Will Obamacare succeed where term limits failed?

This could be the best thing to come from Obamacare....

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Dozens of lawmakers and aides are so afraid that their health insurance premiums will skyrocket next year thanks to Obamacare that they are thinking about retiring early or just quitting.

The fear: Government-subsidized premiums will disappear at the end of the year under a provision in the health care law that nudges aides and lawmakers onto the government health care exchanges, which could make their benefits exorbitantly expensive.

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This is too delicious. The people that wrote and passed the law are now talking about quitting their jobs to avoid being subject to it....

I would cynically state that they would just amend the bill quietly to keep their privileged status, but that would require them to actually pass something. Unless it was hidden in a larger, unrelated bill it's not politically feasible, and an unrelated bill large enough to hide the amendment isn't going to get passed, because, well, Congress.

Sounds like a good way to get a great health system, force the lawmakers and aides to use the same system as everyone else...

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Originally Posted by Gelatinous Cube

Who's everyone else? The upper-middle-classer who thinks they're struggling because they have to pay a hefty premium?

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That would be me. And I spent a ridiculous amount of time this week battling with a hospital that was double-billing my family. Anyone who defends the status quo of our medical system is delusional, probably blinded by ideology.

I remember when the debate over healthcare reform was going on, I kept asking my more rightwing friends, "Show me an example of market-driven healthcare on a national scale that works." Inevitably, they could not. Which tells you everything you need to know. Much like communism, profit-driven national healthcare sounds good in theory. The fact that it's unable to show results in the real world? Don't confuse us with empiricism.

Still, you haven't seen the worst solution, Lemur: New Public Management (NPM).

Properly implemented, this brilliant idea captures the positives of both the market-driven system and the government system. Then it decides to shed all of those, and instead focus on combining the worst aspects of both. Brilliant, I say. No freedom, no choice for the patient, an anal adherence to rules and regulations, time wasted on billing other departments and spiraling deficits.

I Love Thatcher and Blair, I really, really do. I love them so much I wish them to go somewhere very warm in the afterlife.

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Originally Posted by Gelatinous Cube

We need a universal option, with universal standards and universal accountability. Its only fair.

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Since healthcare isn't equal, we need to have government lower the standards until they're equally bad for all. :yes:

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Originally Posted by Lemur

I remember when the debate over healthcare reform was going on, I kept asking my more rightwing friends, "Show me an example of market-driven healthcare on a national scale that works." Inevitably, they could not. Which tells you everything you need to know. Much like communism, profit-driven national healthcare sounds good in theory. The fact that it's unable to show results in the real world? Don't confuse us with empiricism.

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None of this justifies passing Obamacare. It makes healthcare more expensive and doesn't solve any of the problems it set out to address.

Edit:
Here's more...
Coverage may be unaffordable for low-wage workers

An interesting take from Ramesh Ponnuru:

Conservatives and Republicans in Washington — activists, strategists, politicians — are increasingly embracing a theory about Obamacare: It’s going to collapse of its own weight, and its failure could yield a sharp right turn in the 2014 and 2016 elections. That theory is probably wrong, and dangerously so. To be rid of Obamacare, Republicans will have to do more than just wait for it to go away — and more than they have done so far. [...]

Republicans’ confidence that Obamacare will collapse has contributed to their lassitude in coming up with an alternative. It is a perverse complacency. If the program were going to collapse in the next three years, it would be all the more important for Republicans to build the case for a replacement for it.

Problem with a market model for medical care is that it is not a fair buyer-seller relationship.

Often the buyer has to be healthy to get insurance. Wait months before being eligible for various benefits and a lot of insurance benefits tie your medical procedures to the insurers preferred choice. So you have buyers who spend money to get a delayed benefit as determined by the seller, to deal with scenarios which are not always elective for the buyer.

Also it is a highway mans dilemma "Your money or your life". So the rates get ratcheted up and up as time passes. As you become more at risk your premiums go up. So for a lot of retired people it is not an affordable option.

Universal health care provides a baseline access. With private healthcare mixed in it shortens the wait time for those paying for it and the universal healthcare provides a minimum level of competition and covers any overt or covert private health gaps. Also every person who moves to private health should in theory shorten the queues in the public system. However specialists are a limited resource that in Australia have a quota as set by their own colleges. So it doesn't really shorten the line for public health.

Universal healthcare provides here a free to play option. Private health provides bonuses such as queue jumping and a private room.

Get the combination right and you have a cos efficient synergy. Get it wrong and you double up all that is wrong in both big government and big business.

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Originally Posted by Papewaio

double up all that is wrong in both big government and big business.

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Yeah, that's the hybrid jackalope we managed to create here in the States. It may be hideously expensive and bureaucratic, but at least we get middling to sub-par results.

Who's everyone else?
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I was mainly referring to the working/middle classes...

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Originally Posted by Gelatinous Cube

A misleading label, in my opinion. Much of the working class in in poverty, and the middle-class is in fact rich by any standard that isn't coming from a perspective of considerable wealth. If you want Congress to get the point, make them live like the lowest common denominator for a month or so. Hell, that should be like a rite of initiation for politicians--you could even make a reality TV show about it. :creep:

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The US has no concept of classes. When a factory worker or plumber can call himself middle class, you know society is on the wrong path... Fear of the reds, I guess.

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Originally Posted by HoreTore

The US has no concept of classes. When a factory worker or plumber can call himself middle class, you know society is on the wrong path... Fear of the reds, I guess.

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Plumbers actually make good money.

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Originally Posted by drone

Plumbers actually make good money.

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Yes, the working class can make good money. As I said, the US has no concept of classes. A plumber is working class, no matter how much money you throw at him.

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Originally Posted by Gelatinous Cube

Every country has a concept of class, we just do it differently than Europeans. To say we don't have a concept of classes is just silly.

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A plumber can call himself middle class. That's silly.

You're all terrified of being workers.

