United States Health Care Reform: Progress to Date and Next Steps • Hacker News Board

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

#51

Post by deadowl » Tue, Jul 12, 2016, 7:49 PM UTC

MichaelBurge wrote: post #39

dragonwriter wrote: post #27

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.

> Those legislation mainly affected people who weren't US citizens, though.

Then what about Samuel Worcester?

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

#52

Post by dragonwriter » Tue, Jul 12, 2016, 7:51 PM UTC

MichaelBurge wrote: post #39

dragonwriter wrote: post #27

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.

> Those legislation mainly affected people who weren't US citizens, though.

Certainly the Sedition Act's repression of free speech was not restricted to, nor primarily targeting, non-citizens; it principally targeted domestic dissent. (The first prosecution under that act -- or any of the Alien and Sedition Acts -- was of an opposition-party Congressman for writings critical of the administration.)

Not that "worst for American citizens" was the original claim, anyway.

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

#53

Post by Joof » Tue, Jul 12, 2016, 7:51 PM UTC

rbritton wrote: post #42

bduerst wrote: post #29

Earlier quoted context omitted.

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 tran…

It also allows us to pool money and average it in case unknown and expensive procedures are required. We also want to encourage people to get cheaper preventative care instead of avoiding it due to short-term costs. Insurance programs benefit from incentivizing that behavior as much as ordinary people do.

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

#54

Post by burkaman » Tue, Jul 12, 2016, 7:52 PM UTC

toomuchtodo wrote: post #47

alexose wrote: post #36

Earlier quoted context omitted.

> 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))?

Right, but are there any studies or statistics on how the ACA has affected actual care provided, or hospital visitation rates, or something? What makes you say the ACA is failing terribly on this metric?

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

#55

Post by zrail » Tue, Jul 12, 2016, 7:53 PM UTC

andrewpi wrote: post #35

zrail wrote: 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.

Prior to the ACA, many states offered High Risk Pools to cover people in your situation. Were these not applicable in your case?

The only way to get into the pool in my state was to be without insurance for 6 months and provide proof of denial or exclusion of a condition. That was untenable when I was going to follow up visits every 3 months and CT scans every six months.

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

#56

Post by dragonwriter » Tue, Jul 12, 2016, 7:54 PM UTC

rbritton wrote: post #42

bduerst wrote: post #29

Earlier quoted context omitted.

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 tran…

> 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.

The rate of increase in per-capita costs has decreased under the ACA. So, while it perhaps hasn't yet solved the problem, its certainly hard to argue that its been thing worse than the system in place before it was adopted.

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

#57

Post by dragonwriter » Tue, Jul 12, 2016, 7:56 PM UTC

tn13 wrote: post #44

boneheadmed wrote: post #14

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…

> 11 thousand pages of new regulations can not be called reform.

Why not? Now, if you were complaining about someone, hypothetically, calling it "simplification", I can at least comprehend the objection, but what does the number of pages of regulation have anything to do with whether or not it can be called reform?

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

#58

Post by xrange » Tue, Jul 12, 2016, 7:57 PM UTC

peteretep wrote: post #48

boneheadmed wrote: post #14

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.

In what ways do you think the Occupy movement caught on?

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

#59

Post by maxerickson » Tue, Jul 12, 2016, 7:58 PM UTC

dragonwriter wrote: post #56

rbritton wrote: post #42

Earlier quoted context omitted.

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 tran…

> 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. The rate of increase in per-capita costs has decreased under the ACA. So, while it perhaps hasn't yet solved…

We need a period of time that isn't coincident with a huge recession before we celebrate this too much.

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

#60

Post by ashark » Tue, Jul 12, 2016, 7:58 PM UTC

rbritton wrote: post #42

bduerst wrote: post #29

Earlier quoted context omitted.

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 tran…

"People are less likely to question..." seems to be placing the blame at least one notch too far down. Try asking how much something will cost and no-one can tell you—insurance or provider. Medical billing at all levels is batshit insane, and it's not the fault of "consumers" (patients) that they can't figure it out. Even trying is mostly pointless.