Get rid of Obamacare? What would you replace it with?

[jimbo]

The reason I brought up poor people is if they dont have insurace or a means to pay for their health care, you have 2 choices, push them to the curb or pay for it. You can pay for thier insurance or their healthcare. But you cant not pay.

Another time, another thread.

You may not believe this, but I do have opinions on this, and possible solutions.

 

[danarhea]

How about a plane ticket to France?

This is a response to what part I was asking about the health care issue?

 

[jimbo]

Nope. The only thing I see wrong is you have a comprehension problem.

I know it's early in the school year but they will get to the par t where they teach you to think. If you still have a problem understanding what I said then get with the teacher for some extra work. I'll give you a hand, pretty much means almost. So when I said pretty much voluntary it meant almost voluntary.

I'll bite. What the hell is almost voluntary in demanding that someone buy a product that you decide they need?

I'm sorry, I meant pretty much, not voluntary.

 

[Heebie Jeebie]

I'll bite. What the hell is almost voluntary in demanding that someone buy a product that you decide they need?

Not requiring all the other things to be bought. You know like making women buy coverage for vasectomies and making men buy pre-natal care coverage.

If I had meant to say completely voluntary I would have said that. Sorry I used a term that seems to have confused so many people.

 

[ttwtt78640]

Well uh yeah, that's why I included in what I think should be done to health insurance. You do realize it is a separate type of policy you can buy right now don't you?

That type of plan is going to be very, very rare under PPACA:

Individuals under 30 years of age or those exempt from the individual mandate because no affordable plan is available to them or because of a hardship may purchase a catastrophic plan providing the essential benefits package with a deductible equal to the total limitation on cost-sharing above and first-dollar coverage of at least three primary care visits.

http://www.naic.org/documents/committees_b_Exchanges.pdf

 

[Dapper Andy]

This is a response to what part I was asking about the health care issue?

Yeah. And I proposed a plane ticket to France.

Where is the confusion?

 

[ttwtt78640]

You realize that catastrophic coverage is health insurance right?

More accurately is was medical care insurance, it is now baiscally "illegal" under PPACA.

 

[Helix]

my preference is Medicare for all. the basic structure is already there, and we can expand it to include everyone. health care is an essential service with inelastic demand, and it's a fantasy that it will ever be most efficiently delivered via three levels of for profit entities between the patient and the outcome.

Medicare for all would give the program serious leverage to force down prices, and that's what's going to have to happen. a broken arm should not cost ten to twelve thousand dollars. a heart attack should not result in a bankruptcy for anyone. and while i love playing benefit shows for people, no one should have to depend on one just to pay for medication.

here are a couple things that are going to have to happen :

1. Medicare will negotiate prices that will be paid for essential services, and there will be thorough oversight of the process. refusing to accept medicare patients will not be an option.

2. The AMA's artificial bottleneck on the doctor supply ends. financial barriers to becoming a doctor will be removed, and this part of the cost problem will be helped via competition. I work at a med school, so i see how it works.

3. currently, it costs more than a billion dollars to get a drug into phase three, and that doesn't even guarantee that it will be approved. under the current system, aspirin wouldn't even make the cut. the patient is going to have to accept some degree of risk and to forfeit the ability to sue over some mistakes. we simply can't afford the system as it is now.

4. on the same topic, the length of patents for new drugs will be dependent on retail cost. a massively expensive and essential cancer drug will go off patent before a more reasonably priced one. we need to incentivize sanity in drug pricing.

i understand that these are pie in the sky ideas that probably won't happen in my lifetime, but i have worked in the industry, i see where the bottlenecks and problems are, and have thought about it a lot. this would be my ideal solution.

the PPACA will fix almost none of it, because it doesn't control costs, and it leaves in place the idiotic employment-specific health insurance debacle. an employer is not a health care provider, and it makes businesses less competitive.

i'd pay for the new system with taxes and through reprioritization. to me, it is much more important to fix this mess than to be pro bono world cop. we can afford to make a few less things that kill people in favor of making a few more changes that help our own citizens.

 

[danarhea]

Yeah. And I proposed a plane ticket to France.

