Should the U.S. Retain Obamacare?

Notes: 

It is one thing to say that a program is bad and needs to be scrapped, but, when you are in a position to do so, the rubber meets the roead.

There are problems in life people love to complain about, but really cannot solve.  Healthcare seems to be one of those issues.  It is a matter of least worse choices.

So, if you were President Trump or a member of Congress, what would you do beyond criticism and complaint?

Don't be afraid to approximate.  Choose the option that is CLOSEST, not necessarily the most nuanced or with the proper caveats.

I think we should leave Obamacare as it is. It is either best option or too late to fix.
0%
I think we should tweak Obamacare, but retain the vast majority of the program.
8%
I think we should retain some of Obamacare, but make significant, major changes.
21%
Other
8%
I think we should almost completely scrap it, with a few exceptions.
33%
I think we should repeal the entire system and return to what we had beforehand.
29%
We should convince everyone of the prosperity gospel so no one would need healthcare :)
0%
Total votes: 24

Forum Tags: 

If there was an option for "I

If there was an option for "I think the government should not be involved in healthcare at all" I would have voted for it. I don't necessarily want what we had before either but it is better than this. 

People that were insulated by

People that were insulated by employers from insurance really do not know what it was like before ObamaCare. For sure, the exact same price increases were occurring. I have bought health insurance myself for 16 years and it has pretty much gone up 20% year the entire time. There were other problems too. Just getting through the application process was brutal. My wife got denied health insurance once because she had gone to a doctor a year before for pain in her neck (that turned out to be nothing).

I like lots of aspects of ObamaCare and I do tend to believe that universal health care is a good thing for a civilized country. I am not denying it has massive problems though.

Tort reform - think J&J and the $70M talcum powder case

Consider the Johnson & Johnson talcum powder lawsuit 

Everyone pays for this & the lawyers win

http://www.nbcnews.com/news/us-news/tears-joy-after-70-million-baby-powd...

http://www.factsabouttalc.com/ 

https://www.americanactionforum.org/research/tort-reforms-impact-health-...

Overall, we find statistically significant evidence that medical tort reform is associated with a decrease in health care costs. After testing the effect of one, two, and three reforms, we find a significant negative relationship between tort reform and health care costs in states where two medical tort reforms were passed. Specifically, we find that the passage of two medical tort reforms significantly decreased both total premiums and employer contributions to premiums. The results were largely insignificant for states that passed one and three reforms.

 

 

ACA and Universal healthcare

I'm one of those like Greg mentioned above that until the ACA was implemented, was mostly insulated from insurance companies.  Since my insurance was largely employer-provided, I saw some increases each year in what was taken out of each paycheck, but that was it.  Once the ACA was implemented, my company took a couple of years, but eventually moved to a high-deductible plan that will cost me a good bit more, and it was explained that this was because changes in the law and cost of insurance due to the ACA.  So for me personally, the ACA hasn't been a good thing, but that is based on second-hand information.  We were actually offered the choice to keep a coverage similar to our old plan, but that would cost us several thousand more per year.

The really big difference is in what type of plans our church could get for our pastor.  As the ACA was phased in, the costs of available plans went way up, increasing by amounts of 30-40% a year the last couple years.  Of course, those numbers probably depend on the state, but they were not good for our church.

Since I am married to a German citizen, I have had experience with the system there back to 1987, and I've seen both the good and bad sides (cost and rationing/limits on care).  1987 was the year her  father passed away from complications of a lung infection due to lung-cancer.  The staff was way more against any kind of what they considered "extreme" measures than I saw in the U.S. around that time.  By extreme, I only mean they didn't want to do any type of resuscitation at all.  I didn't understand German very well at that time, but it was clear even to me how the staff was not really invested in saving the life of one citizen, and was really pressuring my mother-in-law to "let go" before much had been tried.  Even now, my mother-in-law, like many other Germans, purchases private insurance to get to see doctors more quickly about non-emergency medical issues, and gets no rebate on the large taxes she pays for the universal care.  Without that insurance, it can take additional weeks for her to get an appointment.

On the plus side, I have to admit the German system worked really well for me when I broke my ankle.  I guess that is considered "emergency" care, since I got right in, and although the hospital in that town looked dated, like something out of the 1950's, the doctors and nurses were great, and as far as I could tell, did a great job.  Since I wasn't part of the system, I had to pay for everything in cash.  The total, for examination, x-ray, cast and crutches came out to 138 Euros!  I thought they were missing a zero or two after looking at expenses here.  We could certainly benefit from medical expenses like those here, but I suspect they would come with some amount of care rationing to keep the expense down.

Dave Barnhart

Federal Employee Health Program

My insurance is $700 a month thru the Fed employee program.  I have Blue Cross Blue Shield.  Obama threw this program in with Obama Care.  I just had surgery ie Green Light Laser.  My out of pocket were $2000 with all the expenses added up.  

I have worked at two auto dealerships one large and one mom and pop and both offered their employees health insurance as good or better than mine.  So I'm not getting any great deal. 

There is some truth in shopping for Specialist.  My original pain management guy used to give me a spinal shot via X-ray and did it in 45 minutes in his office.  The price was $60    

This guy went out of business to teach at a Medical School.  I got another shot at a Pain Mangement place and now it is $370 for the same shot and now it is done at a surgery center and takes 3 hours. Same shot.  Now I don't get them otherwise I'd probably get more but the price is bad.  

I don't know what the answer is. 

Dave: Thanks

Dave, it was good to hear about both sides of your experience in Germany.  Your other comments were also appreciated.

This whole healthcare thing seems to have no real fix.  In time, costs should go down as technology improves and new strategies are developed.

