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(Reuters)   As "Obamacare" marks its third anniversary, it's becoming increasingly clear who the real winners are under this law: healthcare lobbyists, of course   (reuters.com) divider line 82
    More: Obvious, obamacare, Amy Klobuchar, National Coalition Party, America's Health Insurance Plans, National Federation of Independent Business, Medtronic, lobbying, medical device  
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1423 clicks; posted to Politics » on 25 Mar 2013 at 11:30 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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Archived thread
2013-03-25 11:26:49 AM  
7 votes:

kiwimoogle84: Oh yeah, that "let's pass it so that we can find out what's in it" bullcrap. That pissed me off so much. And Mentat- for the record, most Republicans are against it, so I'm not sure what point you're trying to make. Rom's main promise was to repeal it. Wealthy republicans who own health insurance companies would of COURSE be against it, because they're the one taking hits.


They're against it now because a Democrat passed it.  They weren't against it when the Heritage Foundation came up with the idea, or when Newt Gingrich offered it as an alternative to HillaryCare, or when Governor Romney signed it into law in Massachusetts and suggested it should serve as a national model for health care.
2013-03-25 12:29:39 PM  
5 votes:

kiwimoogle84: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

I'm not ok with THE GOVERNMENT deciding whether I live or die.


Look, I don't think you are a troll.  At a minimum, the amount of effort you have to expend to keep the arguments up mean you aren't a successful troll, and it seems like you are earnest.

Unfortunately, you are also horribly misguided.  Under the current law, you can purchase your own insurance.  That insurance will place it's own requirements on what it will pay doctors.  You want premium coverage, you can pray a premium penny to get it.  You get to decide, based on your income, whether you live or die.

What the government has placed in the ACA is a coverage floor, minimum requirements for plans to pass the new insurance credits on income tax.  If you don't meet that, you don't get the credit and have to pay higher taxes.  That's the way the mandate has been structured from day one, it's why the IRS is the enforcement agency, and the Supreme Court agreed.  Businesses have similar tax credits they can qualify for.

Non of this places an additional strain on the providers.  Yes, there are some poorly informed, paranoid, conservative doctors that have come out saying it will hurt their business, but it will actually place a positive pressure on demand due to the additional preventative care coverage and increase in the number of insured.  The negative pressure will mostly be against insurance, which is why they have been a leading lobbyist against the ACA, and those who will fund the measure with increased taxes.

Nobody likes increased taxes, but the truth is that the taxes don't actually place pressure do decrease jobs.  That's not how health care taxes work, or any economic industry with entrenched demand (like food production).  Instead, the econometrics show quite clearly that those taxed will have the same demand and thus pass charges across the industry, which will rebalance costs to fill the drain.  This is how most economists, including the CBO, measure the effects here.  And this actually shows that once balanced, the industry will have a slower growth rate than currently.  Why?

Back to insurers.  They are the ones most likely to lose jobs here.  They do not add value to the service and drain the system for profits.  Low value insurance will move to the state-run pools over time, which will have the profit motive mostly removed.  If we had moved to single-payer, it would be completely removed, and since net take after payout would not drain much in either system, year-over-year, the allocations to risk will grow and total cost to consumer will actually fall.

Everything you have said in this thread appears to have been filtered through Fox News or a similar entertainment source geared towards misrepresentation in the name of conservatism.  It is not acceptable to lie about something this important, and you should really feel quite ashamed of yourself.
2013-03-25 11:55:11 AM  
5 votes:

pinual: I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.


You must suck at business.
2013-03-25 11:41:36 AM  
5 votes:
At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?
2013-03-25 11:35:16 AM  
5 votes:
If you're not changing it to single player or public option, STFU.
jbc [TotalFark]
2013-03-25 12:30:58 PM  
4 votes:

kiwimoogle84: I'm just against this whole idea that everyone gets the same care and Uncle Sam decides exactly what that care entails.


Then quit telling people you've read the bill.
2013-03-25 11:56:22 AM  
4 votes:

Sorry for the poor formatting of 2 of 3, trying best to transfer from Word to Forumn.

Part 3 of 3

Effective January 1, 2014

Maintenance of Minimum Essential Coverage


Chapter 48 Section 5000A begins the most controversial and most debated aspect of the Patient Protection and Affordable Care Act and is entitled "Maintenance of Minimum Essential Coverage". The Maintenance of Minimum Essential Coverage in essence declares that any "eligible" individual must purchase and possess "minimum" essential coverage for every "eligible" month that individual can afford to purchase said insurance as defined by PPACA starting January 1, 2013. If an "eligible" individual does not purchase the "minimum" level of required health insurance, that individual will then have a "tax penalty" placed on their yearly tax returns for every "eligible" month he or she has gone without purchasing "minimum" essential coverage. In order to better understand exactly how this process will work, the key aspects of the Maintenance of Minimum Essential Coverage will be broken down into three specific sections: Applicable Individuals, Applicable Minimum Essential Coverage Programs, and Tax Penalty.

Applicable Individuals

Any individuals who don't meet a PPACA Exemption will be required to purchase a Minimum Essential Coverage Program. The following regulations and guidelines have been set by the PPACA in order to determine exempt individuals with a brief description explaining the exceptions:

Religious Exemptions
Any recognized Religious sect or division with tenets and established teachings that would conflict with PPACA regulations and care.

Individuals Not Lawfully Present
Individuals who are not legal residents of the United States of America will not be required to participate in the program nor will they be able to participate if they choose to.

Incarcerated Individuals
Individuals who are incarcerated and/or detained by the state will have their medical care provided for them by the Prison System and will not be required to purchase insurance during the months of their incarceration.

Individuals Who Cannot Afford Coverage
Any individuals who falls below the 113th Poverty Line (~$18,000/annual income) will not be required to purchase Minimum Essential Coverage and will have their medical needs covered under Medicaid

Individuals Related To Employees
Individuals who are eligible and acquire a Minimum Essential Coverage Plan through their employer.

Members of Indian Tribes
As Religious Exemptions but relating to Indian Tribal Customs and Native Americans living on reserves.

Applicable Minimum Essential Coverage Plans

As defined by Section 5000A, Sub-section (b), Minimum Essential Coverage is any Health Insurance Plan that meets a Bronze Level of coverage. A Health Insurance Plan that meets the Bronze level of coverage is one in which the insurance company covers an average of 60% of the annual cost of average care and 40% covered by the individual.  These plans can be private, employer-sponsored, government sponsored, grandfathered health care plans and/or any other coverage that meets the Bronze level of coverage.

Tax Penalty for Non-Compliance

"Eligible" individuals who do not purchase a Minimum Essential Coverage Plan for "eligible" months will have a Tax Penalty attached to their tax returns for every "eligible" month they did not have the necessary plan for a given year. The Tax Penalty is a specific progressive tax over the next 3 years starting with a 1% tax for every month in the year 2014 (~$95), 2% tax for every month in the year 2015 (~$325), and a 2.5% tax for every month in the year 2016 (~695).  An individual will be required to pay 1/12 of the flat dollar amount for every month "eligible" insurance wasn't purchased. As an example, John Smith didn't purchase an "eligible" plan until May 2015 for himself and 2 other dependents. This mean Mr. Smith and 2 dependents were not covered by an "eligible" plan for a total of 4 "eligible" months during the year 2015. Mr. Smith would be charged ~ $27.08 (325/12) per individual not covered per month for a total of ~ $324.96 ([{325 / 12}*3]*4) at the end of the year. In doing this, PPACA hopes to curb the cost of care by taxing those who will eventually need Medical Services at some point in their life but choose not to purchase health insurance until they need it. For those calendar years beginning after 2016, the flat amount used will be $695 multiplied by the cost-of-living adjustment. If the amount increased is not a multiple of $50, such increase will be rounded to the next lowest multiple of $50.