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Originally Posted by HoreTore

Yes, the working class can make good money. As I said, the US has no concept of classes. A plumber is working class, no matter how much money you throw at him.

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If a plumber is self-employed and runs his own plumbing business is he still working class or is he a member of the bourgeoisie?

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Originally Posted by Tuuvi

If a plumber is self-employed and runs his own plumbing business is he still working class or is he a member of the bourgeoisie?

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Then he's moved up to middle class, the petty bourgeoisie. He owns his own means of production, but he is still forced to sell his labour on the market. If he opens a factory producing plumbing equipment, he's a capitalist.

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Originally Posted by Gelatinous Cube

What kind of car you drive, what kind of neighborhood you live in, how you can afford to raise your family, the standard of medical care you recieve, whether or not eating out as a family at a restaurant is something you can even feasibly do, these are things that would indicate your class. What kind of work you do to achieve your standard of living is something pretty far down the ladder.

I like how your apparently some kind of authority on American society. When did you live here? How many different sides of America have you seen? Who's terrified of being workers? Most of the people I know would kill somebody to get a chance to go to trade school.

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The bolded part shows you've got it all turned on its head. The means of production, ie. how you earn your living in your relation to those who contribute or benefit to that income, is what determins your class. Your cultural standing is largely irrelevant, though some like to use those factors to juggle you around your class(like saying "lower, upper, educated, etc" working/middle class).

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Originally Posted by Gelatinous Cube

That you think class is determined by sitting back and calculating some formula is pretty indicative of your class. :shrug:

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I'm a teacher, thus working class. Some like to say I'm part of the "educated working class".

I know the brits like to include family and social relations in their class defintions, and I see some sense in that, at least in the British context(not so much for more egaliatrian societies).

My defintions are the marxist definitions of class. I don't know where you got yours, but since they're obviously not marxist, they're wrong ~;)

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Originally Posted by Gelatinous Cube

That's my point. Your definitions come from a book, because you're part of the comfortable classes. Middle or upper middle, whatever. The reality is that class is determined by what you have control over and what you have access to. Wealth passes in and out of middle-class and even many wealthy families so fast that your old definitons of basing it on how they got the means is kind of outdated. Especially in America.

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It's based on a tradition, the tradition which created the concept ~;)

Even the poor think they're middle class who just have a temporary low.
It takes the market to break them for several years to maybe perhaps make them declare themselves poor.
But in their hearts they will still think they should be middle class and the world around them is treating them unfairly.

Even the rich want to be middle class but the poor chaps are unable to spend their money as fast as it flows in, after a while they just give up as well.

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Originally Posted by Husar

Even the poor think they're middle class who just have a temporary low.
It takes the market to break them for several years to maybe perhaps make them declare themselves poor.
But in their hearts they will still think they should be middle class and the world around them is treating them unfairly.

Even the rich want to be middle class but the poor chaps are unable to spend their money as fast as it flows in, after a while they just give up as well.

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That's the problem with US(and increasingly european) class thinking: you're either poor or you're middle class, the working class has ceased to exist. That's not how it actually is. We've got more and more wage-labourers replacing more independent workers(think the franchise system for shops), so the middle class is smaller, and we've got a record high employment rate meaning that the poor class is smaller.

The working class has become bigger, while the lumpenproletariat and middle class has shrinked(meaning things go according to Marx' predictions).

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Originally Posted by Gelatinous Cube

Who's everyone else? The upper-middle-classer who thinks they're struggling because they have to pay a hefty premium? The homeless guy who has to use the Emergency Room? The Soldier who gets all the second-rate dental work he wants (seriously, I got fillings that look like they were done in rural mexico)? Even the rich with their concierge doctors have their downsides--Michael Jackson got killed by his, after all.

We need a universal option, with universal standards and universal accountability. Its only fair.

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But are you willing to pay the higher taxes that will come with better, universal healthcare? You don't get anything for free, especially when doctors continue to get paid $400,000 a year.

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Originally Posted by FoxLeLay

But are you willing to pay the higher taxes that will come with better, universal healthcare? You don't get anything for free, especially when doctors continue to get paid $400,000 a year.

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Does it matter whether you pay 200$ a month in taxes or 4800$ when you see a doctor every two years?
What's easier, to plan your monthly budget or to prepare for something that may happen ten years down the line?
If you have to take a credit every time you get an expensive health care bill then you also have to add the interest that you pay on the credit to the total cost.

And that's assuming everybody gets the treatment they need either way, of course without universal health care you can let hospitals refuse poor people and watch them die on the streets. If they are forced to treat them for free then they will surely add the cost that is incurred on top of the treatment for other patients just like a convenience store has higher prices for everyone to make up for the losses due to theft.

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Originally Posted by Husar

Does it matter whether you pay 200$ a month in taxes or 4800$ when you see a doctor every two years?
What's easier, to plan your monthly budget or to prepare for something that may happen ten years down the line?
If you have to take a credit every time you get an expensive health care bill then you also have to add the interest that you pay on the credit to the total cost.

And that's assuming everybody gets the treatment they need either way, of course without universal health care you can let hospitals refuse poor people and watch them die on the streets. If they are forced to treat them for free then they will surely add the cost that is incurred on top of the treatment for other patients just like a convenience store has higher prices for everyone to make up for the losses due to theft.

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But that's the problem. Do you really you want to pay higher taxes? I don't think everyone's getting the point. Not only taxes will go up, which would defeat the purpose of universal healthcare anyhow because you will be spending that money elsewhere, thus no savings, but if you don't go to the doctor's and take advantage of what you are paying....

Then the money will be use for someone else, thus, it be no better if someone is treated for free and the cost is put off on other insured people.


Either way, you will not make out. Only these greedy doctors will make out, that's it.

What is the income tax rate in the US?

I'm paying 40%. You either pay taxes or borrow money from other countries.

