• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!

Affordable Care Act threatened as Trump administration, GOP states fight U.S. House, Democratic stat

jonny5 said:
Obviously. Why would the writers put in the constitution a list of all congresses powers, and a method to add to them if the states agree, but then just assume that we knew they meant govt could create massive programs to buy products and services for individuals and create millions of pages of regulations?

Why would Madison (again, hes the guy who wrote it) make that exact argument?
Click to expand...

Great... Let's start there... The GOP should adopt eliminating Medicare and Medicaid as their platform for health care in 2020.
 
BlueTex said:
Great... Let's start there... The GOP should adopt eliminating Medicare and Medicaid as their platform for health care in 2020.
Click to expand...

I wish, but as I said earlier, they ( and the voters) care more about winning elections than law and order, consent of the governed, small govt, liberty, fiscal responsibility, etc.
 
jonny5 said:
I wish, but as I said earlier, they ( and the voters) care more about winning elections than law and order, consent of the governed, small govt, liberty, fiscal responsibility, etc.
Click to expand...

Yeah, theoretical politics is a lot different then applied politics...
 
BlueTex said:
MRI machines were great money makers for a while but alas, the great medicare piggy bank is drying up...

Imaging growth leveling off due to reimbursement cuts, changes in ordering

Is it your assumption that more machines per capita results in better outcomes?
Click to expand...

Uh, yeah? Do you know what the wait time for an MRI scan in Canada is?
Patients also experience significant waiting times for various diagnostic technologies across the provinces. This year, Canadians could expect to wait 4.3 weeks for a computed tomography (CT) scan, 10.6 weeks for a magnetic resonance imaging (MRI) scan, and 3.9 weeks for an ultrasound.
Click to expand...
You are being redirected...

The two times I've needed MRI I had them within 24 hours of the doc saying "we need this". In both cases, had I waited, the treatment I needed would have been delayed leading to a less positive outcome, more pain and possibly lifetime damage to ligaments.
 
BlueTex said:
Hmmm.... Does that have anything to do is reimbursement rates?
Click to expand...

There is significant evidence MRIs once purchased are over used and do not necessarily lead to improved health.

BlueTex said:
Are Medicare and HMO cuts to imaging hurting patients? The New England Journal of Medicine thinks not. There are side-effects to these scans including increased levels of radiation exposure, especially dangerous for kids. As with any test, there is the probability of a false positive (i.e., that patient does not have the disease, but the test claims they do). “A study from the National Institutes of Health found that 17% of patients getting tested for cancer had at least one false positive chest X ray over a four-year period, and 8% of women had at least one false positive ultrasound for ovarian cancer.” These figures lend some more evidence that Americans may be Overtreated (see my post on Shannon Brownlee’s book of the same name).

Forbes also finds that “a doctor who owns his own machine is four times as likely to order a scan as a doctor who doesn’t.” Financial incentives do make a difference (for more information on how physician financial incentive affect surgery rates, see my working paper “Operating on Commission“).
Click to expand...

Pittsburgh has more MRI Machines than Canada – Healthcare Economist

Mortality from cancer is higher in Canada, but that is not necessarily due to better treatment. Also, while mortality from cancer is higher in Canada, mortality for many other conditions is higher in th US.

How do mortality rates in the U.S. compare to other countries? - Peterson-Kaiser Health System Tracker
 
manofknowledge said:
There is significant evidence MRIs once purchased are over used and do not necessarily lead to improved health.



Pittsburgh has more MRI Machines than Canada – Healthcare Economist

Mortality from cancer is higher in Canada, but that is not necessarily due to better treatment. Also, while mortality from cancer is higher in Canada, mortality for many other conditions is higher in th US.

How do mortality rates in the U.S. compare to other countries? - Peterson-Kaiser Health System Tracker
Click to expand...

You mean once someone purchases a multi million dollar machine they tend to use it as often as possible to pay for it?
 
BlueTex said:
Yeah, theoretical politics is a lot different then applied politics...
Click to expand...

Certainly. Theory assumes the citizens who live in a country generally agree on its principles. In reality at least half the country is socialist.
 
manofknowledge said:
We don't need to change it since the legal arguments support my position, not yours.
Click to expand...

Legal arguments support both positions. Legal decisions made by govt generally support govts position. What would happen if we put it to an actual vote of the governed?
 
jonny5 said:
Legal arguments support both positions. Legal decisions made by govt generally support govts position. What would happen if we put it to an actual vote of the governed?
Click to expand...

The governed already voted.
 
JasperL said:
What's clear enough is big deductibles deter use, but that's got upsides and downsides. There's a good reason why lots of private insurance now and even before ACA made some preventive care free, such as an annual checkup. I've also not seen evidence that the kind of 'overuse' that you're referring to is a big cost driver. What I've seen is a relatively small share of the population that's very sick with chronic problems consume a huge share of the healthcare costs.



