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United States Health Care Reform: Progress to Date and Next Steps

jama.jamanetwork.com

41–50 of 80 posts

Re: United States Health Care Reform: Progress to Date and Next Steps

#41
post #30

He published a single author paper even though he acknowledges in the end "I thank Matthew Fiedler, PhD, and Jeanne Lambrew, PhD, who assisted with planning, writing, and data analysis". In my field, those people probably would have deserved a place on the authors list ;)

My exact thought. They did all the work. He took all the credit.

Then again, they're politicians and not academics so not as big a deal.

Re: United States Health Care Reform: Progress to Date and Next Steps

#42
post #29
post #20

Earlier quoted context omitted.

ACA is the best legislation in my lifetime. It has allowed me the luxury of being able to purchase individual insurance as a cancer survivor, allowing me to spend more time with my young family instead of being chained to a 8-5 corporate job. See, I can anecdote too.

I think this is the real win here. Like most legislation ACA is a complex combination of good and pad parts, but the fact that people with pre-existing conditions or terminal illnesses can still get health insurance for treatment is a huge step forward for our society as a whole. Like the report said, there's still progress to be made.

I still contend that the availability/unavailability of health insurance was not the problem that needed solving. Instead, it's one of many symptoms that can be attributed to the unreasonable cost of healthcare, which has escalated in part because of the disassociation between the actual billing and payment. Insurance is similar in concept to chips as a casino in this -- by creating distance from the actual cash transaction, people are less likely to question the cost of something because it doesn't have a direct impact on their wallet.

Re: United States Health Care Reform: Progress to Date and Next Steps

#43

Earlier quoted context omitted.

You're correct. They are losing money, and they are withdrawing from those markets in question. Its important to note that the backstop payments those insurers were to receive from the federal government are being tied up by Congress, to stick a wrench in the ACA. http://www.thefiscaltimes.com/2015/12/17/Congress-Weakens-Ob... The elephant in the room is: How do we spend less on healthcare for everyone when so many p…

Why are we going to end up with single payer? I didn't follow that part of your argument.

I removed that part of my comment, as I thought it was not relevant to the specific point.

As the US population ages, more and more people will be on Medicare [1]. This increases its power, and removes almost entirely the likelihood it would be scaled back.

We will eventually have no choice but to move to single payer, as the cracks in the current model (dictated by the ACA) are already forming.

[1] https://www.census.gov/prod/2014pubs/p25-1140.pdf (warning: pdf)

Re: United States Health Care Reform: Progress to Date and Next Steps

#44

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted wit…

Thanks for calling out what it is but you might get down voted here.

11 thousand pages of new regulations can not be called reform. It is unbelievable how this new giant piece of regulation is even termed as "reform".

The reform in US healthcare could have been destroying the monopoly of AMA over supply of doctors, getting rid of complex procedures for prescription medicine, downsizing FDA and giving more flexibility to doctors to determine quality of service for day to day medical care.

I do not agree with "crony capitalism" part however. The Obama Labyrinth of Healthcare Mess is soviet style big government in action. It does not do good to pharma-companies, insurance companies, doctors or patients. All big insurance companies had to exit in few years from the government insurance exchanges.

Re: United States Health Care Reform: Progress to Date and Next Steps

#45
post #20

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted wit…

ACA is the best legislation in my lifetime. It has allowed me the luxury of being able to purchase individual insurance as a cancer survivor, allowing me to spend more time with my young family instead of being chained to a 8-5 corporate job. See, I can anecdote too.

> It has allowed me the luxury of being able to purchase individual insurance

You could do that before ACA.

> instead of being chained to a 8-5 corporate job

What does this lifestyle choice have to do with ACA? ACA doesn't somehow give you free time or extra money. Unless you are getting your insurance for free (which was possible before ACA, mind you). ACA often does not offer the cheapest plans either...

Re: United States Health Care Reform: Progress to Date and Next Steps

#46
post #4

Sorry if OT but ... Anyone get a snicker out of putting JD by his name? "Barack Obama ... don't know the cat. Oh, he has a law degree? Hm, okay, I guess his opinion might matter then." It would be like seeing "Guido van Rossum, Dropbox Employee".

It's common practice in medical journals and conferences to list academic degrees.

Re: United States Health Care Reform: Progress to Date and Next Steps

#47
post #36

Earlier quoted context omitted.

Hey there! Long term Obama supporter (no longer) and healthcare consumer in the US. I agree with you mostly. Monthly premiums for my wife and I are ~$700/month (both healthy, early 30s, Blue Cross Blue Shield). When our daughter arrives shortly, that will increase to $1000/month. That's a high deductible plan where we're out of pocket for everything for the first $6000/year. I work remotely, so we're looking at movin…

> The ACA was a sham; it measures the insured rate, not the ability of citizens to receive the care they need. On that metric, its failing terribly. Can you elaborate on this? Not because I think you're wrong, but because I haven't been able to find any data one way or the other about health outcomes and the ACA.

It simply mandates everyone buys insurance. It does not mandate affordable care. Does it matter if you buy insurance if your deductible is $6000 and you never seek medical help until its too late (because you can't afford the copay(s))?

Re: United States Health Care Reform: Progress to Date and Next Steps

#48

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted wit…

So it's the worst legislation ever because a person with a very high income has to pay a few hundred bucks more so that healthcare is affordable to all?

Can't think why the Occupy movement caught on in the US.

Re: United States Health Care Reform: Progress to Date and Next Steps

#49

Earlier quoted context omitted.

> The worst piece of legislation ever to be passed in the United States of America. I don't think it competes with, just for two obvious, off-the-top-of-my-head examples, either the Indian Removal Act or the Alien and Sedition Acts. > I have seen many patients lose their doctors because the doctors were not contracted with Covered California. Covered California is the California state health insurance exchange, it do…

> I don't think it competes with, just for two obvious, off-the-top-of-my-head examples, either the Indian Removal Act or the Alien and Sedition Acts. Those legislation mainly affected people who weren't US citizens, though. Obamacare does, which makes it way worse for US citizens. Prohibition or the Japanese internments(if executive orders count) are maybe a better example.

We're diving into the semantics, but the post complained of the "worst legislation", not "worst for American citizens".

Re: United States Health Care Reform: Progress to Date and Next Steps

#50
post #45
post #20

Earlier quoted context omitted.

ACA is the best legislation in my lifetime. It has allowed me the luxury of being able to purchase individual insurance as a cancer survivor, allowing me to spend more time with my young family instead of being chained to a 8-5 corporate job. See, I can anecdote too.

> It has allowed me the luxury of being able to purchase individual insurance You could do that before ACA. > instead of being chained to a 8-5 corporate job What does this lifestyle choice have to do with ACA? ACA doesn't somehow give you free time or extra money. Unless you are getting your insurance for free (which was possible before ACA, mind you). ACA often does not offer the cheapest plans either...

The entire point is that healthcare is no longer coupled to a specific employer.
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