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Originally Posted by FoxLeLay

Not only taxes will go up, which would defeat the purpose of universal healthcare anyhow because you will be spending that money elsewhere, thus no savings, but if you don't go to the doctor's and take advantage of what you are paying....

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This argument conveniently ignores the documented fact that single-payer healthcare programs are cheaper than our capitalist-socialist jackalope system. By a factor of at least 45%, if not more, depending on the system chosen for comparison. Our system is the most expensive in the world, by long margins. To argue that other systems yield "no savings" is either ignorant or mendacious.

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Originally Posted by FoxLeLay

Not only taxes will go up, which would defeat the purpose of universal healthcare anyhow because you will be spending that money elsewhere, thus no savings, but if you don't go to the doctor's and take advantage of what you are paying....

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You mean there are people who never get sick and then suddenly die? There are also cars and houses that are never set on fire but people tend to get insurances for them.

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Originally Posted by FoxLeLay

Then the money will be use for someone else, thus, it be no better if someone is treated for free and the cost is put off on other insured people.

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No, why? It's not like other people become sick more often just because you are healthy. If people don't go to the doctor the taxes/fees can be lowered. Especially if the system is operated properly whereas a private insurance will just pay out the excess money to shareholders or pay bonuses to managers.

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Originally Posted by FoxLeLay

Either way, you will not make out. Only these greedy doctors will make out, that's it.

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Not all doctors are greedy and most single payer systems have a limit on how much 5 minutes at a doctor or certain medications can cost.
I'm not sure whether we handle the doctor thing well here as there seem to be some problems but with medications there are tests and if a cheaper medication yields the same results as a more expensive one then the more expensive one will not have to be covered by basic insurances. It's not that every universal health care system is flawless but they're all better than what the US has now.

To say it's better to do nothing if the result of doing something is "only better but not perfect" is quite weird IMO.

A recent Gallup poll finds the 41% of small businesses have frozen all new hiring because of Obamacare.

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Forty-one percent of the businesses surveyed have frozen hiring because of the health-care law known as Obamacare. And almost one-fifth—19 percent— answered "yes" when asked if they had "reduced the number of employees you have in your business as a specific result of the Affordable Care Act."

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Yeah, I get that our old system was bad- but in the rush to "Do Something", we've made it much worse. This is a complete mess. :no:

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Originally Posted by Gelatinous Cube

That only proves that 41% of "small businesses" are cheap. It is a well-known fact that small business and large businesses have used the economic climate as an excuse for predatory hiring practices. Crying wolf and cutting costs, that's all they're doing.

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They're not hiring because of increased regulatory burden from our government. Whatever subjective personal views you wish to attach to it are immaterial to the fact that they're not hiring. As both parties seem fond of pointing out, small businesses account for most of our employment. If 41% have stopped hiring and 19% have reduced staffing due to government action.... that's a problem.

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Originally Posted by Xiahou

small businesses account for most of our employment.

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It doesn't matter how many politicians like to say that, it still isn't true.

Big government and big business are responsible for employment in the US and all other industrialized countries. Also, the US defines "small business" as up to 500 employees... Not exactly your neighborhood bar, now is it?

Pure rhetoric, no substance. Capitalism acting as it usually does.


Also, a job that does not enable you to live a good, healthy life is an irrelevant job and should be cut.

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Originally Posted by Gelatinous Cube

So says you and them. From the point of view of people trying to get and keep minimum wage jobs, it is pure exploitation. It is actually more profitable to be a community college student and survive on student loans than it is to attempt to get and keep a job that pays a living wage. The problem is the attitude of the employers, and the attitude of the country towards a failed system. These businesses aren't victims, they're assholes.

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What are you talking about? So says me? It's not a problem if 41% of small businesses have stopped hiring?

Please explain. You've got plenty of rhetoric in there, now add some substance to it.

It's the same deal with unpaid internships. Businesses spin government regulations as "Now we can't train the next generation of workers" When in reality they are just frustrated that they no longer have free labor anymore.

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Originally Posted by a completely inoffensive name

It's the same deal with unpaid internships. Businesses spin government regulations as "Now we can't train the next generation of workers" When in reality they are just frustrated that they no longer have free labor anymore.

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And H1-Bs. ~:rolleyes:

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Originally Posted by drone

And H1-Bs. ~:rolleyes:

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I'm afraid I don't understand. H1-B is an immigrant visa?

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Originally Posted by a completely inoffensive name

I'm afraid I don't understand. H1-B is an immigrant visa?

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Companies are using them to depress wages in tech fields. They post job openings with crazy weird requirements, say no one is qualified when no matches are found, then push for more H1-B slots so they can hire an indentured servant on the cheap.

Yeah, listened to an interview about this on the radio, manufacturer complaining that he couldn't get good robotics integration specialists. So I thought, "Wow, that's sad, I hope lots of kids are studying robotics in school."

Then he's pressed a bit, admits he doesn't' want to pay more than $10–$12 per hour, and doesn't see why he should pay more, and that's why he can't find his specialists. Yeah, by all means, let's get him some visas and some cheap labor.

Grrrrrrrr.

Everyone can find horror stories, but remember "anecdote" isn't the singular form of "data".
A study by the Brookings Institute asserts that visa workers actually make significantly more than their American peers in most categories.

There's a guy in my office that's on a worker visa- if you mention any of the stuff being spouted in this thread around him you had better brace yourself to be set straight with a lengthy dissertation from him. Another guy in our office was complaining about the proposed H1-B expansion within earshot and it turned into a 20 minute lecture. I have no problem with people who come into the country legally.

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Originally Posted by Xiahou

Everyone can find horror stories, but remember "anecdote" isn't the singular form of "data".
A study by the Brookings Institute asserts that visa workers actually make significantly more than their American peers in most categories.

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True for "high tech" work, basically US firms will do a lot to avoid hiring Americans and even pay decent wages to tempt foreign workers. Doesn't really apply to the helpdesk drones, airline pilots or the pizza guys, though.