Effective January 1, 2017

State Sponsored Health Care Systems


                Waiver for State Innovation is the title of Section 1332 of the PPACA and provides for States to implement their own Health Care Plan for individuals of the State as long as it meets or exceeds the standards set forth by the PPACA.

Conclusion

The Patient Protection and Affordable Health Care Act has many more provisions and regulations that are currently affecting and will continue to affect the Health Care Industry. Whether or not these changes will result in more efficient and lower cost of care is something that will be determined in time. At the very least, the PPACA is a start in the direction of Health Care Reform in the United States. With the cost of care at ~ $7,000 per Capita (Annual Cost of Health Care / Population), the United States has the highest cost of care of all nations belonging to the Organization for Economic Co-Operation and Development (OECD). If the United States hopes to gain control of its exponential growth of health care cost, Health Care Reform will need to be a continuous and concentrated effort; constantly monitoring and adjusting regulations and procedures in order to ensure best practices, cost efficient treatments and access to quality care will be accessible to all citizens of the United States.

Ressource and Reference

Economic History Association - "Health Insurance in the United States" (Melissa Thomasson, Miami University)
http://eh.net/encyclopedia/article/thomasson.insurance.health.us

Yale Journal of Medicine - "The History of Medical Insurance in the United States" (Katherine Zhou)
http://www.yalemedlaw.com/2009/11/the-history-of-medical-insurance -in- the-united-states/

The Library of Congress - 111th Congress H.R. 3950 (PPACA) Full Text
http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3590:/

Urban Institute - "How Will PPACA Impact Individuals and Small Group Premiums in the Short and Long Term?"
http://www.urban.org/uploadedpdf/412128-PPACA-impact.pdf

The Health Policy Monitor (Bertelsmann Stiftung) - "Pre-Existing Condition Coverage Post-Health Reform"
http://www.hpm.org/us/b16/1.pdf

U.S. Preventative Services Task Force - USPSTF A and B Recommendations
http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm

Healthcare.gov - Comprehensive Guidelines Supported by the Health Resources and Services Administration (HRSA)
http://www.healthcare.gov/law/resources/regulations/prevention/rec omme ndations.html

Healthcare.gov - Health Resources and Services Administration-Supported Women's Preventive Services
http://www.healthcare.gov/law/resources/regulations/womenspr evention.h tml

Bright Future - Recommendations for Preventative Pediatric Health Care
http://brightfutures.aap.org/pdfs/AAP%20Bright%20Futures%20Periodi city %20Sched%20101107.pdf

American Cancer Society - Plan Levels and Standardization of Coverage
http://www.acscan.org/pdf/healthcare/implementation/background/Pla nLev elsStandardizationofCoverage.pdf
2013-03-25 11:50:02 AM  
4 votes:

kiwimoogle84: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

I'm not ok with THE GOVERNMENT deciding whether I live or die.


Well right now that call is made by a group of middle managers on a "recission Committee" who hope to get a promotion by showing the company how much money they've saved it by coming up with loopholes to deny claims and care to subscribers that the company would otherwise be legally obligated to pay for.

You might think that having the government do the same thing isn;t much of an improvement, but consider this: at least you get some say in who is running your government, unless you have the money to become its majority shareholder, you can't say the same thing about your insurance company.
2013-03-25 11:48:46 AM  
4 votes:

kiwimoogle84: Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.


How does it feel to be such a lying liar who lies?
2013-03-25 11:44:58 AM  
4 votes:

kiwimoogle84: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

I'm not ok with THE GOVERNMENT deciding whether I live or die.


But those other people are all totally okay, right?

Jesus. I'm an anarchist and I don't get nearly as pissy-pants about the government as you wingnuts.
2013-03-25 12:41:07 PM  
3 votes:

The Stealth Hippopotamus: 2) force people without healthcare into Medicare


First, you mean health insurance, not healthcare. Second, why would a person without health insurance need to be forced into Medicare? Were I uninsured, I would run at full speed directly to whatever office could get me on Medicare if that was an option. Third, no. PPACA doesn't do that.
2013-03-25 12:06:21 PM  
3 votes:

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


I'm a nurse and I've seen about 10 of my patients die this year. Never did the government intervene. Most of these people were on Medicare. The choice is up to patients or family or the result of being too poor/uneducated to manage illness so they get too sick at home and come to us unfixable.

TL;DR: you are full of shiat
2013-03-25 12:06:09 PM  
3 votes:

kiwimoogle84: IN THE BILL


Why is that in there?  Because A) a REPUBLICAN congressman asked for it and B) its a very good idea.  People die, you see, and Modern American medicine is very good at treating and alleviating symptoms, but sucks at helping a patient manage their life, in particular, the end of it.  As my very soon to be 75-year old mother the nurse has been known to snap at young interns who order whole batteries of tests to determine "what is wrong" witht he 90-year old man admitted with congestive heart failure  "what's wrong with him is that he is dying, and it's your job to make that as comfortable and dignifed as possible, not  to make his reamining hours a living hell as you poke and prod him to treat things that won't matter in a week anyway"
2013-03-25 11:58:42 AM  
3 votes:

kiwimoogle84: Jackson Herring: kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.

oh my god are you for real

like really really for real

Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.

I'm not a foil hat wearer or anything, but I've worked in government healthcare (Medicare and Medi-Cal claims) long enough to know that if you get too expensive to insure, they'll cut you off.


You work in health care and don't understand what end of life counseling is?

1) It's optional.  Health insurers are required to cover it, you aren't required to have it.
2) It's informational. You meet with a doctor and a nurse to talk about your treatment options, which includes but is not limited to stopping treatment if you don't want it.
3) I don't even think it made it to the final bill because idiots thought it was a bad thing.
2013-03-25 11:52:18 AM  
3 votes:

kiwimoogle84: Jackson Herring: kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.

oh my god are you for real

like really really for real

Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.

I'm not a foil hat wearer or anything, but I've worked in government healthcare (Medicare and Medi-Cal claims) long enough to know that if you get too expensive to insure, they'll cut you off.


Like private insurers do.

A law requiring insurers to spend a certain percentage (80, I believe) of their spending on actual medical care is a good thing.  Making it harder for insurers to drop people when they get sick (wtf is that) is a good thing.

Oh no, it's the government!  Who the fark cares?  Millions of people in this country die or go bankrupt because we're failing to provide them even the most basic care that EVERY OTHER CIVILIZED COUNTRY provides.

As to penalties for not being covered, those only kick in for single income earners if they're making 50k or more.  There aren't that many people making over 50k who don't have some sort of coverage in the first place.  Not that 50k is a whole lot of money or anything, but the majority of people who can't afford coverage and don't get it through work are under that bar.
2013-03-25 11:51:58 AM  
3 votes:
Part 2 of 3


Currently in Effect


Pre-Existing Conditions Insurance Plans (PCIP)



Before the passage of PPACA insurance companies were able to deny an individual health insurance based on whether or not a pre-existing condition was a factor. What this means is that if a condition requiring medical attention is discovered before an individual purchases health insurance, insurance companies can then deny that individual health insurance due to already requiring medical care, i.e. having a pre-existing condition. The premise behind this is that it would be too costly to provide insurance for those who already require medical care. Individuals should purchase medical insurance before they require medical attention adding funds into the insurance pool before they take from it. This practice had a very serious consequence, it meant millions of Americans being unable to purchase health insurance and causing countless more to file for bankruptcy due to medical bills. In 2011 more than 60% of all bankruptcy filed were for outstanding medical bills according to The American Journal of Medicine (AJM).

