‘A complete about face’: Some Republicans change tune on Obamacare’s Medicaid expansion

[Razoo]

I would not put too much stock in anything the fake republicans say. They are only looking ahead will do anything to take back the power......... even lie more and more and more.

Most USA health insurance = under insured = death panels = bankruptcy

 

[Razoo]

1. Everybody in,nobody out. Universal means access to healthcare for everyone, period -- the desire of 81% of all Californians, as reported in a January, 2007 Field Poll.
2. Portability. Even if you are unemployed, or lose or change your job, your health coverage goes with you.
3. Uniform benefits. No Cadillac plans for the wealthy and Pinto plans for everyone else, with high deductibles, limited services, caps on payments for care, and no protection in the event of a catastrophe. One level of comprehensive care no matter what size your wallet.
4. Prevention. By removing financial roadblocks, a single payer system encourages preventive care that lowers an individual's ultimate cost and pain and suffering when problems are neglected, and societal cost in the over utilization of emergency rooms or the spread of communicable diseases.
5. Choice of physician. Most private plans restrict what doctors, other caregivers, or hospital you can use. Under a single payer system, patients have a choice, and the provider is assured a fair reimbursement.
6. Ending insurance industry interference with care. Caregivers and patients regain the autonomy to make decisions on what's best for a patient's health, not what's dictated by the billing department or the bean counters. No denial of coverage due to pre-existing conditions or cancellation of policies for "unreported" minor health problems.
7. Reducing administrative waste. One third of every health care dollar in California goes for paperwork, such as denying care, and profits, compared to about 3% under Medicare, a single-payer, universal system.
8. Cost savings. A single payer system would produce the savings needed to cover everyone, largely by using existing resources without the waste. Taiwan, shifting from a U.S. healthcare model, adopted a single-payer system in 1995, boosting health coverage from 57% to 97% with little if any increase in overall healthcare spending.
9. Common sense budgeting. The public system sets fair reimbursements applied equally to all providers while assuring all comprehensive and appropriate health care is delivered, and uses its clout to negotiate volume discounts for prescription drugs and medical equipment.
10. Public oversight. The public sets the policies and administers the system, not high priced CEOs meeting in secret and making decisions based on what inflates their compensation packages or stock wealth or company profits.

 

[Deuce]

If this is "success", I'd hate to see what failure looks like.

This is a bunch of charts showing our healthcare system was broken long before the ACA

 

[Fearandloathing]

It ain't universal health care like Canada has, but hey, considering how backwards the U.S. is, every tiny step is in the right direction.

Long ago I recall a CBC story, part of a series, where it was documented there were less expensive ways to go than what became "Obamacare". They chose a different path to avoid a fight with the insurance companies and what you have now is a compromise. Obama rejected a plan provided on the Canadian system, which was rejected thus avoiding a fight with the insurance companies which Obama did not want.

They opted instead to buy off the opposition of insurance companies by insuring "maximum profits" over the long run.

Canada's system works because the insurance/profit aspect is removed.

If Americans only knew how much it's costing to keep me medicated with three heart conditions and a list of "comorbidities" that I can't even pronounce. My heart tests yeears ago would have been in six figures. Without universal medical care I would have been dead 20 years by now

 

[aociswundumho]

This is a bunch of charts showing our healthcare system was broken long before the ACA

Sure, I agree with that. They also show that the ACA has done nothing to solve the problem.

 

[Lisa]

Sure, I agree with that. They also show that the ACA has done nothing to solve the problem.

Except to cover more people and save 2.3 trillion dollars.

Even before the Affordable Care Act became law, about 90 percent of the conversation and criticism of it was about coverage. Little has been said about its ability to control costs.


March 23, the ninth anniversary of the ACA’s passage, presents a good opportunity to examine its legacy on cost control — a legacy that deserves to be in the foreground, not relegated to the background behind the exchanges, Medicaid expansion, and work requirements.


One month after the ACA had passed, the Office of the Actuary of the Department of Health and Human Services projected its financial impact in a report entitled “Estimated Financial Effects of the ‘Patient Protections and Affordable Care Act’, as Amended.” The government’s official record-keeper estimated that health care costs under the ACA would reach $4.14 trillion per year in 2017 and constitute 20.2 percent of the gross domestic product (GDP).
Fast forward to December 2018, when that same office released the official tabulation of health care spending in 2017. The bottom line: cumulatively from 2010 to 2017 the ACA reduced health care spending a total of $2.3 trillion.

