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Statesman
 
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Post 08 Mar 2017, 4:27 pm

fate
Uh-huh.

The Affordable Care Act is getting a lot less affordable for many Americans
.
All right.

In the US The percentage of GDP that was taken up by health care was 13.1% in 1990.
In 2014 it was 17.1%
Obama care came in 2012....

In the UK the numbers were 6.7% in 1990 and 9.1 % of GDP in 2014.
Denmark 8.1 % and 10.8%
France 10.1 and 11.5%

So its true that the US system always has been too expensive. At least compared to systems that provide universal coverage and similar or better health care. And its also true that health care inflation is greater in the US than in other countries. Even with the introduction of the crappy ACA.

But the ACA has set the bar now for certain things that in 1990 didn't exist. And weren't majority supported. Universal coverage is expected. (Even though most republican states resisting medicaid expansion has thwarted delivery of universal coverage in the US to date.).
How's Ryan Care going to make that happen?
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Post 08 Mar 2017, 11:23 pm

rickyp wrote:
But the ACA has set the bar now for certain things that in 1990 didn't exist. And weren't majority supported. Universal coverage is expected. (Even though most republican states resisting medicaid expansion has thwarted delivery of universal coverage in the US to date.).
How's Ryan Care going to make that happen?


Yup, it's set the bar for forcing Americans to buy coverage they don't need and can't use. It's set the standard for killing competition. It's set the standard for government overreach. It's set the standard for making healthcare unaffordable.
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Post 09 Mar 2017, 6:53 am

And yet Fate, the replacement being proposed has even more flaws. well, in the eyes of the AMA, AARP and the AHA....

While we agree that there are problems with [Obamacare] that must be addressed, we cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations," wrote AMA CEO Dr. James Madara in a letter to Congressional leaders. Madara also cited the bill's cuts to major public health and preventative health funds as unacceptable to doctors.
The AMA opposition follows action from both the 38 million-member strong AARP, which lobbies on issues affecting older Americans, and the AHA on Tuesday. "This bill would weaken Medicare’s fiscal sustainability, dramatically increase health care costs for Americans aged 50-64, and put at risk the health care of millions of children and adults with disabilities, and poor seniors who depend on the Medicaid program for long term services and supports and other benefits," wrote AARP senior vice president Joyce Rogers in a stark, and surprisingly detailed, letter to Congress.


http://fortune.com/2017/03/08/gop-healt ... p-ama-aha/

And of course, the individual anecdotes will pile up...like this woman. A republican Candidate in Wisconsin.
http://www.cnn.com/2017/03/08/health/ob ... index.html
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Post 09 Mar 2017, 8:37 am

rickyp wrote:
U.S. Health Care Cost Increases at Lowest Rate in Nearly 20 years: Aon


http://www.insurancejournal.com/news/na ... 388800.htm

If slowing health care inflation isn't good, i don't know what is...

But Fate, the point of my post wasn't to support the topic specifically but to point to the collapsing attempts to repeal and replace the ACA....
Mostly this is fueled because the promises made about "repeal ad replace " "with something better" can't be met.
And because the majority of Americans now expect health care is a right and Americans should be entitled to access that is both affordable and high quality.

That's a huge mindset change since the ACA was introduced. Due to 6 years of experience of the ACA. Especially in those states that expanded medicare.
Do you think the new RYANCARE has a chance?


The article you posted shows your ignorance. It's an insurance company view and it is a survey of large employers. However, the ACA impact has been at the individual level. The premium rises are occurring for those of us who work for small companies where premiums have increased substantially. We are being required to purchase very expensive insurance which includes items that we don't want. If we don't, we get penalized. The benefit of the ACA is if you don't make money, the government pays for it. But for the rest of us it is very expensive. Also, the government cost is unsustainable without changing the dynamics of the health care industry. (I've heard it is 1/2 of Mass's budget.) The ACA did not attack that so we are caught in the bind of powerful health care providers and powerful health care insurers and endless medical need, some of it real, and some of it imagined, and some of it just so the hospital doesn't get sued, or the doctor is curious.

Dems complain about insurance companies, but they gave them the ultimate gift -- requiring that people buy their services, and offering to pay for it if they can't..