               
Section 1101 of The Patient Protection and Care Act is aimed at providing what is called a "High-Risk Pool" health insurance program to individual with pre-existing conditions so that they are able to purchase health insurance. In order for an individual to be eligible to take part in this new "High-Risk Pool" they must have an established pre-existing condition and are not currently covered by any health insurance plans. This "High-Risk Pool" will be in effect until January 1, 2014 at which point health insurance companies will no longer be able to deny insurance coverage to those with pre-existing conditions and the rates charged as well as the type of coverage cannot be determined by whether or not a pre-existing condition is a factor. This is done in 2014 so that the initial shock of pre-existing condition patients being covered under private insurance companies will be softened. Individuals with pre-existing conditions will have already started their treatments or possibly completed their treatments under the High-Risk Pool program thereby absorbing the initial costs of treating them.


Patient-Centered Outcomes Research Institute (PCORI)


                Section 1181 (b) establishes the non-profit, independent health research organization The Patient-Centered Outcomes Research Institute (PCORI). Their goal will be to assist patients and physicians obtain the most up to date and efficient treatments available as well as conduct research to determine which treatments are the most cost effective. PCORI follows a "comparative clinical effectiveness" research protocol that compares for preventing disease and providing treatment and care. They aim to accomplish this by focusing on 4 goals:


Identifying national priorities for research

Creating research agenda based on identified priorities

Funding research consistent with these priorities and agendas.

Providing Patients and their caregivers with useful research information.


The first two goals will be the main focus of the final section for PCORI as it gives a brief but general understanding of how PCORI plans on achieving their stated goals.


Identifying National Priorities for Research


PCORI has created 5 national priorities that focus on providing patients and health care givers with as much information as possible.


1. Assessment of Prevention, Diagnosis, and Treatment Options

ØDetermine which option(s) work most efficiently for distinct populations with specific health issues.

2. Improving the Health Care System

ØDetermine and establish effective and realistic programs that can help improve health care services.

3. Communication and Dissemination

ØDetermine the most effective way to provide reliable and accurate information to the patient.

4. Addressing Disparities

ØEnsure programs and methods of treatment are considered for all manner of patient populations. Certain treatments are not as effective on certain populations and needs to be taken into account.

5. Accelerating Patient-Centered and Methodological Research

ØDesign and create a way for patients and caregivers to be part of the research project in a quick, safe and efficient manner.


Creating research agenda based on identified priorities

PCORI has established their research agenda will not designate any specific disease or treatment criteria at first but reserves theright to do so in the future. Their first wave of research is aimed at improving any and all aspects of the Health Care System and their available treatments. There 5 focuses of research focus on the national priorities and can be described as follows:


1. Assessment of Treatment, Diagnosis and Treatment Options

ØClinical options with emphasis on patient-preference and decision-making.

ØBiological, clinical, social, economical, and geographic factors that may affect patient outcomes.

2. Improving the Health Care System

  ØUse of non-physician health-care providers, such as nurse and physician assistants, and the impact on patient   outcomes.

ØSystem-level changes that impact all populations, diseases, and health conditions.

3. Communication and Dissemination

ØStrategies to improve patient and clinical knowledge about prevention, diagnosis, and treatment options.

ØMethods increase patient participation in care and decisions-making and the impact of health outcomes.

ØCommunications tools that enhance decision-making and achieve desired outcomes.

ØEnable the use of digital records ("e-health records") to support decision-making.

ØDetermine best practices for sharing research information.

4. Addressing Disparities

ØWays to reduce disparities in health outcomes

ØBenefits and risks of health options available across the population.

ØStrategies that address health care barriers that can affect patient preference and/or outcome.

5. Accelerated Patient-Centered and Methodological Research

ØImprove the usefulness and quality of clinical data in follow up studies.

ØMethods of combining analyzed critical data that follows patients over time.

ØUse of registries and clinical data networks to support research and patient-centered outcomes.

{ØStrategies to train researchers and enable patients and care givers to participate in patient-centered outcome research.


Removal of Life-Time Limit Insurance Caps


Section 2711 establishes new guidelines requiring all new insurance policies after January 1, 2014 to not have a life-time cap on health care expenditure. All plans, including those in affect prior to January 1, 2014 that have life-time spending caps, are to instead establish annual spending caps that set a limit on the dollar value of benefits the patient can receive.


Free Services for Preventative Care


Section 2713 is entitled "Coverage of Preventative Health Services" and outlines 4 new categories in preventative care that must be provided free of charge under insurance plans if they are deemed necessary by a care provider and patient, they are as follows with a few brief examples:


1. Evidence-based services and/or treatments outlined as Type 'A' or 'B' in the current recommendation of the United States Preventative Task Force.

ØDiabetes screening

ØDepression screening in adults and adolescence

ØBreast cancer screening and preventive care

ØCervical cancer screening

2.Immunizations recommended from the Advisory Committee on Immunization Practices of the Center for Disease Control and Prevention.

ØPneumonia

Ø
2013-03-25 11:49:53 AM  
3 votes:

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


Ah, and a BSABSVR into the mix. Awesome.
2013-03-25 11:49:22 AM  
3 votes:

The Stealth Hippopotamus: In other news: People who are good at playing the game will continue to be good at the game no matter what rule changes you make.

Obamacare or ACA was an unfunny joke played on the American people; can't afford healthcare? No worries we'll just fine you (dont worry you can cover that right?) and give you medicare. 'cause we all know medicare is great and is the model of efficiency. And then ACA will make things more affordable by increasing costs!! Cause that's how economies works!


That's not how anything works.  Go spout your insanity elsewhere.
2013-03-25 11:36:23 AM  
3 votes:
can't afford healthcare? No worries we'll just fine you

wow overt lying on fark dot com, must be a day
2013-03-25 11:29:13 AM  
3 votes:

kiwimoogle84: I'm against it because I don't want to be dependent upon the government


So...don't become dependent on the government.
vpb [TotalFark]
2013-03-25 10:30:36 AM  
3 votes:

The Stealth Hippopotamus: In other news: People who are good at playing the game will continue to be good at the game no matter what rule changes you make.

Obamacare or ACA was an unfunny joke played on the American people; can't afford healthcare? No worries we'll just fine you (dont worry you can cover that right?) and give you medicare. 'cause we all know medicare is great and is the model of efficiency. And then ACA will make things more affordable by increasing costs!! Cause that's how economies works!


So we are going to scrap the exchanges and just give everyone Medicare?  You don't even know what Obamacare is do you?
2013-03-25 03:53:58 PM  
2 votes:

austerity101: kiwimoogle84: I'm just against this whole idea that everyone gets the same care

I just wanted to quote this as something someone actually said.


The thing that amazes me the most is that this is all coming from a woman who was selling racy pics of herself to pay for another Farker's medical bills.  And don't get me wrong, it was really nice of her to do that, but...

How on earth can she not see that there is clearly something wrong with a healthcare system that put her (and the farker who needed the money) in that position in the first place?  How could she possibly defend the status quo?
2013-03-25 12:25:13 PM  
2 votes:

Bravo Two: You mean that the reality that people don't give a shiat about each other and are just as much driven by survival of the fittest as any other beast on this planet? And people will generally look out for themselves and their closest niche and ignore everyone else? *Gasp* say it ain't so! Now, if you'll excuse me, I've got work to do because ain't no one else going to come along and pay my bills for me.


Exactly.  We are beasts, and roll around in our own filth on what is almost certainly a prison ship.  Humanity is a hat trick in a medicine show, a fevered dream, a trance bepopulate with chimeras having neither analog nor precedent, an itinerant carnival, a migratory tentshow whose ultimate destination after many a pitch in many a mudded field is unspeakable and calamitous beyond reckoning.  You must fight without honor for whatever worthless creed drives you, for what is honor or honesty, beyond weakness we have agreed to indulge?
2013-03-25 12:12:48 PM  
2 votes:

Bravo Two: verbaltoxin: Probably not, but who cares? Either way it sums up the opposition to single payer: f*ck you, got mine.

You mean that the reality that people don't give a shiat about each other and are just as much driven by survival of the fittest as any other beast on this planet? And people will generally look out for themselves and their closest niche and ignore everyone else? *Gasp* say it ain't so! Now, if you'll excuse me, I've got work to do because ain't no one else going to come along and pay my bills for me.