​

In 2017 alone, health expenditures were $650 billion lower than projected, and kept health care spending under 18 percent of GDP — basically a tad over where it was in 2010 when the ACA was passed. It did all of this while expanding health coverage to more than 20 million previously uninsured Americans.

Name the much-criticized federal program that has saved the U.S. $2.3 trillion. Hint: it starts with Affordable

Despite constant criticism and occasional sabotage, the Affordable Care Act has successfully expanded health insurance coverage and helped control runaway health care costs.

www.statnews.com

 

[aociswundumho]

Except to cover more people and save 2.3 trillion dollars.

Again, look at the charts:





The problem is the price of healthcare, and Obamacare didn't do anything regarding the price of healthcare.

 

[Lisa]

Again, look at the charts:

View attachment 67425499

View attachment 67425500

The problem is the price of healthcare, and Obamacare didn't do anything regarding the price of healthcare.

OK, so we now address the for-net-profit status of insurance companies. for and limit drug prices like other countries do.

 

[aociswundumho]

OK, so we now address the for-net-profit status of insurance companies.

Obamacare capped the profits of healthcare insurance companies:

Rate Review & the 80/20 Rule | HealthCare.gov

The health care law provides 2 new ways to hold insurance companies accountable and help keep your costs down: Rate Review and the 80/20 rule.

www.healthcare.gov

for and limit drug prices like other countries do.

Drugs are only 10% of healthcare spending:

FastStats

FastStats is an official application from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) and puts access to topic-specific statistics at your fingertips.

www.cdc.gov

Healthcare is all labor, and that is the problem. Labor costs need to be slashed in line with the rest of the world.

 

[Lisa]

Obamacare capped the profits of healthcare insurance companies:

Rate Review & the 80/20 Rule | HealthCare.gov

The health care law provides 2 new ways to hold insurance companies accountable and help keep your costs down: Rate Review and the 80/20 rule.

www.healthcare.gov

Drugs are only 10% of healthcare spending:

View attachment 67425504

FastStats

FastStats is an official application from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) and puts access to topic-specific statistics at your fingertips.

www.cdc.gov

Healthcare is all labor, and that is the problem. Labor costs need to be slashed in line with the rest of the world.

Cough, cough,. cough,

So here is this medicine — it is life-saving, keeps me alive — and here we have a few companies who are preying upon people who don’t have a choice but to take this medication or we die,” she said. “So, how do we get it? How do we afford it? Where do we get it? Where are we being forced to go? The U.S. is the only country that gouges [patients]. It’s insane.”


Jane buys her insulin illegally from Canada, where a comparable bottle of insulin costs about $21.


“It makes more sense to purchase it from Canada, where life-saving medication is affordable,” she said. “These prices won’t make you make the choice between going to the grocery store to put food on the table for you and your kids or buying insulin.”


Jane is not alone. According to a 2015 Centers for Disease Control and Prevention report, nearly 5 million Americans bought their prescription medications from other countries in 2013 to save money, despite federal restrictions.

US Drug Prices vs The World

Prescription drugs cost more in the U.S. than most anywhere else in the world. As a result, Americans are illegally importing drugs from other countries.

www.drugwatch.com

 

[Razoo]

OK, so we now address the for-net-profit status of insurance companies. for and limit drug prices like other countries do.

exactly ...........

 

[bullseyelqcs]

Universal healthcare would drastically increase the demand for healthcare, which means drastically increasing prices way, way above where we are now, which is already sky-high:

How Medicare for All will play out

The purpose of this post is to completely and utterly destroy this insane idea that Medicare for All will benefit the American people. I will use Bernie's plan for this post. https://berniesanders.com/issues/medicare-for-all/ Bernie's plan would: 1. Create a Medicare for All, single-payer...

debatepolitics.com

So the obvious solution is to just accept that some people aren't worthy of getting to a doctor, right?

 

[Liberal7360]

You cant be serious,................. but you probably are?

Do you not understand what capitalism seeks?



Snowflake is obviously Canadian so his experience is 10X more accurate than your claims.

I looked up the numbers on people in Canada who die on waiting lists. The most recent I found was for 2020.

The number is 2367 patients.