Where is the confusion?

I respectfully ask you to leave this thread, since you have chosen to troll instead of discuss the issue.

 

[danarhea]

my preference is Medicare for all. the basic structure is already there, and we can expand it to include everyone. health care is an essential service with inelastic demand, and it's a fantasy that it will ever be most efficiently delivered via three levels of for profit entities between the patient and the outcome.

Medicare for all would give the program serious leverage to force down prices, and that's what's going to have to happen. a broken arm should not cost ten to twelve thousand dollars. a heart attack should not result in a bankruptcy for anyone. and while i love playing benefit shows for people, no one should have to depend on one just to pay for medication.

here are a couple things that are going to have to happen :

1. Medicare will negotiate prices that will be paid for essential services, and there will be thorough oversight of the process. refusing to accept medicare patients will not be an option.

2. The AMA's artificial bottleneck on the doctor supply ends. financial barriers to becoming a doctor will be removed, and this part of the cost problem will be helped via competition. I work at a med school, so i see how it works.

3. currently, it costs more than a billion dollars to get a drug into phase three, and that doesn't even guarantee that it will be approved. under the current system, aspirin wouldn't even make the cut. the patient is going to have to accept some degree of risk and to forfeit the ability to sue over some mistakes. we simply can't afford the system as it is now.

4. on the same topic, the length of patents for new drugs will be dependent on retail cost. a massively expensive and essential cancer drug will go off patent before a more reasonably priced one. we need to incentivize sanity in drug pricing.

i understand that these are pie in the sky ideas that probably won't happen in my lifetime, but i have worked in the industry, i see where the bottlenecks and problems are, and have thought about it a lot. this would be my ideal solution.

the PPACA will fix almost none of it, because it doesn't control costs, and it leaves in place the idiotic employment-specific health insurance debacle. an employer is not a health care provider, and it makes businesses less competitive.

i'd pay for the new system with taxes and through reprioritization. to me, it is much more important to fix this mess than to be pro bono world cop. we can afford to make a few less things that kill people in favor of making a few more changes that help our own citizens.

I am playing a benefit for Papa Bluez on September 29th. He died of a heart attack about a month ago. We already raised the money to cremate him, and now we are raising money for his wife and kid, to help them get back on their feet. They did not have insurance. Papa Bluez was a musician, but he also worked a full time job. He did not have enough money to go see the doctor when he first started having possible symptoms, so he said nothing, hoping it would go away. It didn't. It killed him. Because of this, I have examined my own philosophy about whether we should have some kind of health care, and I found something seriously wrong with my old position on this issue. I have changed my mind. While I am not crazy about Obamacare, I believe that we should have something. In a nation this powerful and well off, something is seriously screwed up if we decide that we should just let people die. It is not civilized, and it is certainly not American.

 

[jimbo]

Not requiring all the other things to be bought. You know like making women buy coverage for vasectomies and making men buy pre-natal care coverage.

If I had meant to say completely voluntary I would have said that. Sorry I used a term that seems to have confused so many people.

Almost voluntary, or purty much voluntary are impossible. Things are either voluntary or they are not. In addition, if I am smart or dumb enough to decide that I do not need basic heath care, which you want to decide for me. Then I am smart enough to decide if I want to volunteer for your catastrophic health plan.

PJ O'Rourke had a good quote. Did you ever bother to read it?

 

[Helix]

I am playing a benefit for Papa Bluez on September 29th. He died of a heart attack about a month ago. We already raised the money to cremate him, and now we are raising money for his wife and kid, to help them get back on their feet. They did not have insurance. Papa Bluez was a musician, but he also worked a full time job. He did not have enough money to go see the doctor when he first started having possible symptoms, so he said nothing, hoping it would go away. It didn't. It killed him. Because of this, I have examined my own philosophy about whether we should have some kind of health care, and I found something seriously wrong with my old position on this issue. I have changed my mind. While I am not crazy about Obamacare, I believe that we should have something. In a nation this powerful and well off, something is seriously screwed up if we decide that we should just let people die. It is not civilized, and it is certainly not American.

