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

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

#71

Post by saosebastiao »

zrail wrote: post #20
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…

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.

You say that like the ACA was the only way to get that outcome...that somehow more insurance was the solution rather than the problem. The fact of the matter was that with a democratic president and the largest democratic majority in generations, voted in on a platform of "just fucking fix healthcare already", we still couldn't even see a single payer proposal make it to the floor for a vote.

Not only did we not get the healthcare that we voted for, we got mandated insurance based healthcare at even higher prices, with even more bureaucracy, and huge tech boondoggles as the icing on the cake. Sold to the public as not a tax, but then justified at the Supreme Court as a tax. 5% of the population comes out ahead and everybody else behind.

The 111th congress will go down in history as the most cowardly and counter effective we will ever see. That Obama is whitewashing and patting himself on the back like this is bordering on insanity.

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

#72

Post by dragonwriter »

tn13 wrote: post #65
dragonwriter wrote: post #57

Earlier quoted context omitted.

> 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?

Higher the number of pages in a regulation harder it is for the representatives to read and study. The compliance cost goes significantly higher for all the stakeholders making entire healthcare more expensive all people and since IRS is roped in this cost is also passed on to entire population of United States including those who are not residing in USA and have never made a visit to a doctor in a given financial ye…

> Higher the number of pages in a regulation harder it is for the representatives to read and study.

Representatives don't read and study most regulations, since regulations are issued by appointed regulatory bodies to implement legislation, not elected legislative bodies.

> Reform generally means government gives up control in favor of market so people can get what they want

No, that's what "privatization" means. Privatization can be a reform, but it is not what reform means generally.

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

#73

Post by dragonwriter »

toomuchtodo wrote: post #15
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…

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…

> I despise that the federal government didn't eliminate health insurance companies entirely and move to single payer through Medicare.

Medicare isn't single payer. Its actually very similar to the ACA exchange system, only with a public option alongside private options (all of which must offer at least as much coverage as the public option, and which are partially publicly subsidized for people choosing them instead of the public option.)

(And, in the case of prescription drugs, with a big hole in the public option, for which, if you want coverage, you either have to reject the public option or purchase a publicly-subsized private plan to cover that hole on top of the public plan.)

Medicare was a single payer system, back before most of the people posting on HN were alive.

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

#74

Post by stonemetal »

dragonwriter wrote: post #27
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…

> 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…

The government reduces Medicare payouts by a fixed percentage, starting at 1% in 2014 going up until it reaches 9% in 2022, to any participant who doesn't meet meaningful use requirements. The only way to opt out of the requirement is to completely opt out of medicare. That rather sounds like a nonvoluntary penalty carrying program to me.

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

#75

Post by twotwotwo »

Alupis wrote: post #67
dragonwriter wrote: post #66

Earlier quoted context omitted.

> You could do that before ACA. The GP said he was a cancer survivor. I've talked with several people with serious past or pre-existing conditions, including past occurrences of cancer, who could not find anyone willing to sell them an individual health insurance plan at any price prior to the ACA -- the only way they could get insurance was to be in a job where a group plan was offered. > What does this lifestyle ch…

> It creates health insurance exchanges on which people can by individual insurance without being denied for pre-existing conditions One could (and can) do this without the exchanges. Yes, before ACA some pre-existing conditions would deny access to some policies from some insurers. This was to prevent a career smoker at age 75 from signing up for a new very large policy, and immediately get the benefits they haven't…

> private individual insurance policies are about the same price

Not for `zrail: pre-ACA, insurers charged high-risk buyers like him/her much higher-than-average premiums based on their medical history. Now that's not allowed.

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

#76

Post by rayiner »

bduerst wrote: post #29
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.

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.

The good parts and the bad parts are related. The ACA effectively forces rates to go up for people who can afford it to increase or extend benefits to people who can.

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

#77

Post by SilasX »

stonemetal wrote: post #74
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…

The government reduces Medicare payouts by a fixed percentage, starting at 1% in 2014 going up until it reaches 9% in 2022, to any participant who doesn't meet meaningful use requirements. The only way to opt out of the requirement is to completely opt out of medicare. That rather sounds like a nonvoluntary penalty carrying program to me.

IMHO, that's a feature, not a bug. Though it is unfortunate that some doctors have to be dragged kicking and screaming into the 21st century; I'd be really suprised if such doctors were better, by any reasonable metric, than one that had needed no prodding for EHR.

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

#78

Post by bduerst »

rayiner wrote: post #76
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.

The good parts and the bad parts are related. The ACA effectively forces rates to go up for people who can afford it to increase or extend benefits to people who can.

There was a slight increase in 2010, but (overall) not a significant change to the growth in premium contributions made by single workers and families between 2005 and 2015 - http://i.imgur.com/KCiwoEJ.png

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

#79

Post by dragonwriter »

saosebastiao wrote: post #71
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.

You say that like the ACA was the only way to get that outcome...that somehow more insurance was the solution rather than the problem. The fact of the matter was that with a democratic president and the largest democratic majority in generations , voted in on a platform of "just fucking fix healthcare already", we still couldn't even see a single payer proposal make it to the floor for a vote. Not only did we not get…

> we still couldn't even see a single payer proposal make it to the floor for a vote.

> Not only did we not get the healthcare that we voted for

Three of the Democratic candidates in that election campaigned on something very similar to what the ACA delivered, including both of the top two -- Clinton and Obama.

None of them campaigned on single payer, so its not surprising that what was delivered looked like what was successfully campaigned on. Inasmuch as anything can be said to be the "healthcare we voted for", the ACA is more like that than single-payer would have been.

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

#80

Post by tn13 »

dragonwriter wrote: post #72
tn13 wrote: post #65

Earlier quoted context omitted.

Higher the number of pages in a regulation harder it is for the representatives to read and study. The compliance cost goes significantly higher for all the stakeholders making entire healthcare more expensive all people and since IRS is roped in this cost is also passed on to entire population of United States including those who are not residing in USA and have never made a visit to a doctor in a given financial ye…

> Higher the number of pages in a regulation harder it is for the representatives to read and study. Representatives don't read and study most regulations, since regulations are issued by appointed regulatory bodies to implement legislation, not elected legislative bodies. > Reform generally means government gives up control in favor of market so people can get what they want No, that's what "privatization" means. Pr…

> No, that's what "privatization" means. Privatization can be a reform

Look up a dictionary please.

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