And those same people, in defiance of your hopeless cynicism, rose above their self-interests long enough to ratify the US Constitution, build rocket ships to the Moon, and in other countries, set up a publicly-funded healthcare structure - because, as it turns out, giving a f*ck or two about people you don't know goes a long way towards your own betterment.

But keep on keepin' on there, while people crowd our emergency rooms for health care, getting those costs passed along to you via your insurer.
2013-03-25 12:06:32 PM  
2 votes:

Dr Dreidel: Having also wrked in healthcare, my experience was that private insurers like to dick around, but government likes to get people treated. I had a kid whose private insurance would rather pay for a MONTH in an acute care facility (about 4-10x more expensive than long-term care, depending; typical stay with us was 4-7 DAYS) than a year somewhere else - "somewhere else" having the caregivers better situated for him than us - because they were bickering with some OTHER entity (or entities) over who footed the bill and who was on whose network. Talk about coming between you and your doctor.


I actually worked for a while (admittedly, tangentially, but up to my neck in the financials) in the Yukon Territory health care system. A mostly-socialized system (government-owned hospitals and clinics as well as insurance) with some private clinics. Neither the doctors nor the patients were anything but happy with the system as presented - something like an 80% public approval rate, higher than the Canadian average and even higher among healthcare workers - and there were more than adequate facilities, equipment and supplies available. Wait times lower than the American average.

By every metric I can think of, the Yukon health care system (not Canadian, Canadian health care is managed differently by province and territory, and unsurprisingly the more heavily-privatized systems are rated most poorly) is vastly superior to anything in the US. But we probably had to make Eagle Jesus cry to do it, so there is that.
2013-03-25 12:03:20 PM  
2 votes:

Cletus C.: Masta Kronix: Whether or not these changes will result in more efficient and lower cost of care is something that will be determined in time.

You post all that for a conclusion that says "eh, who knows." I hope you got an F on that project.


Until you realize the point of the paper was to inform the reader as to what the bill actually did.
2013-03-25 12:00:37 PM  
2 votes:

BarkingUnicorn: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

Isn't it really your health care providers who decide whether you live or die?


That depends. Can you get coverage in the first place? If the answer's "no," then you're pretty much f*cked if you have any condition requiring long term care. You're doubly f*cked if it's an emergency that requires additional, in-patient treatment. If you can't pay, a health care provider might never even see you.

Suffice to say, at this point it's insane to say the UK, Canada, New Zealand, Australia, Sweden, Norway, Denmark, Germany, France and a whole host of other nations can run a single payer healthcare program, and we can't. The largest economy in the world with the planet's reserve currency can't operate and fund single payer?

Really?

Really?

Really?
2013-03-25 11:57:20 AM  
2 votes:

Dusk-You-n-Me: kiwimoogle84: I'm against it because I don't want to be dependent upon the government

So...don't become dependent on the government.


The line of reasoning people use in not wanting to become "dependent on government" is so silly because EVERYONE in a modern society is dependent on government. There's no way NOT to be. Businesses use the money issued by governments and the public infrastructure to make a profit. FARKING WELFARE QUEENS
2013-03-25 11:52:08 AM  
2 votes:

kiwimoogle84: paying claims for the gov


do you even have any idea what "Obamacare" actually is i mean holy shiat
2013-03-25 11:47:28 AM  
2 votes:
ahh ok I get the joke now, you are literally sarah palin
2013-03-25 11:47:12 AM  
2 votes:

Yeah another Obamacare thread!

Did a paper on The Patient Protection and Affordable Care Act in College.

Here ya go for people who actually want to educate themselves!! Coming in 3 parts because it's looooonnnngggggg.


PART 1 of 3


Table of Contents

Table of Contents               . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     2

Overview              . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       3

Brief History of Health Care in the United States     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

The Patient Protection and Affordable Health Care Act (PPACA)      . . . . . . . . . . . . . . . . . .             4

Brief History of PPACA  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     4

Key Provisions of the Patient Protection and Affordable Care Act (PPACA)   . . . . . . . . . . .           4

Currently in Effect            . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   4

Pre-Existing Conditions Insurance Plans (PCIP)      . . . . . . . . . . . . . . . . . .             4

Patient-Centered Outcomes Research Institute (PCORI)         . . . . . . . . . . .           5

Identifying National Priorities for Research             . . . . . . . . . . .           5

Creating research agenda based on identified priorities        . . . .         6

Removal of Life-Time Limit Insurance Caps            . . . . . . . . . . . . . . . . . . . . . . . . . .             6

Free Services for Preventative Care            . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               7

Effective January 1, 2014               . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Maintenance of Minimum Essential Coverage          . . . . . . . . . . . . . . . . . .             7

Applicable Individuals     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Applicable Minimum Essential Coverage Plans       . . . . . . . . . .            8

Tax Penalty for Non-Compliance . . . . . . . . . . . . . . . . . . . . . . . . .               8

Effective January 1, 2017               . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   9

State Sponsored Health Care Systems          . . . . . . . . . . . . . . . . . . . . . . . . 9

Conclusion           . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         9

Resource and Reference   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       10

Overview


Health Care in the United States can be traced back to as early as the 1850's. It was first offered by Franklin Health Assurance Company of Massachusetts in the form of Accident Insurance against injuries sustained by railroad and steamboat accidents. Health Care played a relatively small role in the lives of American citizens during the late 1800's and early 1900's and was relatively inexpensive due to technological limitations and limited medical knowledge. Over the past 100 years countless technological advances and medical breakthroughs has caused medical care to become a necessity and the cost of health care to grow exponentially. With costs on the rise and an ever growing population requiring care, the United States is currently attempting to quickly gain control of the rising cost of providing Health Care and develop a system that allows for better access to medical facilities and medical care. The Patient Protection and Affordable Care Act (PPACA) is the latest piece of legislation aimed at helping individuals in the United States gain access to affordable and quality health care as well as reduce the Cost of Care associated with treatments and is the focus of this paper. This paper will give a brief history detailing a timeline of health care in the United States, a brief history of PPACA, and then systematically break down key provisions of PPACA explaining how they have already changed the current Health Care System and how they will affect it for years to come.

Brief History of Health Care in the United States

Franklin Health Assurance Company of Massachusetts was the first business to offer insurance but was quickly followed by sixty other companies offering insurance by the late 1860's. However, due to the limited medical knowledge and technology of the time, the services medical facilities could offer were extremely limited and most individuals were seen by a doctor in their house. During this period it was reported that the cost of missing work due to illness was four times more costly than the cost to treat the illness therefore sickness and accident insurance were offered by companies that covered sick leave rather than medical expenditures.

During the next few decades, numerous associations such as the American College for Surgeons (ACS), the American Medical Association (AMA), and the Council on Medical Education (CME) helped create new and improved standards of quality and care in the medical field as medical technology and knowledge progressed. As medical technology and knowledge progressed, so did the role of health care and how it was provided. Hospitals and medical facilities became the standard treatment facilities for patients, rather than their homes, and new standards of care and quality were creating better treatments and success rates. With improved standards and new medical breakthroughs in treatments, demand and cost for health care started to grow exponentially. By the 1960's national healthcare expenditures were ~ 4.5% of the Gross National Product (GNP), healthcare costs had doubled, over 700 insurance companies were selling health insurance and President Lyndon Johnson had signed into law Medicaid and Medicare providing government assistance to millions of Americans. Health care had become more expansive and more expensive than anyone could have predicted.

Since the 1960's the cost of providing medical care had risen to double the inflation rate and almost 16% of the nations citizens (44 million Americans) were without health insurance by 2000.  During this time multiple pieces of legislation were enacted in order to help provide access to and improve the United States Health Care System. Medicare and Medicaid were created in order to provide assistance to the elderly and impoverished. Multiple attempts at creating a "Single Payer" or National Health Care System have been attempted but never succeeded. With medical technology and knowledge continuing to grow at an exponential rate with no signs of slowing down, the cost of care and treatments available are only going to increase. An effective and efficient strategy that seeks to continually lowers costs and improves access to medical care is needed going forward if the United States hopes to gain control of their Health Care System.