I just got invited to play one next week. Hope that yours goes well.

Edit to add : I used to be very opposed to changing our health care system. Then I lost my job, and due to a problem with my COBRA, I briefly had to navigate the system without insurance. Luckily, COBRA was retroactive, so I didn't have to pay full price. Really opened my eyes, though, and made me do the research that led to my change of opinion.

 

[Dapper Andy]

I respectfully ask you to leave this thread, since you have chosen to troll instead of discuss the issue.

Troll?

You asked a question and I answered it.

Why don't you just tell us what answer you'll accept and we can end the discussion?

 

[danarhea]

Insurance should be pretty much voluntary.

Set a minimum policy level that covers the basics for men and women (office visits, prescription drugs, vaccinations, basic screenings based on your sex, etc) and all companies can offer it in any State they want. Have real competition for business with apples to apples plans. No making men buy OB/GYN coverage and no making women buy vasectomy coverage. You buy your own coverage.

I would limit what insurance companies could consider a pre-existing condition, just because you smoked for a year 20 years ago should not make you have a pre-existing condition. No turning down for pre-existing conditions up to a certain date (say 6 months or a year after the law passed) so you can't wait to get sick then buy insurance but if you already are you can get coverage. I would consider subsidies for costly diseases.

I would also come up with a catastrophic coverage plan that everyone is required to have.

If you want an options you buy a better than minimum policy.

If everyone is required to have catastrophic coverage, then it is not voluntary, of course. But, beyond that, the reason that many illnesses become catastrophic, is because many people do not get yearly checkups, or see doctors for what they wrongly perceive to be minor problems. Therefore, a catastrophic only plan defeats the purpose of having a health care program that is cost efficient.

So, I really see only two logical outcomes for this....... Either include everything in the health care plan, or have no health care plan at all. But, knowing how our government operates, they will choose option 3, which is a plan that is totally illogical. Is Obamacare, as it now stands, that illogical option 3?

 

[Captain Adverse]

Obamacare won't be repealed. Under the Roberts Court, it is settled law.

The only thing "settled in law" is that the government can set up a national insurance plan. It does not have to be "Obamacare." Any Act of Congress can be repealed by Act of Congress. :fyi:

And, more importantly, if there is a better way than Obamacare to offer health care to the American people, I would certainly like to hear it.

Really?

Then how about a National Health Insurance plan modeled on Canada or the UK? Maybe even like the one they have in France, or "God forbid" Cuba?

All simple, clear-cut health insurance plans. Of course they'd all cut into the profits of Health Insurers, Big Pharma, and the "honorable" members of the AMA...

But if you want honest to goodness health insurance any of those plans would be light-years ahead of the one we are stuck with. :twocents:

 

[danarhea]

The only thing "settled in law" is that the government can set up a national insurance plan. It does not have to be "Obamacare." Any Act of Congress can be repealed by Act of Congress. :fyi:



Really?

Then how about a National Health Insurance plan modeled on Canada or the UK? Maybe even like the one they have in France, or "God forbid" Cuba?

All simple, clear-cut health insurance plans. Of course they'd all cut into the profits of Health Insurers, Big Pharma, and the "honorable" members of the AMA...

But if you want honest to goodness health insurance any of the plans would be light-years ahead of the one we are stuck with. :twocents:

Which has been attempted more than a dozen times. Obamacare is here to stay, whether we like it or not. I am being pragmatic in my argument here. I am not crazy about Obamacare either, but am looking for something that it could be replaced with. I have seen some decent ideas from both Conservatives and Liberals in this thread, which means that some kind of common ground exists, which could be used to hammer out a better solution than what we have now.

So what kind of solution exists, within the framework of Obamacare, that both Liberals and Conservatives could spin as a victory, and save face? I believe that this is the only paradigm that would work at this time, in light of the present political situation.

 

[Captain Adverse]

Which has been attempted more than a dozen times. Obamacare is here to stay, whether we like it or not. I am being pragmatic in my argument here. I am not crazy about Obamacare either, but am looking for something that it could be replaced with. I have seen some decent ideas from both Conservatives and Liberals in this thread, which means that some kind of common ground exists, which could be used to hammer out a better solution than what we have now.