Pizza guys, huh? I'd love to see the job description for a pizza guy that would qualify for a H1B. :laugh4:

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Originally Posted by Xiahou

Pizza guys, huh? I'd love to see the job description for a pizza guy that would qualify for a H1B. :laugh4:

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I could swear that sentence started with "Doesn't really apply to [...]" but maybe that's just me.

Not just you..

Another fun Obamacare fact, people on individual plans can expect to pay up to double... or more for the same coverage they have today.

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But that’s not exactly right, because as Sam Richardson has shown, Obamacare Bronze plans aren’t that different from what you can buy today on the individual market in terms of co-pays, deductibles, and actuarial value. Richardson found two nearly-identical plans sponsored by Kaiser in Sacramento, with identical networks of hospitals and doctors.

As Richardson’s table to the right illustrates, the Obamacare plan had a higher out-of-pocket maximum and the same actuarial value as the 2013 Kaiser plan. Today’s plan costs $100 a month; the Obamacare version costs $205.

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Here's the table(click to see it):Attachment 10108

Here's What Happens If You Don't Sign Up For Obamacare

"According to a recent survey, nearly two-thirds of uninsured Americans say they haven't decided whether or not they'll buy health insurance by the Jan. 1, 2014 deadline (even though they'll have to pay a penalty if they don't)."


The future of health insurance for uninsured Americans (Survey)

"Only 19 percent said they will get coverage by the deadline, while 10 percent said they plan to stay uninsured and pay the penalty, which in 2014 is the greater of $95 or one percent of income for an adult. For children under 18, the penalty is half the adult amount. The penalty increases each year, up to the greater of $695 or 2.5 percent of household income for an adult in 2016. And a family would pay a maximum of the greater of $2,085 or 2.5 percent of income then, according to the Kaiser Family Foundation."

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Originally Posted by Gelatinous Cube

Republicans came up with most of the ideas that actually got implemented.

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Yup, the whole thing is predicated on the Heritage Foundation's 1989 proposals, enacted by Repub Gov Mitt Romney is 2006, etc.

And I love how every evil and ill of our healthcare system is laid at the feet of ACA, which is nothing more than an attempt to flatten the market a bit (in a clumsy manner).

Those who complain loudest have no credible plan for reining in the excesses of our medical/insurance colossus. (Buy insurance across state lines! Malpractice caps! Deregulate everything! Yeah, that's about all they've got. Evidence that any of this would work? We don't need no stinkin' evidence.) But we need to maintain the status quo because FREEDOM AND MURICA.

Anyway ...

http://youtu.be/e7cry-4pyy8

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Originally Posted by Gelatinous Cube

I wish people would stop calling it Obamacare. Its a ponzi-scheme that will enrich pharmaceutical companies while lowering the overall standard of care. And Republicans came up with most of the ideas that actually got implemented.

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Obama doesn't mind people calling it Obamacare... because he does care. ~D

Seriously though, you can try to blame whoever you want for the bill, but it was passed on a largely party-line vote and signed into law by President Obama and it's been championed by him ever since.

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Originally Posted by Lemur

Yup, the whole thing is predicated on the Heritage Foundation's 1989 proposals, enacted by Repub Gov Mitt Romney is 2006, etc.

And I love how every evil and ill of our healthcare system is laid at the feet of ACA, which is nothing more than an attempt to flatten the market a bit (in a clumsy manner).

Those who complain loudest have no credible plan for reigning in the excesses of our medical/insurance colossus. (Buy insurance across state lines! Malpractice caps! Deregulate everything! Yeah, that's about all they've got. Evidence that any of this would work? We don't need no stinkin' evidence.) But we need to maintain the status quo because FREEDOM AND MURICA.

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A few points:
"At least he did something!" isn't a good defense. The status quo was bad. Obamacare is worse. Keeping the status quo isn't a long term solution, but it's better than what we're getting now by almost any measure.

Heritage putting out a proposal does not equal widespread conservative- or even GOP support for a mandate.....

"In 1994 Sen. Don Nickles (R., Okla.) and Rep. Cliff Stearns (R., Fla.) turned the Heritage plan into a bill. Peter Ferrara and others, such as Tom Miller at the Cato Institute, rallied other conservatives against the plan. “By endorsing the concept of compulsory universal insurance coverage,” wrote Miller, “Nickles-Stearns undermines the traditional principles of personal liberty and individual responsibility that provide essential bulwarks against all-intrusive governmental control of health care.”

Ferrara convinced 37 leaders of the conservative movement, including Phyllis Schlafly, Grover Norquist, and Paul Weyrich, to sign a petition opposing the bill. “To this day,” Peter writes, “my relationship with Stuart Butler and Heritage has never recovered.”"

Lastly- speaking personally, I would have opposed the Heritage plan (if I wasn't 10 at the time) on the grounds of its individual mandate- but it would have been a vast improvement over Obamacare in that it only mandated catostrophic vs comprehensive plans and it leveled the tax structure between employer-based coverage and individual coverage. The latter was also part of the McCain plan- and is one of the few things proposed that makes some sense.

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Originally Posted by HoreTore

Big government and big business are responsible for employment in the US and all other industrialized countries. Also, the US defines "small business" as up to 500 employees... Not exactly your neighborhood bar, now is it?

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Seriously? Lol...

Businesses are only considered "small" here when they have less than 50 employees and a maximum turnover of 10 million. I think the same norm is used throughout the EU.

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the US defines "small business" as up to 500 employees

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Isn't 50-500 defined as "medium"?

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Originally Posted by Xiahou

"At least he did something!" isn't a good defense. The status quo was bad. Obamacare is worse. Keeping the status quo isn't a long term solution, but it's better than what we have now by almost any measure.