The Patient Protection and Affordable Care Act (PPACA)

Brief History of PPACA


The Patient Protection and Affordable Care Act (PPACA) was first introduced to the House by Charles Rangel on September 17, 2009 as the Service Members Home Ownership Tax Act of 2009  (H.R. 3590). It was reviewed by the Tax and Means Committee and passed by the House on October 8, 2009. This Act originally modified homebuyer's credit for members of the Armed Forces and certain other Federal employees. In a procedural move, the Senate co-opted H.R. 3590, removed all existing language from the bill and replaced it with the Patient Protection and Affordable Care Act.

On December 24, 2009 the Patient Protection and Affordable Care Act was passed, with the Health Care and Education Reconciliation Act of 2010 amendment attached, in the Senate with a 60 - 39 vote and on March 23, 2010 President Obama signed the law into effect. Almost immediately there were challenges as to the constitutionality of the bill. Multiple states as well as private lawsuits were filed in order to have the bill struck down as unconstitutional. After multiple rulings and appeals through the lower courts, on June 28, 2012 the Supreme Court Justices ruled the Patient Protection and Affordable Care Act constitutional and upheld the bill in a landmark ruling under National Federation of Independent Business vs. Sebelius. However there are those who are still opposed to the new law and are attempting to have it repealed. The outcome of the next upcoming Presidential Election will greatly influence the fate of PPACA and the direction of Health Care in the United States.

Key Provisions of the Patient Protection and Affordable Care Act (PPACA)

The Patient Protection and Affordable Care Act is a massive piece of legislation that has hundreds of provisions covering a multitude of different areas in the medical field. From attempting to increase the supply of health care workers, to provisions aimed at increasing medical care for Native Americans, the PPACA is a very large and complicated piece of legislation. Key provisions that will have the most noticeable impact on the United States will be discussed in chronological order and analyzed in order to help garner a better understanding of the broad implications and changes made by the PPACA.
2013-03-25 11:45:10 AM  
2 votes:
Of course, the lesson here isn't that our system of lobbying/political money is broken and needs major reform.  The lesson is that Obamacare = bad because (unlike every other law, apparently) it was written to benefit lobbyists.
2013-03-25 11:42:39 AM  
2 votes:

kiwimoogle84: small business employers


farking lollll
2013-03-25 11:41:47 AM  
2 votes:
The Heritage Foundation/Republican Party's health care plan from 1995 is a big corporate giveaway? I'm farking shocked. But thanks to our conservative politicians on both sides of the aisle, a real solution was never forthcoming.
2013-03-25 11:34:25 AM  
2 votes:
The US health care system is barbaric.  And there is no way it will get any better before it gets a whole lot worse.  But at least my pre-existing conditions will be covered starting in 2014.
2013-03-25 07:38:29 PM  
1 votes:

Biological Ali: How obvious does a troll have to be before you guys will stop responding to it (or at least trying to "debate" it)? Because this:

The Stealth Hippopotamus: The house is now on fire. Before? Nope the house was not on fire. No where near. We had a system people would travel around the world to use, the majority of people were happy with, and a vast majority of the people had access to. How what do we have?

You're not going to cover everyone
Most don't like it

And on top of it all it's killing jobs.

...is so obvious that even he's probably astounded at the number of bites he's getting.


Most of the better commenters I know don't respond to trolls in hopes of convincing the troll they're wrong; they respond to post accurate information and accurate responses for everyone else.
2013-03-25 06:48:23 PM  
1 votes:

mgshamster: One of the things we have to remember is that health care is weird when it comes to economics.  Normally, when two competing businesses operate in the same area, prices are driven down.  However, when you have two doctor's offices near each other, prices go up (or rather, demand goes up - and when demand goes up, prices go up).


This is a real phenomenon, and not just something made up by Ira Glass and libruls at NPR.

You might find these articles interesting:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

http://www.newyorker.com/online/blogs/newsdesk/2009/06/atul-gawande- th e-cost-conundrum-redux.html

TL;DR summary:
1) Utilization is definitely driven by the availability of providers.
2) Higher health care expenditure is not necessarily associated with better outcomes

Patients do not know what level of care is appropriate.  They are at the mercy of their treating physicians/surgeons to responsibly explain diagnostic and therapeutic options.  This is not to say that all physicians/surgeons are greedy assholes who purposely drive up costs to line their pockets - some are covering their asses to avoid potential lawsuits, some are more cautious than others by dint of personality or training.

The other problem is that most physicians/surgeons do not know the cost of the medications, tests, and procedures that they order.  They might know *their* fees, but it is a safe bet that they do not know the total cost.  For some reason, in America discussing the cost of medical care is crass and vulgar.  However, it is unreasonable that doctors and patients should remain totally insulated from the cost of medical care. Without knowing the cost, one cannot make a cost-benefit analysis.  I am not saying that the utility of all health care is quantifiable in dollars, but at some point you have to decide whether that anti-hypertensive still on patent that costs $180 a month is really worth the premium over a generically available ACE inhibitor that costs $10 a month at the Kroger pharmacy.  At some point you should have a discussion with your doctor about whether it makes sense to continue to take medications for your Type 2 diabetes, versus trying to get your BMI down from 40.  At some point you have to decide whether it is reasonable to continue to keep your 80 year old grandmother on life support after a massive stroke, if her prospects of meaningful physical or cognitive recovery that would allow her to live in a manner that she or her family would consider acceptable are low.

And no, I am not saying people need to shop around when they have a heart attack, ruptured appendix, or hip fracture.

All I'm saying is that some transparency with respect to prices and outcomes (from institutions and providers) would help a lot for elective, non-emergency health care costs.  I won't hold my breath, though.
2013-03-25 04:29:49 PM  
1 votes:
Health care reform, GOP strategy:

1) spend 40 years fighting it
2) spend 2 years making it as shiatty as possible
3) spend 3 years saying how shiatty it is
2013-03-25 04:19:20 PM  
1 votes:

The Stealth Hippopotamus: I've known and I'm married to someone that have had to live with single payer in other countries. They laugh at us. They actually laugh at us for our ego. Sure, it doesn't work over there but we're Americans!!!! We can make it work!!


Someone didn't watch the opening ceremonies of the last Olympics.  The UK LOVES their healthcare system.  Canada's pretty happy about it too.  Any other BS you'd like to spew that will be easily refuted?  You're on a roll.
2013-03-25 03:16:26 PM  
1 votes:

The Stealth Hippopotamus: A Dark Evil Omen: Look how stupid you are.

"significantly more satisfied with availability of affordable healthcare"

we'll it ain't the greatest but it's free. And we all know that people's perception is reality.

Let's compare wait times for major surgery.


See how stupid *you* are


Ok what's the wait time for surgery with someone who has no money in the US and has no insurance compared to someone in a country where they have universal single payer.

Opps you lost again.
2013-03-25 03:11:31 PM  
1 votes:

Bravo Two: verbaltoxin: Bravo Two: A Dark Evil Omen: Why are huge, unaccountable corporations better, though? There seems to be a gap in your argument here.

That implies that I think they are. I rather like a local doctor who has prices based on services rendered, like a small auto shop. I pay for what I use, and it's all local.

Huge corporations are no different than governments, just with less checks and balances, and a far smaller group of people with voting rights.


verbaltoxin: Bravo Two: verbaltoxin: I'm inclined to believe at this point you just don't know what you're arguing against; you're just against it because it's a government program.

I think that about sums it up. I have nothing but bad experience dealing with healthcare systems privately, bad experiences dealing with healthcare systems from the government, and very little trust or desire to see the government responsible for yet another thing.

