The GOP and the ACA

[Dave Roberts]

It seems that there is a missing element in the reporting on the repeal of the ACA. It's not the insurance the GOP hates, It's the fact that the richest among us are having to help pay the subsidies. Here is the article:

[William Thornton]

Middle class folks are being tapped to pay for insurance for those who were uninsured. unfortunately gummit has no money except what they print or take from folks who have been responsible enough to earn it.

It was a mess preobamacare. It's a mess now. I'm not clear on how trump can clean it up.

[Dave Roberts]

I'm old enough to remember when Medicare was adopted. The original bill had a number of problems, but Congress, over the next five years or so, crafted solutions and adopted them. Now we would rather make partisan points than to solve problems and appeal to our base rather than to the good of the whole. Sad state of affairs.

[Lou]

If the richest among us are able to use the arcane intricacies of the tax code to avoid paying taxes, as they are frequently excoriated for doing, how is it that they are paying for the ACA (even if their ultimate contribution is only a token amount)? Color me confused. William is correct that it is the middle class that is footing the bill.

[Dave Roberts]

[Lou]

[Haruo]

The middle class will also foot the bill for the return to pre-ACA treatment systems and for the fallout from lack of care where that results.

[William Thornton]

[KeithE]

You guys just simplify the situation to say "the middle class pays" or the "wealthy pays" or 'the poor pay nothing'. I could add the 'those in their 60's pay'.

Truth is all classes and age brackets pay a share. Speak with more precision else it is just angry screeds. Yes the young and poor pay less but that is how it should be.

The poor deserve a break; where are your ethics?? The young need less care and I assume that is Actuararily suitable.

If Trump / Congress gets to single payer, our country will have done the right ethical thing for all.

I'm waiting for Brandy to finish an endoscopy in a fantastic Medical complex in downtown Chicago

[KeithE]

While I wait in this very upscale medical complex complete with an over abundance of fancy furniture, boutiques shops, big screen tvs, restaurants, I see one reason why our medical costs are so high. It is nice but not as needed as cheaper health care.

Think about your town - what buildings are the newest and fanciest? My town it is hospitals. banks and the larger aerospace companies. My daughter is just now getting anestisized(sp?) by an anestisist ( sp?) who probably draws at least $500K a year min. You can't tell me that some price controls would not make health care more affordable. Free market is not working for all! When the exploiters got you needing them and only them, they can and do exploit. We can and should do better for all especially those suffering from
Ill health.

And on one of those big screen TVs I witnessed Franken take down Price for insider knowledge based stock purchases through special "offerings".

So I'm for more price controls and a Price rejection

[Sandy]

Well, basically what we had prior to the ACA wasn't working. Premiums were increasing at a rate that was ten times or more higher than the actual inflation rate, as were co-pays and deductibles.

What's been interesting to watch is the development of public opinion toward the ACA. Most of the opposition to it, the screeching, hollering and shrieking holy horror when it first came about, was from right wing extremist sources or the obstructionist Republicans who never bothered to explain exactly what it was that they so opposed, and never informed people of the actual benefits that were provided. What it took was actually getting people on the programs and exchanges, and covered by the insurance for a slow, gradual realization to occur that, hey, this really isn't the "mess" that the extremist obstructionists are saying it is. Most of the problems and the stuff that gets highlighted in the press are isolated instances, not overall, major problems. Any number of sources can be googled to point to the relatively tiny number of people who got caught in some kind of "mess" based on changes in the kind of policy they held before the ACA.

I said, a couple of years back, that once the learning curve and lag time on this thing cleared, and false impressions and propaganda were overcome with fact, a majority of Americans would be fine with the ACA, and that now appears to be the case. People are finding out that they like things like coverage for pre-existing conditions, extended coverage for children, an 80-20 split for spending on actual care as opposed to operational costs that include profit margins, the co-pay and prescription coverages, what's not to like? Yeah, a few companies have backed away because they don't like limiting their profits to multiple millions instead of billions, but can you imagine how well a system like this would work if the primary motivation of the insurance providers was actually serving people, instead of using a government initiated program as just another scheme to get rich without actually providing anything in return? Gosh, we might actually get to the point where we'd have the quality and speed of medical care that is delivered to the Germans, Swiss, Danes, Dutch, and Canadians.

[KeithE]

I basically agree with you Sandy but I doubt the 10 times inflation rates bit.

Having gone thru Brandy's major illnesses, I'm not impressed with American health care especially the speedy part. She has waited months for important appointments often with her health declining and only told at times it is all in her head (then be vindicated by tests thereafter) - especially bad has been ER rooms. More and cheaper care is needed and guess what that adds jobs. But instead we have specialists making sure they have a high priced monopoly (whether they are aware of it or not).

We can and should do better.

I've been pleased with Medicare and its low administration costs ( less than 2%) compare in health insurances with their big campuses (e.g. In BCBS in Birmingham) which is well over 10% in admin costs (17% if memory recalls).

Big Pharma has been overcharging for decades. Price has just said he is not in favor of cheaper drug buys like from Canada - guess he has some more stock purchases in mind. Guess I'm getting a bit cynical here, but little pills do not cost that much to produce and neither does drug qualification which Big Pharma gets paid for as well - then they use that as justification for high drug costs. I have seen their big gated campuses as well. Hoarding intellectual property should not drive costs up as much as it does.

Chris Murphy (D- Conn) is now taking on Price for his stock ownership with 6 drug firms and his legislative positions always limiting big drug buys from cheaper sources. His answer is his stock broker picked all of them - possible but I'll have to check that out later.

And Sandy is right about other countries are doing it better, faster and often at half the cost.

[Sandy]

http://www.usinflationcalculator.com/in ... s/1000357/

Based on that information, the increase that my employer paid for premiums on the Aetna policy I had that same year was 23.5%. That may be an isolated instance, though it appears not too far off the mark of what was happening at the time.

http://kff.org/health-costs/issue-brief ... tion-2008/

[Jim]

The thing to remember is that ACA was designed to fail, as proven by the MIT genius Gruber, who admitted he was paid (some say $400,000) to write the act so nobody could understand it, as acknowledged by then-Speaker Pelosi. Predicated on service by insurance companies that are not in business for health-reasons but to turn a profit, ACA was used by those companies until they began to lose money—entirely predictable from the start—at which time they started pulling out in 2015-16. The plan was to then put “single payer” in place as the last resort (Bernie Sanders/Clinton/Obama socialism-approach). The employer mandate was supposed to have been inculcated years ago but Obama, in violation of his oath to uphold the laws, never enforced it, knowing that his legacy would be totally deep-sixed by the resulting fiasco (remember employers gearing-up for the 30-hour work-week). No republican in Congress voted for the act and it was universally unread by those who did, not that it mattered since it was written precisely to be obfuscatory, especially to the legislators. It was passed by some kind of technicality (negating the filibuster) at Christmas Eve midnight in 2010. It was egregiously codified by SCOTUS Chief Justice Roberts, who identified the “fine” described in the act for those not buying insurance as a “tax.” The government may not “fine” people for not buying something they don't want but Roberts had his reasons, the main one probably being that the government can “tax” people, ergo, he just changed the act, a sort of executive action much appreciated by Obama. Obama may not have understood the act since he lied through his teeth about one's keeping his/her insurance and doctor, for instance...or maybe he did. Who knows? In any case, it needs to be understood that healthcare for everyone, regardless of methodology, will cost gazillions and people should prepare themselves to pay for it (I have no argument with that), meaning a colossal redistribution of the wealth if the international defense obligation is adhered to, also.

[Dave Roberts]

[Jim]

[Sandy]