More than 2,000 patients in Canada died while waiting for medical care in 2020: report

In Ontario, the province's Financial Accountability Office predicts the province’s surgical backlog will take more than three years and $1.3 billion to clear

nationalpost.com

Compare that to the at least 45 thousand Americans who die every year because they don't have insurance and can't see a doctor.

The Americans dying because they can't afford medical care

Millions of Americans – as many as 25% of the population – are delaying getting medical help because of skyrocketing costs

www.theguardian.com

From the article:
A December 2019 poll conducted by Gallup found 25% of Americans say they or a family member have delayed medical treatment for a serious illness due to the costs of care, and an additional 8% report delaying medical treatment for less serious illnesses. A study conducted by the American Cancer Society in May 2019 found 56% of adults in America report having at least one medical financial hardship, and researchers warned the problem is likely to worsen unless action is taken.

Dr Robin Yabroff, lead author of the American Cancer Society study, said last month’s Gallup poll finding that 25% of Americans were delaying care was “consistent with numerous other studies documenting that many in the United States have trouble paying medical bills”.

Despite millions of Americans delaying medical treatment due to the costs, the US still spends the most on healthcare of any developed nation in the world, while covering fewer people and achieving worse overall health outcomes. A 2017 analysis found the United States ranks 24th globally in achieving health goals set by the United Nations. In 2018, $3.65tn was spent on healthcare in the United States, and these costs are projected to grow at an annual rate of 5.5% over the next decade.

High healthcare costs are causing Americans to get sicker from delaying, avoiding, or stopping medical treatment.A 2009 study conducted by researchers at Harvard Medical School found 45,000 Americans die every year as a direct result of not having any health insurance coverage.

 

[multivita-man]

Probably not cutting cost growth in half at the same time it provides tens of millions access to care, one assumes.

"Success" is defined in terms of controlling costs while providing more people access, and in that sense, Obamacare is a moderate success. A single payer M4all scheme would be better, but Obama is the only real compromise if we want to clutch on to the belief that private for-profit healthcare is a superior system, which it is in some cases but not in others. I definitely believe in a private system that supplements and acts as an alternative for those who can afford it, but a Canadian or European style system for everyone else.

 

[multivita-man]

So the obvious solution is to just accept that some people aren't worthy of getting to a doctor, right?

Increasingly, the average US patient doesn't see an MD anyway - at least not directly. You're likely to be evaluated by an RN or PA, which is probably okay in most situations but some serious situations can get missed in the process.

 

[Greenbeard]

Sure, I agree with that. They also show that the ACA has done nothing to solve the problem.

Nah, your numbers show something remarkable: the ACA cutting health care cost growth in half at the same time tens of millions of Americans gained access to care (something you indicated above should "drastically increase the demand for healthcare, which means drastically increasing prices"):

ESI Average Annual Premium Growth

	Before Obamacare (2000-09)​	After Obamacare (2010-19)​
Single Coverage	8.2%​	4.1%​
Family Coverage	8.8%​	4.4%​

Growth in NHE

1970s to 1980​	1980s to 1990​	1990s to 2000​	2000s to 2010​	2010s to 2020​
211%​	158%​	71%​	73%​	50%*​

*That's including the huge pandemic-induced spike in health care spending in 2020.

Ultimately more interesting is the fact that it bent the cost curve, bringing cost growth in the health sector in line with growth in the non-health portion of the economy:

Growth in Health Care as a Share of GDP

1960s​	1970s​	1980s​	1990s​	2000s​	2010s (Obamacare era)​
2 percentage points​	2 points​	More than 3 points​	More than 1 point​	About 4 points​	0.4 points​

Health care spending grew almost not at all as a share of GDP in the decade after the ACA passed, its growth largely fell in line with the rest of the economy. Again, during a period in which 20+ million people newly gained coverage.

Meanwhile, the long-term budget picture of the federal government health spending changed dramatically over that period.

Pre-Obamacare (the June 2009 Long Term Budget Outlook), federal health spending--which was then only Medicare + traditional Medicaid--was on track to constitute 12.5% of GDP by 2052.

Post-Obamacare cost slowdown (the most recent July 2022 Long Term Budget Outlook), federal health spending--i.e., Medicare + traditional Medicaid + Medicaid expansion + ACA marketplace subsidies--is on track to constitute 8.8% of GDP by 2052.

That's a whopping 30% decline, despite adding financial support for tens of millions of Americans. All because of the Obamacare-era marked decline in health care cost growth.