If that's the case then you are at a huge disadvantage at explaining just why we shouldn't adopt such a program.The reasons our our government programs are so f*cked up are they're designed that way, because Medicare, Medicaid and SSI are NOT intended to care for everyone indefinitely, for they are insurance policies; and we have to compromise with groups who are against government doing anything useful. That's why our healthcare industry is a titanic clusterf*ck of semi-private orgs with one foot in corporate graft, and one foot in government waste.

I'm trying not to make single payer look like this cure-all, because it will have problems and will cost a lot of money, but also helps in smoothing a lot of this half-hearted bullsh*t out. It also takes the actuary, your boss, and shareholders out of the chain between you and a doctor. It is one, single price negotiator charged with getting the best rate for its customers; i.e. you, me and every other American taxpayer.

There's also a mountain of empirical evidence just across our Northern border showing that this system works. <b>At this point opposition is basically what you're saying: you don't like it because, government bad. If that's what you have, then that's pretty facile.

</b>

Yes, it's all they have.  That and lying--like the guy upthread who tried to conflate reimbursing providers for end-of-life counseling with pulling the plug on grandma.
2013-03-25 03:09:01 PM  
1 votes:

A Dark Evil Omen: Oh, and we have a term for this: Society. Even if you have the biggest bootstraps in the world, if the rest of us vanished you'd suddenly find it really hard to maintain your little survivalist shack.


There's also a term for self-described "libertarians" who take everything civilization has built handed to them on a silver platter and turn up their noses and say "phooey, who needs your society" : spoiled, selfish brats.
2013-03-25 02:34:14 PM  
1 votes:

Bravo Two: verbaltoxin: I'm inclined to believe at this point you just don't know what you're arguing against; you're just against it because it's a government program.

I think that about sums it up. I have nothing but bad experience dealing with healthcare systems privately, bad experiences dealing with healthcare systems from the government, and very little trust or desire to see the government responsible for yet another thing.


If that's the case then you are at a huge disadvantage at explaining just why we shouldn't adopt such a program.The reasons our our government programs are so f*cked up are they're designed that way, because Medicare, Medicaid and SSI are NOT intended to care for everyone indefinitely, for they are insurance policies; and we have to compromise with groups who are against government doing anything useful. That's why our healthcare industry is a titanic clusterf*ck of semi-private orgs with one foot in corporate graft, and one foot in government waste.

I'm trying not to make single payer look like this cure-all, because it will have problems and will cost a lot of money, but also helps in smoothing a lot of this half-hearted bullsh*t out. It also takes the actuary, your boss, and shareholders out of the chain between you and a doctor. It is one, single price negotiator charged with getting the best rate for its customers; i.e. you, me and every other American taxpayer.

There's also a mountain of empirical evidence just across our Northern border showing that this system works. At this point opposition is basically what you're saying: you don't like it because, government bad. If that's what you have, then that's pretty facile.
2013-03-25 02:20:33 PM  
1 votes:
So shut your pieholes and tell your US House Rep and Senators to support a single-payer, universal, primary-care health insurance system.  That's what Obama would love to jump to but he knew that you corporate-dick-gobbling goatfarkers would never go for it, and was stuck with making a deal with the devil. A bunch of douchebags -- who keep getting elected *BY YOU* -- are holding up the inevitable switch to the most efficient delivery of the aforementioned.  Meanwhile ~3/4 trillion bucks a year is misallocated to said private insurers, where they can grift off the top by denying essential claims and profiting on the back of others' prolonged misery, if not their ultimate deaths.

YOU jammed us in this position, so shut the fark up.

farking retarded voters in this country...

/AND NO, MORE PRIVATIZATION OF A PUBLIC GOOD/SERVICE WILL NOT HELP
//IT WILL ONLY EXACERBATE THE PROBLEM
/SO STFU YOU DUMBASS, KNOW-NOTHING, REASON.COM-READING JACKHOLES
2013-03-25 02:20:24 PM  
1 votes:
Bravo Two

Basic healthcare should be available to everyone, and how we provide it should change. But that doesn't change the fact that until we do something about the costs involved in PROVIDING healthcare, and the attitudes all around, all you end up doing is setting up a system that basically pays mostly what is asked by whomever, which then must in turn be recouped from taxes and other sources, thus making it so that instead of people paying whatever price they can get that's the best for them on the open market, they're taxed a fixed amount that the government figures is right for their coverage, since we have a huge debt and military burden we have to shoulder already.

So, while I do agree with your sentiments, I don't agree that a system that focuses only on coverage without equally reducing the costs as much as possible for the equipment/medicine/services being provided so as to minimize the impact in terms of new taxes.


You're making a lot of unfounded assumptions about a national healthcare system. We have UK, Australian and Canadian farkers. If you want to know how they're actually run, you could ask them, or look into it yourself.

Plus, as we've proven several times over the years, we're not so great at setting aside funds to cover just about anything, from the moving of Social Security to the general fund to then diverting funds meant for Social Security into other programs in lieu of an IOU that lead to some of the issues we're having right now with those programs.

Ah, this old chestnut again. Read "5 Huge Myths about Social Security."

Personally, I want to believe that medical offerings should be available such that I can see my Primary Care doctor for yearly physicals, go to a clinic if I have a nonemergency issue, and have emergency care that doesn't leave me sitting in a lobby for four hours, all basically free for most things, that would be a good thing.

The PPACA already mandates that preventative care not be charged to you. Your provider has to cover your physical. If you want the ER unclogged, then single payer is the way to do that. If people aren't worried about being bankrupted, then they are more likely to actually see the doctor before it's a last resort. That's what we keep telling you, but you continually ignore it. Also if you want cost controls, then imagine what happens when sick people have an incentive to get preventative care (As they do now, under current law), and healthier people aren't worried about a high doctor bill for something like a physical.

This part of the law is already in effect too. My physical cost me nothing. I only paid for laboratory work on my blood analysis. There is already incentive for me to go get my physical this year.

(or, basically, a community-agreed-upon trust system whereby everyone contributes to the trust, and everyone is entitled to withdraw up to a limit from the trust in cases of medical necessity, such as paying for major medical treatments).

That is what the public option was: everyone paid into it, and could use it for their medical treatment. That's what got axed from the early version of the PPACA. In single payer, you have a system where, again, everyone pays into it, and then it negotiates with health care providers for an affordable price. The provider gets paid regardless, and there is actually security in that. This can in turn save money, because nobody can skip on their bill. Everyone has already paid up-front through their taxes.

I'm inclined to believe at this point you just don't know what you're arguing against; you're just against it because it's a government program.

As it stands, however, I look at the way our government has handled managing funds for things like Social Security and Medicare/Medicaid, the former having been moved from having a separate, isolated fund to being part of the general funds in order to allow the government to use the equity there on other things in lieu of future returns, and the way our government handles waste, excessive spending on contractors and such, and the whole farked up system that is our healthcare industry with this mishmash of private entities, corporate interests, and federal laws all that end up leaving us with a morass of impossible complications, and I figure that maybe it's better that I find a way to deal with some stuff on my own than to expect a reliable, expedient government program.

The reason it's f*cked up is because our insurance is tied to a bottom line, and not keeping people from dying. Medicaid was "reformed" 20 years ago, and those reforms effectively punish you for even drawing from it. It's a pain in the ass to obtain, and a huge pain the ass to keep.

Medicaid is nothing like a universal healthcare program, and neither is Medicare. They are limited, restricted programs set up that way on purpose, because people like you are afraid of "moochers" ripping off the system. It's actually cheaper for you, yes, you personally, if everyone has to pay into the same thing and is guaranteed coverage and access. SSI, Medicaid and Medicare not those things. They act as contingency benefits. A universal system covers everyone, regardless of age, class or condition.
2013-03-25 01:55:59 PM  
1 votes:

BarkingUnicorn: HawaiiE: I hope we eventually get health care off the backs of employers. That will the biggest business tax break ever.