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The obvious long-term solution is implementing what every other industrialized nation on Earth has, which is some sort of single-payer system. I know that's not what Ayn Rand (who wrote the Constitution and gave birth to George Washington) would want, but it's the only system demonstrated to control costs while providing a baseline of health for citizens.

Because Obamacare is entirely derived from a Republican think-tank and Republican politicians, it addresses none of the underlying problems. It's still trying to pretend that national private-sector healthcare can work, a proposition for which there is zero evidence.

It will be interesting to see if a measure as watered-down as Obamacare can be implemented despite the nihilist opposition of Republican governors. Time will tell. You take the fialure and costliness of Obamacare as a given, as a priori truth that only madmen and ideologues might question. I'd suggest there's a bit more divergence of thought on the overall cost of it, coming from sources such as the CBO.

And anyway, you have no positive agenda to put forward, just Obamacare bad bad bad. You can't defend the status quo ante because it is indefensible, and the only changes you can suggest are Randian free-market solutions which have never been demonstrated to work in the real world. They have exactly as much evidence for their efficacy as communist economic theory and crystal-powered healing.

Obamacare is a very mild start on reining in some of the worst practices of health insurance. It doesn't go nearly far enough, but neither does it appear to be the flaming disaster you tangibly yearn for it to be.

And if this amounts to an "At least he did something" defense, I'd say it has more heft than your "Oh no he did something" offense.

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Originally Posted by Lemur

The obvious long-term solution is implementing what every other industrialized nation on Earth has, which is some sort of single-payer system. I know that's not what Ayn Rand (who wrote the Constitution and gave birth to George Washington) would want, but it's the only system demonstrated to control costs while providing a baseline of health for citizens.

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There. Isn't that much more pleasant to read? All that's missing is some supporting statements.

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Because Obamacare is entirely derived from a Republican think-tank and Republican politicians, it addresses none of the underlying problems. It's still trying to pretend that national private-sector healthcare can work, a proposition for which there is zero evidence.

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Again, you can try to blame whoever you want for it, but it was passed by a Democrat congress and signed into law by Obama. Let's deal with reality. If the Democrats didn't like it, they need not have passed it.

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And anyway, you have no positive agenda to put forward, just Obamacare bad bad bad. You can't defend the status quo ante because it is indefensible, and the only changes you can suggest are Randian free-market solutions which have never been demonstrated to work in the real world.

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Nor have they been tried. If you had a hangnail and someone suggested sawing off your arm to fix it and I said we shouldn't, would you chastise me for not having a plan??

It's hardly a "Randian" suggestion... whatever that means. Employer-based coverage grew out of FDR era wage controls. That was a major factor in ballooning medical costs. I'm not even claiming it would solve everything- but beginning to separate coverage from employment by breaking down the tax favoritism would make it better than it is now.

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Originally Posted by Xiahou

I'm not even claiming it would solve everything

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You haven't got any evidence suggesting it would solve anything. Nor has any substantial proposal been put forward by the nihilists in Congress.

You appear to have an almost purely negative agenda, with no politically or financially realistic plan for what to do afterwards. See earlier quotes from Ramesh Ponnoru to see what I think of this.

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Originally Posted by Xiahou

Again, you can try to blame whoever you want for it

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Not trying to "blame" anyone, just correctly and factually charting the legislative and published history of the initiatives that became Obamacare. It's all factual, it's all on record. Any resemblance between Grouch Marx singing "I'm Against It" and current Republican doom-sayers is purely voluntary.

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Originally Posted by Xiahou

If you had a hangnail and someone suggested sawing off your arm to fix it and I said we shouldn't, would you chastise me for not having a plan??

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I'd say, "Show me successful hangnail removal, please," and you'd be able to do so. I can reel off dozens of countries that have successfully integrated some form of single-payer healthcare into their economy, and I can link to the overall healthcare results and cost savings. Hell, in this thread I already have. These aren't even controversial or contested statistics.

Single-payer healthcare has facts, empiricism, and real-world results. Private sector healthcare has ideology (and in the USA, inertia). Explain to me which of these proposals, on this basis, is more "conservative."

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Originally Posted by Lemur

You haven't got any evidence suggesting it would solve anything. Nor has any substantial proposal been put forward by the nihilists in Congress.

You appear to have an almost purely negative agenda, with no politically or financially realistic plan for what to do afterwards. See earlier quotes from Ramesh Ponnoru to see what I think of this.

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Let's be honest... would it make any difference if a congressional "nihilist" proposed an Obamacare alternative? There have been Republican proposals. The fact that you're seemingly unaware of them illustrates my point. The Republicans are nihilists with no plan of their own... even if they have several plans. There are many reasons they don't get any traction.... that the GOP isn't in power and the GOP electorate feels a far less pressing need for reform than the Democrat base are two big factors.

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Not trying to "blame" anyone, just correctly and factually charting the legislative and published history of the initiatives that became Obamacare. It's all factual, it's all on record. Any resemblance between Grouch Marx singing "I'm Against It" and current Republican doom-sayers is purely voluntary.

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The "Heritage Plan" never had widespread support among conservatives. If it had, something like it would have passed when the GOP had control of congress and the White House. Yet, it required Democrat control for it to get passed. To me, it doesn't seem fair to describe such that as a "Republican plan".

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I'd say, "Show me successful hangnail removal, please," and you'd be able to do so. I can reel off dozens of countries that have successfully integrated some form of single-payer healthcare into their economy, and I can link to the overall healthcare results and cost savings. Hell, in this thread I already have. These aren't even controversial or contested statistics.

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That's the problem with trying something new/innovative. There is no proven track record. A big difference between the recent conservative proposals and Obamacare is that they are incremental and each step could stand alone. Obamacare has popular provisions in it, to be sure- but they are completely unsustainable without the mandate and forcing people into paying for coverage they don't need.

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Single-payer healthcare has facts, empiricism, and real-world results. Private sector healthcare has ideology (and in the USA, inertia). Explain to me which of these proposals, on this basis, is more "conservative."