So what kind of solution exists, within the framework of Obamacare, that both Liberals and Conservatives could spin as a victory, and save face? I believe that this is the only paradigm that would work at this time, in light of the present political situation.

So I provide you with a valid response and that is the best you can do? LOL

It can be repealed, and it can be replaced with something akin to my suggestions. Of course since we all know our representatives are bought and paid for by special interest groups who forced them to create "obamacare" in the first place we don't expect them to act in OUR best interests.

You made an incorrect legal assertion and asked a question. I provided valid answers. I can't help it if you refuse to accept that our government does not really have our best interests at heart, or if you prefer, that you are "thinking practically" because you know they don't have our best interests at heart.

 

[danarhea]

So I provide you with a valid response and that is the best you can do? LOL

It can be repealed, and it can be replaced with something akin to my suggestions. Of course since we all know our representatives are bought and paid for by special interest groups who forced them to create "obamacare" in the first place we don't expect them to act in OUR best interests.

You made an incorrect legal assertion and asked a question. I provided valid answers. I can't help it if you refuse to accept that our government does not really have our best interests at heart, or if you prefer, that you are "thinking practically" because you know they don't have our best interests at heart.

Of course, I know they don't have our best interests at heart, but given the current political climate, they only solution that exists is going to have to be a pragmatic one.

And, again, there have been more than a dozen attempts to repeal Obamacare, and they all failed. Are we really going to keep going down that road, when it has already been demonstrated many times that it can't be done?

 

[Captain Adverse]

Of course, I know they don't have our best interests at heart, but given the current political climate, they only solution that exists is going to have to be a pragmatic one.

And, again, there have been more than a dozen attempts to repeal Obamacare, and they all failed. Are we really going to keep going down that road, when it has already been demonstrated many times that it can't be done?

They have failed because they are unilateral action on the part of one party, while the other does not want to embarass their seated President. They also fear the special interest groups who led them into creating obamacare. If the voting citizens were active enough (yes, a laughable suggestion) and Congressmen were worried about their seats, it could be done.

Most Americans are just too damned lazy-minded to act these days. I blame television! LOL

 

[jimbo]

Which has been attempted more than a dozen times. Obamacare is here to stay, whether we like it or not. I am being pragmatic in my argument here. I am not crazy about Obamacare either, but am looking for something that it could be replaced with. I have seen some decent ideas from both Conservatives and Liberals in this thread, which means that some kind of common ground exists, which could be used to hammer out a better solution than what we have now.

So what kind of solution exists, within the framework of Obamacare, that both Liberals and Conservatives could spin as a victory, and save face? I believe that this is the only paradigm that would work at this time, in light of the present political situation.

The problem with your questions are the modifiers i.e. "within the framework of Obamacare, and "save face". Starting with the last, I don't care whether anyone saves face or not. If the perps of this scam come off looking like scammers, good. The first, within the framework of Obamacare, why? The health care bill is so flawed that thousands of groups have been exempted, including the politicians whut brung us here, and Barry has, without input from those who passed the bill, delayed or scratched over a third of the original bill. This is a bye bye for me.

 

[mpg]

When you put out a fire, what do you replace it with?

 

[Heebie Jeebie]

If everyone is required to have catastrophic coverage, then it is not voluntary, of course. But, beyond that, the reason that many illnesses become catastrophic, is because many people do not get yearly checkups, or see doctors for what they wrongly perceive to be minor problems. Therefore, a catastrophic only plan defeats the purpose of having a health care program that is cost efficient.

So, I really see only two logical outcomes for this....... Either include everything in the health care plan, or have no health care plan at all. But, knowing how our government operates, they will choose option 3, which is a plan that is totally illogical. Is Obamacare, as it now stands, that illogical option 3?

Well that's why I said it was mostly voluntary.

