Will Obamacare succeed where term limits failed?

[Xiahou]

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

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.

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....

[drone]

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.

[LittleGrizzly]

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

[Lemur]

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

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.

[HoreTore]

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.

[Xiahou]

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

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

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.

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

[Lemur]

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.

[Papewaio]

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.

[Lemur]

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

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.

[LittleGrizzly]

Who's everyone else?
......................

I was mainly referring to the working/middle classes...

[FoxLeLay]

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.

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.

[Husar]

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.

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.

[FoxLeLay]

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.

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.

[Papewaio]

What is the income tax rate in the US?

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

[Lemur]

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....

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.

[Husar]

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....

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.

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.

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.

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

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.

[Husar]

The website problems are a bit overblown. Name any online product that had to meet that kind of demand on launch and succeeded... you can't. Overflowing servers are the norm with any launch.

"I could give a 12-year old a hundred bucks and he'd make me a website in three hours..."

It is indeed amazing how a government healthcare database is now equal to a myspace page. But it proves the Republicans right in that people are spoiled and want things they cannot afford.

[Seamus Fermanagh]

"I could give a 12-year old a hundred bucks and he'd make me a website in three hours..."

It is indeed amazing how a government healthcare database is now equal to a myspace page. But it proves the Republicans right in that people are spoiled and want things they cannot afford.

Oh come on. That kind of line is the usual snide political hyperbole. Such cheap shots have been a political norm, I feel certain, at least since the Greek city states. I dare say you could find a few home-grown German examples without stressing your google-fu all that much.

Gelcube is correct about the overwhelm factor. I put down most of the initial problems to the volume thing. Only the most recent spate of issues can be said to be design problems. It still wasn't that well thought out a web-site system -- they were planning on hits in the millions from the outset. That was the point of the program. Trouble free was never possible, but this was still a bit sloppy.

[Husar]

Oh come on. That kind of line is the usual snide political hyperbole. Such cheap shots have been a political norm, I feel certain, at least since the Greek city states. I dare say you could find a few home-grown German examples without stressing your google-fu all that much.

Gelcube is correct about the overwhelm factor. I put down most of the initial problems to the volume thing. Only the most recent spate of issues can be said to be design problems. It still wasn't that well thought out a web-site system -- they were planning on hits in the millions from the outset. That was the point of the program. Trouble free was never possible, but this was still a bit sloppy.

That's exactly what I said when I said it's funny that people compare a huge database with a myspace site.

And our country is quite a bit behind when it comes to utilizing technology in the public and some other sectors, I wasn't claiming that we're better. In fact we are worse. Just because I may have successfully acquired a reputation of being an Anglo-hater, that doesn't have to be true.

[ICantSpellDawg]

Lemur, are you suggesting that insurance would have saved his life?
Because from what you are suggesting, the guy lived his life without paying into insurance and died of a fast illness that would have killed him anyway. Sounds to me like he got away with 400k.

[Xiahou]

The website problems are a bit overblown. Name any online product that had to meet that kind of demand on launch and succeeded... you can't. Overflowing servers are the norm with any launch.

I agree insofar as the website not being the "big" story, but the magnitude of the technical failure that is heathcare.gov is most definitely not being overblown....

They didn't begin any actual testing of the site until just a couple weeks before launch- far too late to make any significant changes. But, even with the testing they did, the website was crashing under a load of just a few hundred users- on a website that was expecting to receive millions. Some problems are to be expected when you roll out a major e-commerce portal. The problems with heathcare.gov go far beyond that. It was essentially non-functional on its go-live date.

The President's healthcare sign-up web page was supposed to handle tens of thousands of people at once. But in a trial run days before its launch, just a few hundred users flatlined the site.

Despite the problems, federal health officials pushed aside the crash cart and rolled out HealthCare.gov on October 1 as planned, The Washington Post reported.

[Lemur]

As disgusted and saddened as I am about the Obamacare rollout, I'm forced to root for its implementation, because there simply is no other realistic plan. Either we achieve something similar to the Swiss model, which is what all of these plans are based on, or we fall back into the Reagan-created jackalope socialist/crony capitalist hybrid.

