge for a lapse in coverage, and potentially having their pre-existing conditions not covered... I don't know if even that would be enough, quite honestly. People tend to be pretty bad at long term planning and especially when you're in your 20s, you feel invincible and age 60 seems an eternity away. If you are capable of some long term planning, you're probably also the type of person who already has a salaried job and employer provided insurance. So I'm not sure that even under the new GOP plan that any more people will buy in. That and, probably a good chunk of states would keep the ban and no one will buy insurance in those states, same as under Obamacare. So I expect premiums will continue to rise, no matter what.

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That was the auto correct and swype on my tablet. That should have read When you're asking people who were forward thinking to be responsible for paying for them.

 

Like I said it's a tough issue. People generally want to help others. The same people though tend to clench their cheeks though when you ask for money to do it.

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Guest El Chalupacabra

This repeal/replace nonsense is ridiculous, and it all boils down to a dog and pony show for the republicans to point to and say they did "something," whether or not it is actually a good idea.

 

I was not a fan of how ACA was passed, and some of its provisions, and did not support the idea of mandatory coverage, but it is not ALL bad. Covering preexisting conditions is one of the elements I support in the ACA, and now the GOP seeks to roll that back. Stupid. For literally decades, the GOP has wanted to pass laws that erase state lines for insurances to compete, on the basis that like auto insurance, premiums will go down. I believe in that philosophy, and before trying to push through the AHCA, they should have tried to pass a bill allowing health insurance companies to compete across state lines. I would have also applauded a bill that repealed elements I didn't support in the ACA, such as the mandatory coverage requirement.

 

But no. The republicans want to screw around and do a complete repeal, some wanting to pass the AHCA which retains some elements of the ACA, while others want to go back to pre- ACA standards and could care less if people who need coverage go without. They want to place credit for "their" idea above what is good for the nation as a whole. Moronic and just smoke and mirrors. And it appears they want to pass their plan using similar parliamentary acrobatics that brought us the ACA. When they aren't the majority party any longer, what will potentially happen is democrats reversing their changes, and re-enacting the ACA in some form.

 

What I fear is this could lead to ping-pong legislation where we will see a series of different health care plans passed depending on who is in power at the time. That uncertainty and inconsistency, more than anything will cause healthcare prices to skyrocket out of control.

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Should have been single-payer from Day One.

Well, I think there is merit to that position... but you have your own party to thank for that one. When the Dems had total control of government, the most liberal plan that could get through was an old GOP plan from the 90s.

 

Forget single-payer. Actually forget even a public option. Just Obamacare passed by the narrowest of margins and required all sorts of shenanigans to get it through (remember the Cornhusker kickback?)

 

The fact of the matter is, the employer/insurance model is so entrenched in our health care system by this point, that Obamacare, or something like it, is realistically all we're gonna get, and it ain't going anywhere. If the window was ever open for some type of government-run, universal coverage system, that window probably closed some 50 years ago. And funny enough, it was actually Democrats that helped close it the first time too.

 

It's NOT "my" party, but yeah. Obama capitulated to the ****ing GOP WHINERS on single-payer.

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This repeal/replace nonsense is ridiculous, and it all boils down to a dog and pony show for the republicans to point to and say they did "something," whether or not it is actually a good idea.

 

I was not a fan of how ACA was passed, and some of its provisions, and did not support the idea of mandatory coverage, but it is not ALL bad. Covering preexisting conditions is one of the elements I support in the ACA, and now the GOP seeks to roll that back. Stupid. For literally decades, the GOP has wanted to pass laws that erase state lines for insurances to compete, on the basis that like auto insurance, premiums will go down. I believe in that philosophy, and before trying to push through the AHCA, they should have tried to pass a bill allowing health insurance companies to compete across state lines. I would have also applauded a bill that repealed elements I didn't support in the ACA, such as the mandatory coverage requirement.

 

But no. The republicans want to screw around and do a complete repeal, some wanting to pass the AHCA which retains some elements of the ACA, while others want to go back to pre- ACA standards and could care less if people who need coverage go without. They want to place credit for "their" idea above what is good for the nation as a whole. Moronic and just smoke and mirrors. And it appears they want to pass their plan using similar parliamentary acrobatics that brought us the ACA. When they aren't the majority party any longer, what will potentially happen is democrats reversing their changes, and re-enacting the ACA in some form.

 

What I fear is this could lead to ping-pong legislation where we will see a series of different health care plans passed depending on who is in power at the time. That uncertainty and inconsistency, more than anything will cause healthcare prices to skyrocket out of control.

 

They've already skyrocketed out of control. Just today Aetna pulled out of Obamacare. They lost $450 million in 2016 while covering 15 states and project a $200 million loss in 2017 if they had retained their remaining 2 states.

 

Or do you think that they should just eat those costs? If not, who should pay for it?

 

It's simply not financially sustainable.

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Guest El Chalupacabra

 

This repeal/replace nonsense is ridiculous, and it all boils down to a dog and pony show for the republicans to point to and say they did "something," whether or not it is actually a good idea.

 

I was not a fan of how ACA was passed, and some of its provisions, and did not support the idea of mandatory coverage, but it is not ALL bad. Covering preexisting conditions is one of the elements I support in the ACA, and now the GOP seeks to roll that back. Stupid. For literally decades, the GOP has wanted to pass laws that erase state lines for insurances to compete, on the basis that like auto insurance, premiums will go down. I believe in that philosophy, and before trying to push through the AHCA, they should have tried to pass a bill allowing health insurance companies to compete across state lines. I would have also applauded a bill that repealed elements I didn't support in the ACA, such as the mandatory coverage requirement.