I have no problem with high deductible plans or HSAs, but a bronze ACA plan is pretty much there, and as you know high deductible plans are also permitted under ACA. The problem is when people are old or sick, those "high deductible" plans aren't anything but high cost plans, year after year after year, because sick and old people need and use lots of care. I have arthritis and the cost of the drug that keeps me from being a cripple costs $5,000/month taken as prescribed. I take it 1/4th that often, but the 'cost' is still about $15,000. So a plan with a $10k deductible to me is just a plan with premiums of what I pay directly plus that $10k deductible, because I WILL meet it every single year. For the 45 years before I was diagnosed with arthritis, a high deductible plan would have worked great, then overnight it didn't.



OK, great, then I'll wait on the 'free market' GOP plan that's not coming to see how this fictional plan will work.... :roll:

The serious point is all this is very easy to say on a debate forum, but putting the details to paper is incredibly difficult and there is NO indication the GOP has any desire to do that hard work, because by all indications they simply don't care about the issue. The kind of plan you envision will also have lots of losers, like me most likely, which is fine, but politically allowing voters to see who loses, which happens when an ACTUAL plan is put to a vote and scored, doesn't work that well. So it's easier to promise a bunch of stuff that sounds good, call what the other guy does terrible, awful, etc. and never put your own plan into practice. That's the GOP strategy as far as I can tell.
Click to expand...

(Intended as a "response to thread, but not possible. Your message pops up.)

Conservatives, republicans, libertarians... You accept the VA, you made your peace with Social Security, you got over Reagan's absurd predictions about Medicare, you will not abolish the ACA, and you are moving a bit to not only repeal, but "replace" Obamacare. Your position used to be that "America has the best healthcare in the world", or as an alternative, "you have to wait 20 years for a chest x-Ray in Canada". Get over it. Americans want some form of government sponsored health care. Help out.

Trump gets it. He has promised a bigger better health care system than Obamacare, no doubt to be paid for by Mexico.
 
jonny5 said:
Legal arguments support both positions. Legal decisions made by govt generally support govts position. What would happen if we put it to an actual vote of the governed?
Click to expand...

We effectively do.

You're a Libertarian. Let's count the number who share your views in the U.S. Congress. Do we hit a handful, who run as Republicans?
 
Jay59 said:
Good point. What does Trump say?
Click to expand...

He's for UHC, or so he said in the campaign, covers everyone, cheaper, better, you know, the kind of thing only Dear Leader can do! I know I'm sitting on the edge of my seat waiting for his bestest, greatest, healthcare plan of all time that will come out in the next few weeks, he promised.
 
manofknowledge said:
The governed already voted.
Click to expand...

We never voted on adding powers to congress. Voting in reps does not create powers. But the obvious answer is if you tried to put in an amendment giving power to congress to regulate healthcare, it would fail to be ratified by 3/4 of the states.
 
Jay59 said:
The real issue is that the core federal program is insolvent.
Click to expand...

The ACA has been less expensive than anticipated. It was already designed to be a deficit-reducer and yet ended up saving more and spending less than projected.
 
JasperL said:
He's for UHC, or so he said in the campaign, covers everyone, cheaper, better, you know, the kind of thing only Dear Leader can do! I know I'm sitting on the edge of my seat waiting for his bestest, greatest, healthcare plan of all time that will come out in the next few weeks, he promised.
Click to expand...
A little checking shows that Trump is in favor of a national healthcare program. That is not the same thing as UHC. He has been very clear that ACA is a step in the wrong direction. Again, UHC is contraindicated.

It was an open ended question and you gave nothing of substance. Did you bother to check?
 
Greenbeard said:
The ACA has been less expensive than anticipated. It was already designed to be a deficit-reducer and yet ended up saving more and spending less than projected.
Click to expand...

It's higher than anticipated per person, but with much lower enrollment.
 
Renae said:
Uh, yeah? Do you know what the wait time for an MRI scan in Canada is?

You are being redirected...

The two times I've needed MRI I had them within 24 hours of the doc saying "we need this". In both cases, had I waited, the treatment I needed would have been delayed leading to a less positive outcome, more pain and possibly lifetime damage to ligaments.
Click to expand...

Weird you didn't give waiting times for other countries.
 
Jay59 said:
A little checking shows that Trump is in favor of a national healthcare program. That is not the same thing as UHC. He has been very clear that ACA is a step in the wrong direction. Again, UHC is contraindicated.

It was an open ended question and you gave nothing of substance. Did you bother to check?
Click to expand...

Trump is not into having plans. The guy just improvises as things come and go. He could not even have a plan for way less complicated issues like how to fund a border wall. He campaigned on claiming that the Mexicans would pay for it. He did not have a plan for processing way more asylum seekers and illegal immigrants up until we learned about the horrible conditions in the detention centers. Do you really believe that Trump has a vision and a plan for a different healthcare system?
 
Jay59 said:
It's higher than anticipated per person, but with much lower enrollment.
Click to expand...

Just to be clear, you're acknowledging that this "insolvent" program costs less than the money that was dedicated to paying for it (which more than covered it, even before it came in below cost projections)?
 
You must log in or register to reply here.
Back
Top Bottom