As a tonic and corrective, have a quick read about Ron Paul's campaign manager, who died of pneumonia with massive debt (handed on to his surviving mom), because the jackalope insurance system ratcheted up his rates due to a pre-existing condition.

This is what Randian freedom looks like, folks. Drink it in.

Back in 2008, Kent Snyder — Paul's former campaign chairman — died of complications from pneumonia. Like the man in Blitzer's example, the 49-year-old Snyder was relatively young and seemingly healthy* when the illness struck. He was also uninsured. When he died on June 26, 2008, two weeks after Paul withdrew his first bid for the presidency, his hospital costs amounted to $400,000. The bill was handed to Snyder's surviving mother, who was incapable of paying. [...]

After Snyder's death, Paul posted a message to the website for his Campaign for Liberty — a pre-Tea Party organization which served Paul as both presidential marketing tool and platform to promote his non-interventionist, free market ideals.

He wrote:

"Like so many in our movement, Kent sacrificed much for the cause of liberty. Kent poured every ounce of his being into our fight for freedom. He will always hold a place in my heart and in the hearts of my family."

And that, friends, is what freedom is really all about.

[Xiahou]

As disgusted and saddened as I am about the Obamacare rollout, I'm forced to root for its implementation, because there simply is no other realistic plan.

The ACA isn't realistic.

[Lemur]

The ACA isn't realistic.

If "realistic" equals X, then give X value of, "Coherent plan based on real-world model that has some chance of being enacted in current dysfunctional political climate."

Obviously there are other plans that are implemented by other industrialized nations, some of which are far superior to the Swiss model. None would make it through the toxic swamp we call Congress.

Your free-market-everything notions are no more likely to be enacted than a Norwegian-style single-payor system.

I realize that sitting in a padded, wing-backed chair made entirely of radical ideology is, if nothing else, comfy—but on this issue I would appreciate seeing you step outside of your comfort zone and address what is possible, all things considered.

The Swiss model (as mutated through HeritageCare, RomneyCare, and Obamacare) can be made to work. It does not need to evolve into single-payor, or national insolvency, or any of the other apocalyptic tropes that appear to give such visceral pleasure when forecast.

The status quo ante was not acceptable, affordable, or humane. See the fate of Ron Paul's campaign manager for reference.

[Xiahou]

The status quo ante was not acceptable, affordable, or humane. See the fate of Ron Paul's campaign manager for reference.

Kent, as an obvious Ron Paul supporter, chose to work for the Ron Paul campaign knowing it did not provide insurance. I'm pretty sure, as a Paul supporter, he would not have supported Obamacare or socialized medicine. I don't think he would want to be used as a political football by Obamacare supporters. You should probably stop.

[Lemur]

Lemur, are you suggesting that insurance would have saved his life?

Last I checked, pneumonia was treatable, if you get to it quickly enough.

why are we disparaging the dead guy?

Noting that the essential supporter of a libertarian candidate died of preventable causes, uninsured, leaving his mom with $400k in medical bills, is somehow off-limits? Please.

The real-world results of libertarianism are relevant, especially when the only alternatives posited to Obamacare are (a) the status quo ante, or (b) an untested libertarian experiment in national-scale free-market healthcare provision.

ICSD, you clearly didn't read even the bit of the article I snipped. GC ... really? You're falling for this?

[Xiahou]

Last I checked, pneumonia was treatable, if you get to it quickly enough.

The guy had a pre-existing condition, a un-named"blood disorder" and died from pneumonia. Kinda sounds like HIV to me. But we're both talking about a dead man and trying to attribute motives that we neither know nor understand. We should probably stop.

Noting that the essential supporter of a libertarian candidate died of preventable causes, uninsured, leaving his mom with $400k in medical bills, is somehow off-limits? Please.

You don't inherit debt. Debts are paid from the deceased's estate. If there isn't enough value in the estate to cover it... the lender takes a haircut. The only way she could be "left with his debts" is if she was the payer in the first place. In which case, they were her debts all along.

Lastly, I'd like to address the hypocrisy accusation over people who take tax deductions they aren't in favor of or receive benefits from programs that they don't like the structure of.....