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Single-payer... as implemented in some countries... would be an improvement over what we have now. But Obamacare is not such a plan. It adds more expense and bureaucracy to an already bloated system while still trying to call itself "market based".

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Originally Posted by Xiahou

There have been Republican proposals.

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I appreciate that you can say that with a straight face. Yes, proposals were made, especially around the time Obamacare was being introduced. No, none of them were serious, or intended to do anything but prolong the status quo. (The more recent proposals are ... well, read for yourself.)

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Originally Posted by Xiahou

The "Heritage Plan" never had widespread support among conservatives. If it had, something like it would have passed when the GOP had control of congress and the White House.

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So let's see what sorts of "reforms" the Republicans passed when they had control of the Federal government ... hmmm ... would it look like a massive, unfunded giveaway to seniors and the Pharma industry? Is that the sort of conservative reform we can look forward to?

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Originally Posted by Xiahou

That's the problem with trying something new/innovative. There is no proven track record.

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Two thoughts:

(1) Basing national healthcare on principals and ideology that you self-describe as having "no proven track record" in this context is literally playing with people's lives. If the line where free-market absolutism meets reality is not as smooth as you believe it to be, you will get people killed for your grand theory. (And in such an occurrence you would probably argue that we just didn't apply Free-Market-Everything perfectly or purely enough; after all, a Sacred Truth cannot be wrong, it can only be wrongly applied.) Hence my repeated comparisons to communism in this thread. There really is a disturbing and precise parallel.

(2) Advocates of large-scale, untested, unproven new applications of ideology cannot ever be described as "conservative," unless we want to throw the English language under a large fleet of buses. The correct term is radical.

Delayed a year.

L O Effing L. Republican blame game GOGOGOGOGO

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Originally Posted by Lemur

Not trying to "blame" anyone, just correctly and factually charting the legislative and published history of the initiatives that became Obamacare. It's all factual, it's all on record. Any resemblance between Grouch Marx singing "I'm Against It" and current Republican doom-sayers is purely voluntary.

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Again, the adoption of a mandate-type plan was an half-hearted response to Hillarycare that never enjoyed widespread support among Republicans or conservatives.

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Single-payer healthcare has facts, empiricism, and real-world results. Private sector healthcare has ideology (and in the USA, inertia). Explain to me which of these proposals, on this basis, is more "conservative."

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Single-payer, socialized medicine would not be my favored choice. I think it would almost certainly, however, lower the astronomical growth of medical costs. Would it lower them enough to make them sustainable? I doubt it- not without rationing. Regardless, Obamacare != single-payer healthcare. It is increasing costs. And it makes most of our problems worse.
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Originally Posted by Major Robert Dump

Delayed a year.

L O Effing L. Republican blame game GOGOGOGOGO

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Conveniently, that puts the implementation after the mid-term elections. The Democrats know they're got a big steaming turd on their hands and the last thing they want is a year of suffering under the employer mandate leading up to the elections. :no:

Edit:An exit question.. Under what authority can the administration postpone implementation? I'm not aware of the law having that flexibility in it. Anyone want to set me straight here?

Looks like the new thing will be to blame all healthcare problems on Obamacare. Whih is quite clever—there are a lot of problems. Great summation:

[An anti-Obamacare] ad mentions not being able to choose your doctor, which would be bad. If you chose an insurance plan in an exchange established by Obamacare, that plan will probably have a network of doctors from which you have to choose if you want your care paid for, and if your doctor isn't on it, then you've been prevented from choosing your own doctor.

Of course, that isn't because of Obamacare, it's because of the way insurance works in America; it's how it worked before Obamacare, and it's how it'll work after Obamacare. But it's a lot simpler to say, "Now that we're under Obamacare, I didn't get to choose my doctor!" And did you know that under Obamacare, medications could come with dangerous side effects? Or that under Obamacare, kids who get shots will cry? Not only that, under Obamacare, you could get cancer and die—even if your doctor wanted to save you. In fact, under Obamacare, we're all going to die one day. Thanks for all the misery, pain, and death, Obama.

And what if you need to choose a new insurance plan due to Obamacare and none of the compatible new plans feature your current doctor in their networks?

Is it fair to blame Obamacare then? Think it won't happen?

No, because it was already so that in the event you had to swap insurance for some reason, you wouldn't necessarily get to keep the same doc.

You can't blame the new system for carry-over* faults in a new system, while at the same time praising the old system. You can whine about them both at the same time, but you can't pick and choose. Sorry.







*couldn't find a good word on the spot, suffer my norwenglish....

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Originally Posted by Xiahou

Single-payer, socialized medicine would not be my favored choice. I think it would almost certainly, however, lower the astronomical growth of medical costs. Would it lower them enough to make them sustainable? I doubt it- not without rationing. Regardless, Obamacare != single-payer healthcare. It is increasing costs. And it makes most of our problems worse.

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I'll point out that the US are beaten by a lot of countries in life length, child mortality, etc, etc, running around with 50-70% of the costs. To be fair the americans might be sicker than the rest, but that rationing does seem to work better than yours.

And Obamacare looks this way because the Republicans decided to think like you. The earlier versions were quite a bit stronger towards single-payer socialized medicine.

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Originally Posted by Gelatinous Cube

Sometimes I like to put on my tin foil hat and consider the possibility that Obama and the entire democratic party are incompetent on purpose, in order to further the Republican agenda of discrediting government in every way possible, to further their own master plan of making us all corporate slave-bitches.

Then I take the tin-foil hat off, cuz those things give you a headache.

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That would require the politicians to give up power, for money or something. Now power without purpose and getting payed extra for (ab)using that power, that fits your gloomy view.

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Originally Posted by Gelatinous Cube

But the money is the power. After serving in Congress, many politicians go work for lobbyists. The entire system is self-perpetuating. Also, insider-trading laws don't apply to Congressmen, so conflicts of interest are just a-okay. I wouldn't put any level of corruption past our most venerable institution. It takes suspension of disbelief just to take it seriously.