Why aren't businesses in favor of single-payer for this very reason?

I honestly don't know why the business community isn't the one advocating for single payer to free them to focus on their business.

What makes you think businesses don't favor single-payer?  Even Forbes mag has been beating the single-payer drum since last year. But it's a much bigger lightning rod than gay marriage, a subject upon which most businesses still keep their mouths shut.

Also, health insurance is still a significant recruiting and retention tool, if your business can afford it.


A business Forbes gives a sh*t about can afford it. They can also afford to support passage of single payer, yet I don't see anyone on the Fortune 500, or anyone ranked on the S&P index cracking a whip on their liveried Republican servants to get going on it. These companies could off-load that "benefit" and recruit talent by paying their workers more. (That's bullsh*t, by the way; if it's become vital to one's well-being then it's no longer a benefit. It's basically a wage in service form, and a sh*tty one at that.)

But no Fortune 500 company wants to do this. They'll swallow the cost of private insurance and defer paying their workers better wages and salaries, leading to the continuation of a near-40 year stagnation of middle class pay. All for what, you ask? A quarterly stock report reflecting "growth."

Forbes may have a tangential interest in single payer, I'm not sure. They aren't serious about it though, and nobody in business is doing anything but screaming about their taxes going up a couple percentage points.
2013-03-25 01:32:52 PM  
1 votes:
As a medical underwriter who will be losing his job by 01/01/2014 due to this new healthcare law, I'm getting a kick...
2013-03-25 12:57:58 PM  
1 votes:

The Stealth Hippopotamus: Obamacare or ACA was an unfunny joke played on the American people; can't afford healthcare? No worries we'll just fine you (dont worry you can cover that right?)


no it doesn't that work that way at all. If you can afford it you are not fined and your insurance gets subsidized. You are wrong.
2013-03-25 12:46:10 PM  
1 votes:

A Dark Evil Omen: TimonC346: A Dark Evil Omen: The Heritage Foundation/Republican Party's health care plan from 1995 is a big corporate giveaway? I'm farking shocked. But thanks to our conservative politicians on both sides of the aisle, a real solution was never forthcominG


Exactly. I feel like I only defend Obamacare because of the stupid myths I hear about it like "It's Socialism" or whatever other nonsense Fox News has crammed Into their viewership's weak brains--I honestly have to remind myself often it isn't the plan I really even advocate.

It's an improvement over the status quo ante, and that's all. I don't accept that it's this abomination of Communism that will doom your grandmother to the death panels and FEMA camps, but neither is it any more than a bandaid over a sucking chest wound.


It's a shame that much of this country is so brainwashed into fearing single-payer systems.  It would have been nice to circumvent Obamacare and avoid that growing pain altogether.
2013-03-25 12:36:59 PM  
1 votes:

TimonC346: A Dark Evil Omen: The Heritage Foundation/Republican Party's health care plan from 1995 is a big corporate giveaway? I'm farking shocked. But thanks to our conservative politicians on both sides of the aisle, a real solution was never forthcominG


Exactly. I feel like I only defend Obamacare because of the stupid myths I hear about it like "It's Socialism" or whatever other nonsense Fox News has crammed Into their viewership's weak brains--I honestly have to remind myself often it isn't the plan I really even advocate.


It's an improvement over the status quo ante, and that's all. I don't accept that it's this abomination of Communism that will doom your grandmother to the death panels and FEMA camps, but neither is it any more than a bandaid over a sucking chest wound.
2013-03-25 12:36:12 PM  
1 votes:

The Stealth Hippopotamus: vpb: So we are going to scrap the exchanges and just give everyone Medicare? You don't even know what Obamacare is do you?

Do you know exactly what it is? 'cause the people who help make it law don't even know. I know what they tried to do, and I know how it is unfolding. What this will end up being is anyone's guess but what has happened so far is a cruel joke and a complete waste of money and time.


Tell that to the millions of people that are now able to get insurance or stay on their parents' insurance that otherwise were not able to.
2013-03-25 12:34:59 PM  
1 votes:

Bravo Two: Single payer may be more efficient, but when you have so many bottom-feeders raping the system before it even gets to the consumer, It's going to turn into a giant flustercluck.

Effecting a lifestyle change is going to be difficult, and not the least bit because of the American Way of Life™ and our propensity for fast food and poor habits fed by companies that push vices via our Nanny Box.


This line is pushed by people who are against doing anything in the face of the fact that Americans are not unique in this, but somehow fat white people drinking soda and eating poutine does not make public health care in Canada not work.

Half of it's a chicken and egg problem; these pervasive health problems are health problems and having reasonable access to health care - which many of the people who are most affected by these "lifestyle" issues do not - is an important step to alleviating them. In other words, you're backwards.
2013-03-25 12:33:28 PM  
1 votes:

kiwimoogle84: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

I'm not ok with THE GOVERNMENT deciding whether I live or die.


But you're A-OK with an insurance company deciding that?  Amazing.  And before you say that they would never do that, take a look at the stories out there of people being dropped from their insurance once they REALLY need it and/or being told their policy doesn't cover whatever life saving treatment may be out there.
2013-03-25 12:33:12 PM  
1 votes:

A Dark Evil Omen: The Heritage Foundation/Republican Party's health care plan from 1995 is a big corporate giveaway? I'm farking shocked. But thanks to our conservative politicians on both sides of the aisle, a real solution was never forthcominG



Exactly. I feel like I only defend Obamacare because of the stupid myths I hear about it like "It's Socialism" or whatever other nonsense Fox News has crammed Into their viewership's weak brains--I honestly have to remind myself often it isn't the plan I really even advocate.
2013-03-25 12:25:15 PM  
1 votes:

kiwimoogle84: I'm just against this whole idea that everyone gets the same care


I just wanted to quote this as something someone actually said.
2013-03-25 12:13:20 PM  
1 votes:

Bravo Two: verbaltoxin: Probably not, but who cares? Either way it sums up the opposition to single payer: f*ck you, got mine.

You mean that the reality that people don't give a shiat about each other and are just as much driven by survival of the fittest as any other beast on this planet? And people will generally look out for themselves and their closest niche and ignore everyone else? *Gasp* say it ain't so! Now, if you'll excuse me, I've got work to do because ain't no one else going to come along and pay my bills for me.


Be careful! You may have to use Roads, Electricity and Sewage during your work day!

Wouldn't want to use any of those darn "Socialized" dangerous programs to assist you in your daily life!
2013-03-25 12:12:09 PM  
1 votes:

Bravo Two: if you'll excuse me


There is no excuse for you.
2013-03-25 12:10:33 PM  
1 votes:

Bravo Two: Now, if you'll excuse me, I've got work to do because ain't no one else going to come along and pay my bills for me.


Be sure to stay off our roads.
2013-03-25 12:05:04 PM  
1 votes:

pinual: I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.


One more reason we should have single payer. I'm going to keep repeating it, because it's f*cking true.
2013-03-25 12:05:03 PM  
1 votes:
I'd like to add that I don't want to be dependent on the government to ensure the safety of the food that I buy. If you don't inspect and slaughter the animal yourself, that's pure, unadulterated, Maoist, communism.
2013-03-25 12:01:16 PM  
1 votes:

pinual: I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.


www.mountainside-medical.com
2013-03-25 12:01:16 PM  
1 votes:
I honestly had forgotten that there are people in the real world who earnestly believe that Obamacare is some sort of government health insurance
2013-03-25 12:00:25 PM  
1 votes:

Masta Kronix: Whether or not these changes will result in more efficient and lower cost of care is something that will be determined in time.