Now hospital and doctor orgs are fighting tooth and nail against the Republican plan, partially because they care, and partially because of the gravy train.
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Post 09 Mar 2017, 9:00 am

The important step that the ACA has done is make most Americans recognize that in a wealthy country health care is a basic right. When people want to get health care costs under control they will turn to single-payer. Before, a good proportion of the population might have had good health care at a reasonable cost, but that came at the expense of many people not having health care because of pre-existing conditions or they were too poor or they were 50-65 and premiums were too costly. The old system was immoral in a wealthy country; I don't see how a reasonable argument could be made for it, except out of pure selfishness. So we can't go back. Single-payer is the only system that will cover everyone and keep costs under control. The Republicans' plan to fix the ACA is garbage.
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Post 09 Mar 2017, 9:08 am

The important step that the ACA has done is make most Americans recognize that in a wealthy country health care is a basic right.

That statement is simply imagined, trying to paint Obama in some light he does not deserve.
The ACA in absolutely NO way does this. It requires people to pay for insurance. If it were a basic right, then my costs would not have risen as much as they have, I would not have to pay for my family more and more each and every year.
You want universal coverage...fine. But puh-lease do not give any credit to this insipid Obamacare nonsense we now have.

Yes the new plan is garbage
But so is the current Obamacare plan and most liberals are firm in their stance that any attempt to make it better will be ignored. Dems don't want things better, they want to be the ones who make it better or they will not accept any change whatsoever.
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Post 09 Mar 2017, 9:14 am

It was not possible to go to single-payer directly. There is now resistance now to kicking people off of Medicaid and those who bought insurance under subsidies. Those who are paying higher premiums are unhappy. Viola! Single-payer....Seems kind of brilliant to me.
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Post 09 Mar 2017, 9:39 am

Viola? Perhaps you meant as easy as cello? :winkgrin:

The easiest thing is to have doctors who get tuition assistance for their upcoming career serve in public hospitals for 5 years. The care there could be government mandated to whatever level they would deem. People could choose where they would go. If you wanted a different level of care, then, as a consumer, you could choose an insurance plan that would cover what you (again as a consumer) would desire, and at what cost. The only mandate from the government would be to those who accepted the government monies.

Seems even more freedom based.
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Post 09 Mar 2017, 11:17 am

freeman3 wrote:It was not possible to go to single-payer directly. There is now resistance now to kicking people off of Medicaid and those who bought insurance under subsidies. Those who are paying higher premiums are unhappy. Viola! Single-payer....Seems kind of brilliant to me.


I don't see insurance companies relinquishing their power and profits on this. Do you? The downside of any government program is you create winners who will fight to protect the program as if their livelihoods depend on it, since they do.
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Post 09 Mar 2017, 1:51 pm

Let me get this right,
You want to try and tell us Obama was soooo smart, he created a system he knew would fall apart in only a few short years just so a universal plan would then be desired? His colossal mistake was actually planned? Wow, that's just giving him credit he doesn't deserve. almost God-like qualities. I heard it all now.
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Post 09 Mar 2017, 2:22 pm

Well, RJ, I think it would be worthwhile buying out the insurance companies if it came to that.
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Post 10 Mar 2017, 6:27 am

rayjay
However, the ACA impact has been at the individual level. The premium rises are occurring for those of us who work for small companies where premiums have increased substantially.


Sure. Depending on the state and your personal circumstance that include access to subsidies.

1. Cherry-picking premium costs. The numbers Ryan cited are scary: Premiums for a benchmark plan in the ACA marketplace rose 59 percent in Minnesota this year, 53 percent in Pennsylvania, 63 percent in Tennessee, 58 percent in Alabama, 69 percent in Oklahoma and 51 percent in Nebraska. “Arizona,” he said, “clocked in at a 116 percent increase in their health insurance premiums with Obamacare.”

His numbers aren’t wrong—they come from a report from the Department of Health and Human Services, released last fall. But Ryan is cherry-picking the states with the highest premium increases. He doesn’t mention that premiums rose just 2 percent in New Hampshire, 5 percent in New Jersey, 2 percent in Ohio or 2 percent in Arkansas. In Indiana and Massachusetts, premiums actually fell. He also doesn’t mention that Americans are often protected from those rising premium increases by their subsidies, which increase as premiums rise. That’s not free—the extra cost is borne by taxpayers—but it draws an inaccurate picture of how premium hikes are actually hitting enrollees nationwide
.
http://www.politico.com/agenda/story/20 ... ure-000349

ray
Also, the government cost is unsustainable without changing the dynamics of the health care industry

Absolutely true. And the ACA did not do anything particularly substantive about this.
But Ryan Care does even less.