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You suggested that it was general party policy, ergo even the ancient ones. Yes the springboard politicians could very well be playing that game, but for the veterans, the pull would rather be to be flattered into appearing very important by changing laws. Bribery is a part of that, but not the main driving force. They would not intentionally outsource their own power though.

I have not followed this, as I live outside the country and hope I am not effected by it.

But I do have a question or two.

If it is so good, why is there a tax penalty for individuals who don’t want to use it?
And, what happens to Doctors who are not employees of a large health care provider?

Most of the rest, I assume is a degree of scare mongering by the Republicans.

The only other thing I have heard that could be alarming is the supposed doubling or tripling of individual plans. This could be more of the scare tactics, I hope, but maybe not.

Also, as everyone is to be insured and everyone must be excepted but smokers pay a higher premium, I find that somewhat disingenuous.

After all, doesn’t someone obese or with another lifestyle related condition, not an equally high risk nonsmoker or not as the smokers who have to pay higher premiums? Just a little social engineering to go along with the program, huh?

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Originally Posted by Fisherking

If it is so good, why is there a tax penalty for individuals who don’t want to use it?

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Because if we are to prop up and nurse along our broken system of private insurance, we have to expand the pool and convince the majority of citizens to buy some sort of coverage. In other words, force the reckless, the healthy, and the young to buy coverage they otherwise might not, thus spreading the pool and market to cover the sick, the lame, and the old.

I believe it's superficially similar to what's implemented in Switzerland.

Of course, I would argue that there is zero evidence that private insurance is the appropriate way to fund healthcare, but that's because I don't see evidence that market forces work properly in healthcare. Market capitalism is great at many, many things. But when there's no evidence that it works in a certain context, it's time to re-think.

For example, I become a screaming socialist state-lover when it comes to the military. I think PMCs are a horrible idea. I don't much like mercenaries or their side-effects. I think the military should be paid for straight outta taxes. I hear that makes me a pinko commie.

Likewise, I simply do not see evidence that national healthcare is best run by market principles—and those who advocate complete privatization and deregulation have nothing but theory and ideology on their side (which should tell you a great deal). But if we need to broaden the market to force our jackalope system to limp along for a bit ... eh, okay.

At least Obamacare sets up state exchanges, out of which something useful may grow.

I support government services where that is efficient(healthcare, military).
I support private services where that is efficient(groceries and tv's).
I support a combination of the two above where that is efficient(kindergartens).

The distance from a conservative US republican(Lemur) and a Norwegian socialist(myself) isn't always so huge...

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Originally Posted by HoreTore

The distance from a conservative US republican(Lemur) and a Norwegian socialist(myself) isn't always so huge...

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:laugh4: Lemur comes across more as a 90's moderate, which in this day and age means he's a freedon hating pinko to most of the Republican base.

I'm a bit further to the right, but even I knew this scheme would be a disaster. If true healthcare reform is to happen, we need to go to a single-payer system. As it stands (both pre- and post-Obamacare) the system's main goal is to siphon as much money out of your pockets before your die. As long as healthcare is not non-profit, this will always be the case.

It was passed by Congress, so there is no doubt it is flawed.

Just looking from here, without reading the thing I figure the main beneficiaries of the program are insurance companies, large healthcare providers and government agencies.

It is just an estimation but I think the people will take it in the shorts, and the pocket of course.

The German system works well here, but I have serious doubts that it can work there. I shudder at the thought of a government run healthcare system as it would be under funded and so filled with red tape you would long since have died before you got in to see a government doctor.

My guess is this will be about as good as you can get. You will never find a way of getting back to charging according to the means of the patient to pay. Docs don’t work for a chicken dinner any more.

The need to avoid waste, the number one leading cause of birth among bureaucrats, will always be present, private or public.

Though the extreme number of people who wish to "avoid waste of tax payer money" do seem to have a special ability when it comes to pissing away money on useless levels of red tape.

Yes, I'm looking at you, conservatives.

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Originally Posted by Fisherking

I figure the main beneficiaries of the program are insurance companies, large healthcare providers and government agencies.

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Largely correct. Health Insurance and hospital stocks skyrocketed the moment Obamacare was passed.

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Originally Posted by Fisherking

It is just an estimation but I think the people will take it in the shorts, and the pocket of course.

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Hard to estimate. Our pre-Obamacare system was already outpacing inflation by well over 100%. As economists say, trends that cannot continue ... don't. So something was (is) going to break. I doubt you can blame the deep dysfunction of our healthcare system exclusively or even primarily on an initiative as watered-down and modest as Obamacare. Not that people won't try, bless their little hearts.

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Originally Posted by Fisherking

I shudder at the thought of a government run healthcare system as it would be under funded and so filled with red tape you would long since have died before you got in to see a government doctor.

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If this were true, you would see corresponding health data from single-payer systems, showing less efficiency and worse health results. The opposite is true.

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Originally Posted by Fisherking

My guess is this will be about as good as you can get.

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What are you basing that on? Other nations have enacted objectively better systems than ours, and have decades of documented experience to back it up. I am continually amazed by the empiricism-free and data-free nature of these sorts of objections.

I agree with Drone that a single payer system is the best solution, and is long overdue. I wonder though, the more things change, the more they stay the same. It's been implied in posts here that our bureaucratic red tape creators would make our single payer system a dysfunctional system, getting nothing done. People with money would still find the healthcare they want, only at additional expense than the taxes they already pay. Long term, no difference.

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Originally Posted by Lemur

At least Obamacare sets up state exchanges, out of which something useful may grow.

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Currently over half the states have refused to set up the exchanges, and due to laws within their state, might never do so. This means that in those states the federal gov't will set up the exchange, which Obamacare legislation itself declares cannot be done.