I remember in the early 60's when color TVs were around 1,000 dollars, and not all that good.  Now you can buy better for a bit more than 100 dollars, even though a dollar is worth maybe 1/5th of what it was then.  Eventually, I believe, this will happen in the medical world.   But things probably won't begin to drop for decades. So what do we do until then?   No one seems to have a good answer, except that it is a lot cheaper to die.

And Jim, thanks for your links.  I agree we need tort reform.  The first link in the message above, however, did not work! Alas.

"The Midrash Detective"

Individual insurance before and after

Like GregH I bought individual insurance (church funded) for myself and my family. I did it for more than a decade and, yes, did see some steep increases. However, with some creativity (increased self-insuring through a savings account, etc.) and switching insurers several times, we were able to significantly mitigate the cost.

Unlike Greg, I see no value whatsoever in ACA or in universal health insurance, for several reasons. 

  1. Insurance is actually what got us in this mess in the first place. When you insulate the actual cost of a product from market forces you always encourage increased cost.
  2. "Insurance" is a misnomer for what most people want now in a health plan... and this sort of funding arrangement never was really insurance. The insurance model can only work if more people pay into it than withdraw from it. So it's a product you buy "just in case" and expect to rarely, if ever, use. This is not what "health insurance" was or is.
  3. What we want is simply not possible: something for nothing... or the more popular variant: a whole lot for very little. Excellent care cannot be had for few dollars. All we're doing when that happens is shuffling the cost around. But it's still there. Universal healthcare always lowers availability and quality. It has to, becuase value always incurs cost and when costs are held down, so is value.
  4. In our particular case, three things contribute most to the cost of health care: 1-layers of cost and payment processing through pseudo insurance and subsidies (insulating costs from market forces), 2-class action/tort costs, 3-very high quality. Item 1 has resulted in a situation where medicine has advanced way beyond the market's ability to fund it. The only way to fix cost is to slow advancement. Don't like it, but that's reality. Our situation is like a car market where all the vehicles are Ferrari or Rolls Royce. Having it on the cheap is a delusion.
  5. Restoring as much market dynamic as possible (getting rid of pseudo-insurance would be progress) can help slow advancement while shifting resources to increased efficiency. We might see more Chevy's in the healthcare market, which is not like Ferrari, but is accessible at reasonable cost to the masses.

Ditto Josh

Gov't shouldn't be involved in providing healthcare or insurance. I understand the kind of regulations needed for licensing and national infrastructure, but the ACA is as coercive, confusing, punitive, and unConstitutional as it gets. 

When the ACA kicked in, we lost a very nice plan we could afford, and then were fined for not having insurance. ACA gave us very few choices, but we found a plan last year that was OK-ish--and now it's time to sign up for a different plan (WHY???) and the only plans we qualify for now come with premiums that are double last year's and 1/3 more than the plan we had before ACA. So we are out in the cold again insurance wise, trying to figure out what we are going to do.

Guess we'll get fined again, since it is now a crime to not be able to afford health insurance. 

Susan Has A Good Point

Government run healthcare across the board would probably be a disaster.  I have personally experienced Gov run healthcare when I had in the line of duty injury.  

In August of 1998 I was at the range just stepping up to fire the shotgun for qualification.  The first three rounds were slug at 50 or 70 yards.  Well with out thinking I loaded and fired with a weaver stance ie feet parallel under me instead of correctly one foot back one foot forward to absorb the recoil.   The weaver is used to fire a pistol. 

Well I finished the three rounds and I knew something went wrong in my back but their was no great pain at the time.  I went home slept and the next day yikes!!!!  At that point I knew I herniated a disk big time  I then filed a Workers comp claim but like a idiot I continued working in pain.

Now from that point on I got my healthcare from the Department of Labor.   Little did I know I had bucked the system by continuing to work.  Getting treatment was a horror show.   I had doctors refused to see me because the Gov did not pay the bills.  

Getting thru to the Customer Service (CS) was another horror show.  I had one  CS Rep tell me what are you complaining about you are getting your check.  I then  informed CS Rep that I was working wounded and short of the worst  cases I should be next in line for help ie not sitting on my rear collecting money.  Well that did not go over well.  

Needless to say right up to my surgery and after my horror show went on.  I had to go to my Congressman to get them to cut the crap out .  

After this I had Agents who injured their backs on the job call for advise Once I told them the story  everyone of them said Joe I never told you I was hurt on the job.  They decided to go through private insurance ( Prior to Obamacare)  

If these knuckleheads treat Law Enforcement with such disdain think how they would treat the regular public. 

Back in the early 80s the FBI was in a knock out drag out gun fight with two armored car robbers.  These were the days when Police were under armed.  The two bad guys were armed with a mini Ruger m14 rifle converted to automatic and a high capacity automatic pistol.   The 8 FBI Agents had to 9 mm semi automatic pistols 4 wheel guns and two shotguns. Eventually they killed the bad guys but not without loosing 3 Agents and the rest were seriously wounded. 

Well one of the survivors took a 223 to his spine. The bullet by his words ricocheted downward and followed a track right down his spine and out by his anus. I met this guy he used to practice breathing exercises to deal with his pain.  I asked him how Department of Labor treated him.  He said they never paid his health bills which totaled toward a mil. The Agent said he found out when he went to get a car for his daughter.  The Department of Labor had totally destroyed his credit.   What a thing to for a man willing to lay his life down for the safety of the public.  Those Armored car robbers had already killed at least 4 innocent people on the street. 

So the moral to the story is can you imagine a one payee system run by Uncle Sam.  The whole countries credit would be destroyed and the service would stink. Just look at the VA Hospitals.  I guess it would be good for collection agencies. 


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