Health Care Reform Dead

[Stephen Maturin]

Have no fear, everyone. Rand Paul is going to save America by proposing a real alternative. That's right! America's most beloved hothouse flower, whose presidential campaign went up in a puff of facepalming when he repeatedly stormed out of interviews in a snit at the first hint of an uncomfortable question, has a legislative alternative to the ACA: "freedom," in particular "[t]he freedom to choose inexpensive insurance free of government dictates."

That, of course, is functionally identical to the freedom to accept the proffered nocturnal handjobs of the invisible bunny rabbits whose only desire is to don velveteen gloves and lovingly masturbate us to completion as we sleep.

[Kamilah Hauptmann]

Originally Posted by erimir

This thread might just have been 8 years too early.

Anyhow, I hope to God this is real:

"I'm not on Obamacare..."

[JoeP]

Originally Posted by Stephen Maturin

the freedom to accept the proffered nocturnal handjobs of the invisible bunny rabbits whose only desire is to don velveteen gloves and lovingly masturbate us to completion as we sleep.

Is there a kickstarter?

[Kamilah Hauptmann]

The irony of the US Senate becoming the Death Panel the conspiracy freaks warned about.

[SR71]

Ryan seems to be heading towards self funded Health Savings Accounts as a mainstay of the replacement for the ACA. If that was any kind of solution there would be no need for insurance companies, yes? What am I missing?

[SR71]

I was confused. The Flexible Spending Account and the Health Savings Account are two different things, the FSA sucking infinitely worse of the two. Despite the tax advantage of the HSA, it still amounts to you paying for your own health care rather than just paying premiums and deductibles?

[Jerome]

How to reduce health care costs 101:

Stop taxing health care.

[Sock Puppet]

Originally Posted by SR71

Ryan seems to be heading towards self funded Health Savings Accounts as a mainstay of the replacement for the ACA. If that was any kind of solution there would be no need for insurance companies, yes? What am I missing?

Oh, the insurance companies will do fine. They can get back to their core business model: insuring only people who don't need insurance.

[Stephen Maturin]

I have no idea whether it's still true, but the workers' compensation system in my original home state of Ohio was once widely considered among the best in the country. The reason was pretty goddamn simple: the state constitution prohibited private insurers from participating. Other than GM-sized employers with the assets to qualify as self-insurers, every employer paid into the state workers' compensation fund. Since private insurers couldn't cherry pick all the the low-risk employers, the state fund was a true risk pool.

Ohioans are among the stupidest fuckheads on the planet, but even we had enough collective sense to shoot down a proposed constitutional amendment that would have let private insurers fuck up the system.

[Jerome]

Originally Posted by Sock Puppet

Oh, the insurance companies will do fine. They can get back to their core business model: insuring only people who don't need insurance.

ACA was a great deal for big health care inc., total transfer of wealth from the working class to the elite class with less access to care.

[Jerome]

Originally Posted by Stephen Maturin

I have no idea whether it's still true, but the workers' compensation system in my original home state of Ohio was once widely considered among the best in the country. The reason was pretty goddamn simple: the state constitution prohibited private insurers from participating. Other than GM-sized employers with the assets to qualify as self-insurers, every employer paid into the state workers' compensation fund. Since private insurers couldn't cherry pick all the the low-risk employers, the state fund was a true risk pool.

Slush fund.

[lpetrich]

Originally Posted by Jerome

ACA was a great deal for big health care inc., total transfer of wealth from the working class to the elite class with less access to care.

You're complaining about that?

Also, Jerome, your political drag-queen act is not very very convincing.

[Jerome]

Well yea, just like pretty much every idea sold to liberals, ACA was a scam to take from the worker to give to the elite.

Liberals can not think rationally when they are told an idea will 'help the (insert group)'.

[Jerome]

Originally Posted by Jerome

Well, as the national debt is $38,000 per citizen now, maybe stop spending.

That number was from 2009, today it stands at over $61,000.

Obama and the ACA is the worst thing ever.

[Crumb]

The ACA was never a liberal plan. The liberals wanted single payer.