 

But no. The republicans want to screw around and do a complete repeal, some wanting to pass the AHCA which retains some elements of the ACA, while others want to go back to pre- ACA standards and could care less if people who need coverage go without. They want to place credit for "their" idea above what is good for the nation as a whole. Moronic and just smoke and mirrors. And it appears they want to pass their plan using similar parliamentary acrobatics that brought us the ACA. When they aren't the majority party any longer, what will potentially happen is democrats reversing their changes, and re-enacting the ACA in some form.

 

What I fear is this could lead to ping-pong legislation where we will see a series of different health care plans passed depending on who is in power at the time. That uncertainty and inconsistency, more than anything will cause healthcare prices to skyrocket out of control.

They've already skyrocketed out of control. Just today Aetna pulled out of Obamacare. They lost $450 million in 2016 while covering 15 states and project a $200 million loss in 2017 if they had retained their remaining 2 states.

 

Or do you think that they should just eat those costs? If not, who should pay for it?

 

It's simply not financially sustainable.

 

I realize they are already out of control. They already were even BEFORE the ACA, in fact. Not to mention, if their goal is to prevent costs from becoming worse, why jack around with repeal/replace, when the end product will just be basically the same, minus some of the worst aspects of the ACA. Why not instead just pass a bill lifting insurance restrictions across state lines, and fix what is wrong with the ACA? But the GOP is more interested in simply throwing red meat to the base.

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Guest El Chalupacabra

Do you really think that's going to make any kind of government mandated insurance affordable?

Did you read the OTHER part of my post that stated I think the mandatory coverage portion of the ACA should be repealed? I clearly said I didn't like that part of the ACA.

 

What I am getting at is that had the republicans worked together with the democrats to fix the existing ACA, rather than try to ram rod a repeal of the entire thing, then try to pass a replacement (AHCA) which essentially is the same thing minus the parts most people agree is wrong with the ACA, things would get fixed a lot quicker. But once again, the GOP is putting politics ahead of common sense, and doing the same crap they accuse the dems of doing. The dems are not innocent either, but this petty pay back nonsense needs to stop on both sides.

 

 

Why is your response always "do nothing"? Don't protest. Don't speak up. Don't change. Don't care-- that's what you seem to boil down to.

Trust me, if it were the dems doing the same thing, he'd be all over that sh*t. Since the GOP is his team that is doing it, they can do no wrong.

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I just don't think there's anything that can be done to fix it. Obama got this thing pushed through with no long term plan. As Pelosi said when confronted with numerous issues people had with the functionality of ACA "let's just get this pushed through and worry about it later." That seemed to be the overall mentality of the nitwits who unleashed this turd on America.

 

I don't think there's any real solution other than getting rid of it entirely.

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Let's help people first and figure it out as we go.

 

Yeah, that's just terrible.

 

Not saying it was responsible, and obviously it was as much of a political move as a moral one-- but you don't become better without trying, or changing, without challenging the status quo.... as evidenced by the Revolutionary War, the last 17 amendments, the suffrage movement, the civil rights movement, or anything else that was initially started with protest.

 

We socialized fire and police to better serve and save, don't you think in that vein we should try to make it work?

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I agree with you on the let's help people aspect. IMO I think where people are is that they don't trust the government to work together to come up with a solution. So the general belief is why try? I can't speak for Tex and say that's his take, but I've seen and read enough to get that vibe.

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Well the problem is that if you put something out there that's not financially sustainable and eventually have to take it away as a result you're gonna piss off a lot of people.

 

Think about the people who signed up for ACA and then allocated their finances everywhere only to find out it's going away and now have to find insurance on their own.

 

Simply put it was irresponsible to put a crappy product out there because it messes with people's lives. And now rather than taking ownership for their mistake the Dems simply want to bury the Rebs for trying to take people's insurance away, when they know deep down they never had a viable plan to pay for it.

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Okaaayyyyy-- cause you realize your team didn't have to take it away, right? It wasn't immediately causing the fed to go bankrupt. The chaos and pissing off of people you're talking about is because the GOP had to dismantle it for purely political reasons after getting their base all worked up over it during the election.

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Of course they didn't have to do anything. Why would they ever want to fix a plan that costs more money than it's worth while charging insured more for shitty coverage? We should all be fine with higher premiums and deductibles only to find out that key procedures aren't covered, shouldn't we?

 

What the hell were they thinking? ACA for life!

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I'll further add that with Aetna now bowing out, much like Humana, this leaves Blue Cross to weather what one Aetna executive referred to as a "death spiral".

 

If the insurance companies can't make this work, even with government help, how can any logical person think ACA will ever last?

 

Thanks Obama for "affordable" healthcare.

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Of course they didn't have to do anything. Why would they ever want to fix a plan that costs more money than it's worth while charging insured more for ****ty coverage? We should all be fine with higher premiums and deductibles only to find out that key procedures aren't covered, shouldn't we?

 

What the hell were they thinking? ACA for life!

Because the definition of FIX is to make something work. I'm not sure why you have just decided it could never ever work ever for any reason (even though several other countries have figured it out). And "costing more than it's worth" is a statement that tells me all about where you stand on the moral aspect of it. I'm starting to really try and wonder why every conservative really seems to have zero interest in not being a garbage person that just looks out for themselves.

 

I'm currently in the highest tax bracket and I am just fine with taxes being higher if it means that money can help those less fortunate than me have health coverage. It's not a question of rights vs. privilege, it's a question of being better human beings and taking care of each other.

 

But whatever-- I don't know why I bother with you. The "THANKS OBAMA" crowd are among the most myopic. Go read your freedomeagle.org news letter and jerk off to the imaginary wall some more.

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