Stuff like buying insurance across State lines presmes that this "competition" will decrease costs. But again, this doesn't attack underlying health care inflation. Insurance is just overhead and in the US is adding 8 to 12% on top of actual health care costs. (Actual administration costs and health insurance profits.) Single payer systems cut that administrative costs to 2 to 3%. All over head...
The US insurance system is entirely superfluous. Competition across State lines would have a negligible effect..
What else in Ryan care is going to actually attack health care costs?
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Post 10 Mar 2017, 6:35 am

Tom
Yes the new plan is garbage

Glad you admit it.

But so is the current Obamacare plan and most liberals are firm in their stance that any attempt to make it better will be ignored. Dems don't want things better, they want to be the ones who make it better or they will not accept any change whatsoever.


So how does this new garbage plan improve the old garbage plan?

ray
The downside of any government program is you create winners who will fight to protect the program as if their livelihoods depend on it, since they do
.

That's the downside of the system before the ACA and with the ACA too.
Conservatives always talk about running government like a business. No business would tolerate superfluous over head. Nor would any business tolerate monopolistic relationships.
When that happens, such as with utilities supplying water... government regulates costs/prices.
Negotiation between health care industries and government is the only way that health care costs can be significantly impacted.
And that really only can happen with a single payer system.
Give Trump he's due. He said he would negotiate with the pharmaceutical industry to lower drug costs.... we'll see how he accomplishes this or whether it was just campaign BS.
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Post 10 Mar 2017, 7:08 am

The new plan is garbage, we agree.
How is it better than the current garbage plan???
At least it can sustain itself. The Obamacare plan is falling apart FAST and simply can not continue, it's imploding.

a few things I found pretty funny in Ricky's posting
He states competition across state lines would help reduce costs yet still stands by the Obamacare plan,He try's to downplay HUGE price increases in some states (many states that is) by cherry picking data (that he complains others are doing) where some states had modest increases only to slight decreases. Problem is, the increases far outweigh the decreases now don't they and nobody can champion such dramatic increases in so many states ...yet he CHERRY PICKS the data himself to point out it's kinda-ok is a few states, he calls the Obamacare plan "Current garbage" but again stands by it. Let's not try and reduce cost or try and fix anything, well not as long as any fixes are suggested by Republicans seems to be his reply.
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Post 10 Mar 2017, 1:35 pm

tom
He states competition across state lines would help reduce costs

Actually I don't Tom.

rickyp
Competition across State lines would have a negligible effect.
.

tom
How is it better than the current garbage plan???

The individual and employer mandates are eliminated. They’re not repealed exactly, but the penalties are repealed, which amounts to the same thing. What this means is that healthy young adults would not buy coverage till they needed it. And they could because pre-existing conditions don't disqualify them. This totally distorts the insurance pool and will cause premiums to go up... (People won't be paying premiums until they are also in a position to draw benefits)

Essential health benefit rules are repealed. As of Dec. 31, 2019, ACA rules that required qualified health plans to provide hospitalization, maternity care, mental health services and other benefits would be sunsetted at the federal level. States would have the authority to set them instead. The impact on private, non-Medicaid plans would therefore vary by state. If a state removes maternity benefits, for example, that’s likely to make maternity coverage, among other services, immensely expensive, if available at all.

Income-based premium subsidies would be replaced by age-based subsidies, which will hurt working-class families in many states. Under the ACA, subsidies to help individual buyers afford premiums and (for poorer households) deductibles and co-pays were based on household income. The GOP measure will base them on the buyer’s age, instead, with older buyers receiving more help than younger. The GOP plan limits subsidies to $4,000 per individual; under the ACA, which also keys subsidies to the cost of benchmark insurance plans in the buyer’s home market, the subsidies theoretically could be several times higher. No family could receive more than $14,000 in subsidies, and no more than five family members could be eligible for subsidies.

http://www.latimes.com/business/hiltzik ... story.html