[The Man]

...I mean, it's liberal in the sense that it is something of a downward redistribution of wealth, and, as Lemieux points out, repealing it would redistribute wealth upwards. Requiring the coverage of preexisting conditions was also on liberals' list of requisite reforms. But no, it was never liberals' preferred plan, and certainly not the left's; it was at most a compromise. Then again, so were the New Deal and the Great Society.

[Crumb]

The ACA is big, so there were certainly some bits like the coverage of preexisting conditions that I think most people would agree with. The central idea of the ACA though is the mandate which I don't think was really supported by the left. I think what got the left on board was the promise of a public option. A promise which was broken, of course.

You are right that it was a compromise, any legislation like this will always be full of compromises. It also could be a much better system if it were possible that it could have been fine tuned and adjusted over the years since it was adopted. Our congress has not allowed this to happen though.

[Jerome]

Originally Posted by Crumb

The ACA was never a liberal plan. The liberals wanted single payer.

lol @ rewriting history

ACA was a Democrat President and a Democrat Congress. Liberals were all supporting it at the time, now when it failed they are trying to walk back.

[Jerome]

Originally Posted by The Man

Lemieux points out,

The Affordable Care Act, in summary, taxed the rich in order to provide benefits to the poor and middle class

No, it took money from the working class and funneled it to Big Insurance Corp.

Then the working poor were required to have insurance, paid through borrowing, thus inflation tax, which is a regressive tax, for insurance they can not access because of the high deductibles.

Thus Big Insurance Corp. took in more in premiums and paid out less in services.

[Crumb]

Democrat ≠ liberal

[Jerome]

No True Scotsman.

Obama, Pelosi and Byrd sure were sold as liberals ...

Typical with liberals, their ideas suck, they fail when implemented, and then they blame someone else for the failure, or deny it was their idea.

[JoeP]

Originally Posted by Crumb

Democrat ≠ liberal

Jerome ≠ worth replying to

[Ari]

Yep, typical. Sad. Unlike republicans who never fail, trust me.

[Kamilah Hauptmann]

Originally Posted by Crumb

Democrat ≠ liberal

The Democratic Party is a fine moderate conservative party.

[erimir]

Originally Posted by Crumb

The ACA is big, so there were certainly some bits like the coverage of preexisting conditions that I think most people would agree with. The central idea of the ACA though is the mandate which I don't think was really supported by the left. I think what got the left on board was the promise of a public option. A promise which was broken, of course.

The central idea of the ACA... well, it has a lot of parts. None of them is central unless you wanna get abstract like "expanding coverage and making it more affordable". But I would say that the big ticket items are:

• Subsidies for health insurance + expansion of Medicaid for poorer people
• Ending the ability to refuse coverage based on preexisting conditions
• Ending or reducing certain other kinds of discrimination (like different prices by gender, for example)
• Minimum standards for coverage (including items like contraception coverage, mental health, etc.)
• Children can stay on family plans until age 26

The mandate is essentially the payment mechanism. If you had single payer there would also be a "mandate": you have to pay your taxes, which fund the single payer system. There would also be "subsidies" in that our progressive income tax system means the poor pay less in taxes (this would also be true even with a flat tax). I don't really see any reason for the left to oppose the mandate other than simply because you want single payer instead. If you are still going to have private insurers, then you pretty much need a mandate in order to get to universal coverage.

The only argument I might make is that the mandate is kinda making very obvious the payment mechanism and making it more "painful" than simply paying your income taxes through withholding. It's more obvious how you're being forced to pay for the system. But in reality, all universal healthcare systems have a "mandate", the difference is just how it is implemented and how obvious it is. I think the Democrats need to put a bit more focus on trying to submerge payment mechanisms and highlight services more. I don't understand why there's nowhere in the US that forces businesses to include sales tax in listed prices, for example. The mandate is necessary, but I agree that it is not the best design. Unfortunately, single payer would require destroying most of the insurance industry, so it will be resisted far more. It's not going to be easy, and I don't understand why anyone thinks that anything happening lately did or could have made it likely, not even the election of Sanders. Likelier, perhaps.

Public option probably doesn't make as much sense without a mandate, otherwise you have to increase taxes a lot to ensure it doesn't blow a giant hole in the budget because only sick people sign up for it. And if you're doing that, you might as well just go to single payer. That is to say, public option and the mandate are not in opposition, they would be complementary.