Catastrophic coverage is the most expensive and unknown quantity in insurance. You can't predict when a drunk driver is going to hit you and put you in the hospital racking up hundreds of thousands of uncovered bills. You can't predict when cancer will strike and require life saving surgery and treatment. You can't predict when a heart attack will occur that requires emergency surgery and aftercare.
By requiring everyone to be in that pool you make the basic maintenance of people, the health part of health care as opposed to the life saving care of emergency surgery. You take a lot of the unknown, expensive things out of the equation. Then you could choose what sort of 'maintenance' plan you wanted to buy, if you desired one at all. Not a female, then you don't buy anything related to being pregnant. 20 years old, then maybe you don't want colonoscopy coverage. Hypochondriac, then maybe you want to buy everything offered whether you will ever need it or not. Just want the bare minimum, buy the bare minimum plan.
It didn't have to be made so complicated. Whatever it is we have now with Obamacare is not affordable, does nothing to improve healthcare and is indecipherable to the average person. I think what we have is option 3 now. I'm not sure you could purposely design something worse.

 

[Harshaw]

Obamacare won't be repealed. Under the Roberts Court, it is settled law.

The one has nothing to do with the other.

In addition, any attempt to defund Obamacare, using the debt ceiling as a hostage, or threatening to shut down the government. will end up destroying the Republican party, since a vast majority of people are now in favor of it. The more moderate faction of the Republican party sees this, and will undermine any attempt by the Tea Party faction to carry this out. Thus, any attempt at this will fail in the House, as it already has, many times in the past. Like it or not, Obamacare is here to stay.

Obamacare? It's a mixed bag. Having the Federal government dictate our health care is a repugnant idea, but what is the alternative? Emergency rooms? Do you have any idea how much THAT costs the taxpayers? At least, with the individual mandate, the taxpayers will be recovering some of what they lose when people go to the emergency room, and then not pay for the visit.

Here is what I would like to see. What would YOU advocate as a replacement for Obamacare, would it be a better option, and how and why?

I would like to see some serious ideas. "Obamacare is a Leebrul Communist conspiracy" or "Republicans want to get rid of Obamacare because they hate poor people" are NOT valid ideas. They are stupid and moronic troll posts, so don't be a moron or a troll. If you have an idea, I would certainly like to see it. If you have no ideas, but still feel, for a legitimate reason, that Obamacare needs to go, then that is OK, but please explain why, and explain intelligently, and I will have no problem with that.

Bottom line here..... Is health care a right, or is it a privilege to be enjoyed by only those who can pay for it, or who you feel deserve it? If it is a right, then explain why you support it. If it is a privilege, then explain why you don't support it. And, more importantly, if there is a better way than Obamacare to offer health care to the American people, I would certainly like to hear it.

At this time, my lean is against Obamacare, but I have an open mind. Convince me, one way or the other.

:shrug: The implication is that there needs to be an alternative; that is not necessarily so.

But there are plenty of meaty of proposals out there. The idea that there aren't any simply says you haven't tried very hard to find any.

Here's a detailed proposal from the American Enterprise Institute, for example:

Constructing an alternative to Obamacare: Key details for a practical replacement program - Health - AEI

Here's a description of the Pipes Plan:

The Best Alternative to Obamacare - Clark S. Judge (usnews.com)

Here's a rundown of Republican proposals from over the years:

Republicans Have Introduced Alternatives To Obamacare For Years | RedState

Here's Business Insider with a rundown of "12 Alternatives":

12 Alternatives To Obamacare - Business Insider

It goes on and on if you just dig around a little.

 

[Greenbeard]

Here's a rundown of Republican proposals from over the years:

Republicans Have Introduced Alternatives To Obamacare For Years | RedState

I think you're underestimating the degree to which those overlap with Obamacare. A number of Enzi's steps are in Obamacare (in fact, the language from his tort reform section was copied verbatim into Obamacare), the Patients Choice Act was built around state-based exchanges as was Obamacare, etc.

Plenty of those ideas appear in some variation in the law, which is part of the reason the GOP has had such difficulty coalescing around a real alternative since it passed.

 

[obvious Child]

Honestly, nothing will matter until we get some transparency into health costs.

When an operation can cost $500 in one place and $50,000 in another, we have a severe information problem.

We gotta fix that before anything else.