You post all that for a conclusion that says "eh, who knows." I hope you got an F on that project.
2013-03-25 11:58:23 AM  
1 votes:

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


Having also wrked in healthcare, my experience was that private insurers like to dick around, but government likes to get people treated. I had a kid whose private insurance would rather pay for a MONTH in an acute care facility (about 4-10x more expensive than long-term care, depending; typical stay with us was 4-7 DAYS) than a year somewhere else - "somewhere else" having the caregivers better situated for him than us - because they were bickering with some OTHER entity (or entities) over who footed the bill and who was on whose network. Talk about coming between you and your doctor.

Also, "end of life consultations" = a conversation my dad had with my granddad's doctor (my grandfather had been living on machines for 4 months, had some advance directives and also a girlfriend, but had just taken a very serious turn) about their options:
1) Keep him alive indefinitely. It's expensive as hell and there's little hope, but yay he's alive.
2) Keep him on just those machines that do X, but not Y. No pain, and he stays around longer, but he gets to go in peace.
3) Shut down everything. It's not like he's suddenly going to wake up and dance the hora.

I won't bore you with the details, but that should be an hours-long conversation with a doctor (or two). Who pays for their time?
2013-03-25 11:56:26 AM  
1 votes:

kiwimoogle84: Fine. You know what? Go ahead and ignore all of my experience in a field that I know like the back of my hand. But it's not going to be pretty.

/exits stage left


We'll all come and ask you for your totally expert and not at all ignorant as shiat opinion when there is any government health plan to speak of instead of a massive private insurance expansion. Also DEATH PANELS.
2013-03-25 11:56:11 AM  
1 votes:

pinual: I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.


If you don't want healthy employees, then good riddance.
2013-03-25 11:52:20 AM  
1 votes:

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


Oh, You're so adorable! I just want to snuggle you!
i3.kym-cdn.com
2013-03-25 11:51:49 AM  
1 votes:

A Dark Evil Omen: kiwimoogle84: Jackson Herring: kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.

oh my god are you for real

like really really for real

Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.

I'm not a foil hat wearer or anything, but I've worked in government healthcare (Medicare and Medi-Cal claims) long enough to know that if you get too expensive to insure, they'll cut you off.

DEATH PANELS!!!


ZOMGZ!!!! Socializms gonna kills da Stephen Hawkings!!!!!
2013-03-25 11:49:09 AM  
1 votes:

kiwimoogle84: Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.

I'm not a foil hat wearer or anything, but I've worked in government healthcare (Medicare and Medi-Cal claims) long enough to know that if you get too expensive to insure, they'll cut you off.


Oh shiat, the death panels!!  OoooOOOoooOO~~~!!!!
2013-03-25 11:48:48 AM  
1 votes:

verbaltoxin: Medical device makers, health insurers, retailers and restaurants are waging what lobbyists call a coordinated effort to gain Senate Democratic support for overturning $130 billion in taxes that will be used to fund the new law, and repealing a mandate requiring employers to provide insurance coverage for full-time workers or pay a fine.

This right here is only feeding the oncoming demand for single-payer. The President couldn't wrangle single payer from blue dogs and teabaggers, so this was put into place. I said it once, and I'll say it again: PPACA was designed to suck just enough to make Americans finally cave and implement single payer.


And yet PPACA is still worlds better than the system we had before.

Which leads me to believe that, while single-payer/a public option might be inevitable, we're going to be living with PPACA for at least 15 more years. Barring some major change in the way healthcare works (independent of new law, I mean - something like a new scanner that can be MacGuyvered with household parts by a toddler with a learning disability and has 103% accuracy with a 3% error rate), it's far better than what we had, so most Americans will be fine with that for the time being.

Alternatively, we see how little things have changed, coupled with a new system (whether the new taxes and fees are higher or not, they'll seem higher - and people left and right will biatch about them, whether they're government fees or not), so people may be motivated to effect some real change.

// but then I put down the bong
// use take 1
2013-03-25 11:47:01 AM  
1 votes:
I've given up arguing about Obamacare. Three years of reading fark threads & Facebook posts have taught me that conservatives have no idea what the ACA does, and don't want to learn.

It's very odd behavior to me, if anyone has ever had a success story I'd love to hear it.
2013-03-25 11:45:46 AM  
1 votes:

Jackson Herring: kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.

oh my god are you for real

like really really for real


Probably not, but who cares? Either way it sums up the opposition to single payer: f*ck you, got mine.
2013-03-25 11:44:41 AM  
1 votes:

kiwimoogle84: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

I'm not ok with THE GOVERNMENT deciding whether I live or die.


WAAAAA, SOCIALISM!!

The health care industry has spent more than $700 million to lobby Congress and U.S. agencies from 2010 onward, according to the nonpartisan Center for Responsive Politics. Companies, executives and employees have poured millions more into the coffers of House and Senate members up for re-election in 2014

$700 million. All that NOT spent on providing medical coverage to millions.

Sure, let private industry stand between you and your doctor, not people we elect and can kick out if they don't represent us. Good move there.
2013-03-25 11:44:22 AM  
1 votes:

kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.


oh my god are you for real

like really really for real
2013-03-25 11:42:14 AM  
1 votes:

verbaltoxin: Medical device makers, health insurers, retailers and restaurants are waging what lobbyists call a coordinated effort to gain Senate Democratic support for overturning $130 billion in taxes that will be used to fund the new law, and repealing a mandate requiring employers to provide insurance coverage for full-time workers or pay a fine.

This right here is only feeding the oncoming demand for single-payer. The President couldn't wrangle single payer from blue dogs and teabaggers, so this was put into place. I said it once, and I'll say it again: PPACA was designed to suck just enough to make Americans finally cave and implement single payer.


IDK if it was designed that way, but I hope that's how it turns out.
2013-03-25 11:39:43 AM  
1 votes:
I hate to break it to you  Subby, lobbyists win no matter what the situation is.  They are the best political influence that money can by.  A government (initially) by the people, of the greedy and power-hungry, and for the richest corporations.
2013-03-25 11:39:17 AM  
1 votes:
Medical device makers, health insurers, retailers and restaurants are waging what lobbyists call a coordinated effort to gain Senate Democratic support for overturning $130 billion in taxes that will be used to fund the new law, and repealing a mandate requiring employers to provide insurance coverage for full-time workers or pay a fine.

This right here is only feeding the oncoming demand for single-payer. The President couldn't wrangle single payer from blue dogs and teabaggers, so this was put into place. I said it once, and I'll say it again: PPACA was designed to suck just enough to make Americans finally cave and implement single payer.
vpb [TotalFark]
2013-03-25 11:29:54 AM  
1 votes:

The Stealth Hippopotamus: vpb: So we are going to scrap the exchanges and just give everyone Medicare? You don't even know what Obamacare is do you?

Do you know exactly what it is? 'cause the people who help make it law don't even know. I know what they tried to do, and I know how it is unfolding. What this will end up being is anyone's guess but what has happened so far is a cruel joke and a complete waste of money and time.


Of course they know, or do you mean that they don't have every single detail memorized?

I'm sure they know that it isn't putting everyone on Medicare and making them pay a fine too, but the right wing derposphere has it's own reality.
2013-03-25 10:56:39 AM  
1 votes:
That's how Republicans designed it to work.
2013-03-25 10:39:27 AM  
1 votes:
Medical device makers on Thursday won a victory of sorts in the Senate, when more than 30 Democrats joined Republicans to approve a non-binding budget amendment calling for repeal of a 2.3 percent tax on medical device companies.

Once again, nobody actually cares about the deficit.
2013-03-25 10:27:14 AM  
1 votes:
"thrid?"
2013-03-25 10:21:27 AM  
1 votes:
In other news: People who are good at playing the game will continue to be good at the game no matter what rule changes you make.

Obamacare or ACA was an unfunny joke played on the American people; can't afford healthcare? No worries we'll just fine you (dont worry you can cover that right?) and give you medicare. 'cause we all know medicare is great and is the model of efficiency. And then ACA will make things more affordable by increasing costs!! Cause that's how economies works!
 
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