I don't have a mortgage, but you can bet I'd take the tax deduction if I did. Also, if Social Security is still paying out when I'm old enough to get benefits- I will most certainly take any benefits that I am eligible for. I don't think Social Security is sustainable as it's currently constituted, nor do I think it is a good investment. Were I to take the 12% of my income the federal government is taking from me and invest it into an IRA- I could get a much better ROI than I will get thru Social Security. That does not change the fact that the government has been taking 12% of my income for this program my entire working life. Therefore, if I get the chance to get any of that money back- I'm going to take it.

[ICantSpellDawg]

The guy had a pre-existing condition, a un-named"blood disorder" and died from pneumonia. Kinda sounds like HIV to me. But we're both talking about a dead man and trying to attribute motives that we neither know nor understand. We should probably stop.

My friend died from almost exactly the same thing. Healthy, fit as a fiddle, just bought a BMW, started job with a new firm as a financial analyst in Manhattan (at 24 years old) , 95k per year, met a girl. He began complaining of chest pain on Friday night, was dead by 1 pm the next day in a hospital in the NY metropolitan area. Fully insured, Cadillac plan, asymptomatic up to 24 hours prior. Some childhood anemia diagnosis which never gave him a problem, coupled with walking pneumonia was the cause of his total body toxicity and organ failure.

I don't mind that Lemur is vilifying and using as political cudgel a man who died from a serious form of pneumonia who happened, also,to refuse to buy into the absolutely broken medical insurance system; but I'm not sure that it is the kind of argument that someone who wasn't solely trying to rationalize his own tacky argument would continue to make. It's ok to back down sometimes - or to press on instead, like the reasonable moderate who never backs down from firmly held positions which lampoon the "right" that he is.

[Lemur]

I'm not sure that it is the kind of argument that someone who wasn't solely trying to rationalize his own tacky argument would continue to make.

This sentence is kinda beautiful. It's like a serpent eating its own tail.

I haven't brought up the subject of your high dudgeon in about a day and a half, so by all means, keep going back to that well.

As a governing philosophy, libertarianism is exactly as realistic as communism. Both suffer from good intentions and starry-eyed idealism, neither works once you scale past the family level. The similarities between the two are quite striking.

Note the mushiness and emptiness of the libertarian answers to our troubled healthcare system. Note the real-world consequences of this sort of adolescent thinking, and the hostility its acolytes express when confronted with same.

Much like communism, libertarianism can never be wrong, because it is a complete, perfect theory. It can only be misapplied or misunderstood.

Feh.

[Ironside]

Back on topic
The type of "fraud" that the late individual was guilty of was not fraud in the true sense. It was merely one man refusing to pay a bill which was unconscionably high. You wouldn't charge him with fraud, you (as the provider) would enter litigation to sue him for services rendered unpaid. If the taxpayer or insured's are kind enough to extend credit to him unsolicited, that is their own kindness/foolishness. The coldly bureaucratic arguments which suggest that people should be hauled off for insulting the thought police or daring not to purchase a product which is optional and wildly overpriced is just vacuous, hyperbolic, claptrap. All valid political beliefs for a German to hold, at any given point in history.

You sure you want the health industry to only accept payments in advance and that they always stop the treatment if things get more expensive than expected? Companies are usually neither openly kind or foolish you know.

Note the mushiness and emptiness of the libertarian answers to our troubled healthcare system. Note the real-world consequences of this sort of adolescent thinking, and the hostility its acolytes express when confronted with same.

... Point 2 openly contradict their own goal (it's on the top of the page) and point 3 is in lala land when it comes to medical safety. I'll be very surprised if they do know the origin of FDA and are aware on what type of corruption scandals FDA has been involved in (hint, getting disaproval on a dangerous, non-funtional drug is still as expensive as getting an approval on a functional one).

As a governing philosophy, libertarianism is exactly as realistic as communism. Both suffer from good intentions and starry-eyed idealism, neither works once you scale past the family level. The similarities between the two are quite striking.

I haven't red it in full, but the description of John Galt land have struck me as pretty close to a communist ideal (From each according to his ability, to each according to his need), only inhabitated by supermen, all with very high abillities, with a thin capitalistic veil to cover it up. Not sure if the impression changes by a detailed description.