This is a strange one.

There are so many healthcare systems in the world.

Why not look at the top ten as rated for infant mortality, life expectancy, emergency queue length, surgery queue length.

Then look at the cost to implement these and how they were implemented.

Pick and choose based on real world results.

I would prefer to be optimistic and say it is only a small problem that can quickly brought under control.

I know other governments have done a decent job of it and single payer systems can work.
My pessimism is based on how the US Government tends to function and how Congress behaves.

I am truly sorry to hear that healthcare has skyrocketed to those levels.

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Originally Posted by Fisherking

I would prefer to be optimistic and say it is only a small problem

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It's a huge problem. Costs in the USA healthcare system are completely out of control.

Just in the last few years, healthcare as a percentage of our national gross domestic product went from 16.6% (2008) to 17.9% (2011).

Note that healthcare growth as a percentage of the economy slowed during this period. And still managed to leave inflation, and every other national economic sector, in the dust.

Like I said, trends that can't continue, don't. My hope is that we have a soft rather than hard landing.

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Originally Posted by The Lurker Below

People with money would still find the healthcare they want, only at additional expense than the taxes they already pay

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That's how most single-payer systems work. A national baseline of healthcare, and then more or faster or better service if you have the means to pony up. Seems to work pretty well.

My mother and step-father are obsessive Fox News viewers, and they insist that private healthcare is illegal in Great Britain. Because, you know, socialism and stuff. No matter how many times I explained that this was false, to this day they will tell anyone who will listen how private doctors are illegal in Merry Olde Englande.

Fact-free. So much of this debate is blissfully devoid of data and empiricism. Makes me crazy.

In Aus it works like this:

1.5% Medicare tax
After a certain threshold:
1.5% Medicare tax + Private Health Insurance or 2.5% Medicare tax without Private Health Insurance.

Medicare covers the basic health system and it is the primary one for emergency care.
Private health insurance reduces and/or removes private health costs. The private health system allows either a private room in the same hospitals, more options, quicker access via private hospitals etc. Private health is also the primary way for elective surgery.

If you are really rich you could just pay outright for private health. But if you really are rich you would know how to reduce your cost base in the first place.

So it is similar to a free to play game where you can pay to get better outfits or shorter queue to server.

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Originally Posted by Lemur

That's how most single-payer systems work. A national baseline of healthcare, and then more or faster or better service if you have the means to pony up. Seems to work pretty well.

My mother and step-father are obsessive Fox News viewers, and they insist that private healthcare is illegal in Great Britain. Because, you know, socialism and stuff. No matter how many times I explained that this was false, to this day they will tell anyone who will listen how private doctors are illegal in Merry Olde Englande.

Fact-free. So much of this debate is blissfully devoid of data and empiricism. Makes me crazy.

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If you was curious, the biggest private providers in the UK are Bupa.

I would be interested for you to use their "get a quote" to get a price comparison. To see if it is cheaper or more expensive than typical insurance in the US.

For me by myself, it looks between £41-65 per month. So $61-100 in your money.

This could be cheaper due to the public funding aspects as well.

I am with Bupa here. Costs vary by state and type of cover.

I don't have hospital cover just extras such as optical and dental.

So I pay the 2.5% Medicare rate.

Eventually the US will move to single payer. It's only a matter of time. The current situation will literally choke us to death financially and it has been, and only then will Americans come kicking and screaming to the same policy that every other industrialized nation has adopted.

Union leaders who helped push Obamacare's passage, now seem to be suffering from buyer's remorse...

Union Letter: Obamacare Will ‘Destroy The Very Health and Wellbeing’ of Workers

Can't say we didn't try to warn them....

The link didn’t work!

But here it is: http://blogs.wsj.com/corporate-intel...ng-of-workers/

I do find it disturbing that the Named Representatives are called Leader, regardless of what ever title they may have in Congress.

Smacks too much of Der Führer.

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Originally Posted by Xiahou

Union leaders who helped push Obamacare's passage, now seem to be suffering from buyer's remorse...

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Did we read the same letter? They just want some specific changes made to the implementation, and they're using apocalyptic language in a fit of overstatement. Nowhere do they demand the repeal of Obamacare; rather, like everybody with fingers in this pie, they want bits bent to suit their needs. Seems like perfectly normal lobbying.

Deeply amused that it's signed by Jimmy Hoffa. Does this mean they found him?

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Originally Posted by Lemur

Deeply amused that it's signed by Jimmy Hoffa. Does this mean they found him?

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Close. Being aware of his forthcoming death, Jimmy Hoffa decided to conduct a biochemical project, where he implanted his genetical material into a living host, where the specimen grew, to eventually emerge after the incubation period ended. Due to limitation in this process, genetical material from the host were also used, creating only a partial clone, that despite having a diffferent upbringing decided to pursue a similar career.

Spoiler Alert, click show to read: 

Or in other words, he had a son.

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Originally Posted by Lemur

Did we read the same letter? They just want some specific changes made to the implementation, and they're using apocalyptic language in a fit of overstatement. Nowhere do they demand the repeal of Obamacare; rather, like everybody with fingers in this pie, they want bits bent to suit their needs. Seems like perfectly normal lobbying.

Deeply amused that it's signed by Jimmy Hoffa. Does this mean they found him?

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It sounded concerned enough for me. I have wondered about those 30 hour part time help limits my self.

If employers have incentives to cut work hours to save an expense they will not hesitate.

I would have also thought that existing employer/union plans would have been grandfathered in.

Tax exemptions and subsidies one would think would be based on income and not on whether the plan was a non profit or for profit plan.

Isn’t supposed to be about getting people affordable health care instead of benefiting large Insurance plans and major health care corporations?

If this were a sane world workers and small businesses would have woken up and seen that both established parties were only out to please the big money of corporations and founded a new party.

Instead they just believe the lies of their preferred group and blame the other side. And nothing changes.