 

[LetsGoBrandon]

Probably not cutting cost growth in half at the same time it provides tens of millions access to care, one assumes.

Care that they cannot really afford to take advantage of.

 

[Greenbeard]

"Success" is defined in terms of controlling costs while providing more people access, and in that sense, Obamacare is a moderate success.

A decade ago, when the official bean counters published their figures on national health care spending at the time the ACA passed, they reported that health care made up 17.9% of GDP in 2010 ("Growth In US Health Spending Remained Slow In 2010; Health Share Of Gross Domestic Product Was Unchanged From 2009"). There must've been some subsequent revisions, as downloading the historical data now shows health care as 17.2% of GDP in 2010. The same official bean counters generated some negative press for the ACA just after its passed when they projected it was going to push health care spending up to almost 21% of GDP by the end of the 2010s decade.

The most recent estimates ("November 2022 Health Sector Economic Indicators Briefs") have health care constituting 17.4% of GDP as of this fall.

There's a lot left to do but occasionally we need to take a moment and realize that the last 10-12 have been extraordinary and unprecedented.

 

[Greenbeard]

Care that they cannot really afford to take advantage of.

Medicaid coverage is as affordable as it gets, and marketplace plans offer considerable financial support to lower out-of-pocket exposure for buyers with limited means.

 

[LetsGoBrandon]

Medicaid coverage is as affordable as it gets, and marketplace plans offer considerable financial support to lower out-of-pocket exposure for buyers with limited means.

Uninsured Under the ACA: Millions of Americans Can't Afford Coverage

Rocky Rush, a 37-year-old single father from Nebraska, has gone without health insurance for years due to the cost, and the Affordable Care Act hasn't changed that.

news.yahoo.com

 

[Greenbeard]

Uninsured Under the ACA: Millions of Americans Can't Afford Coverage

Rocky Rush, a 37-year-old single father from Nebraska, has gone without health insurance for years due to the cost, and the Affordable Care Act hasn't changed that.

news.yahoo.com

An eight year old article about the coverage gap created by certain red states refusing to expand Medicaid? You came to the right thread! There’s been some important updates since your article was published in 2014. Head back up to the OP in this very thread to learn more. (Spoiler alert: the number of states refusing to expand Medicaid has dwindled considerably since then and even the remaining holdouts are starting to waver.)

 

[LetsGoBrandon]

An eight year old article about the coverage gap created by certain red states refusing to expand Medicaid? You came to the right thread! There’s been some important updates since your article was published in 2014. Head back up to the OP in this very thread to learn more. (Spoiler alert: the number of states refusing to expand Medicaid has dwindled considerably since then and even the remaining holdouts are starting to waver.)

Yes it has become far more expensive since then. Now you librul;s are just gloating about an alleged slowdown in the rate of increases.

 

[Greenbeard]

Yes it has become far more expensive since then. Now you librul;s are just gloating about an alleged slowdown in the rate of increases.

Your article tells the story of a guy in Nebraska who couldn’t get expanded Medicaid under the ACA because Nebraska’s GOP politicians blocked Medicaid expansion there. The update to that story is: the voters in Nebraska stepped in and did it for them. Nebraska expanded Medicaid last year.

Medicaid expansion in Nebraska, one year later

The final full roll out of Medicaid expansion was just over a year ago, and Nebraskans are feeling the benefits.

www.1011now.com

A happy ending.

 

[LetsGoBrandon]

Your article tells the story of a guy in Nebraska who couldn’t get expanded Medicaid under the ACA because Nebraska’s GOP politicians blocked Medicaid expansion there. The update to that story is: the voters in Nebraska stepped in and did it for them. Nebraska expanded Medicaid last year.

Medicaid expansion in Nebraska, one year later

The final full roll out of Medicaid expansion was just over a year ago, and Nebraskans are feeling the benefits.

www.1011now.com

A happy ending.

It's not just about those eligible for medicare or expanded medicare. It's about the middle class in general.

 

[Galactic Spin]

No, it is a failure. No amount of your bullshit can refute the below charts, and prices will just keep rising with no end in sight.

View attachment 67425482


View attachment 67425483

View attachment 67425484

If this is "success", I'd hate to see what failure looks like.

You forgot to make any actual point. You literally only demonstrated that forces other than medicaid expansion are responsible for driving costs. Duh.