How RBG’s death could trigger a devastating blow to the U.S. health-care system

[Rogue Valley]

How RBG’s death could trigger a devastating blow to the U.S. health-care system

9/24/20
Ruth Bader Ginsburg’s death last week was undoubtedly a loss for those who loved and admired her. It also may have dealt a devastating blow to the entire U.S. health-care system and nearly every American who interacts with it — young and old, Republican and Democrat, healthy and sick alike. The week after Election Day, the Supreme Court is scheduled to hear arguments in a case seeking to strike down the Affordable Care Act. The case, filed by 20 red states and supported by the Trump administration, rests on a convoluted legal argument: When Congress reduced the penalty for not having health insurance to zero dollars, the individual mandate ceased to be an exercise of Congress’s taxing power and became unconstitutional. Congress also designed everything in the law to be inextricably linked, the plaintiffs argue, so if the individual mandate is gone, the rest of the law should fall, too. Of course, just as it acted to zero out the mandate, Congress had the opportunity to destroy the rest of the law. Instead, lawmakers voted, many times, not to do so. For this and other reasons, even conservative scholars who oppose Obamacare have dismissed the case as baloney. But lower courts agreed with the plaintiffs, and the question has reached the Supreme Court.


A of range outcomes is possible, depending on whether President Trump gets another court pick confirmed in time, and whether justices vote as they have in prior challenges to the law. Obamacare’s destruction, in whole or in part, could wreak havoc and financial ruin. If the ACA were struck down, its protections for people with preexisting conditions would disappear. Insurers wouldn’t have to sell plans to everyone, at nondiscriminatory rates; they could exclude coverage for illnesses they determined to be preexisting; and they could reimpose caps on how much they paid out for essential benefits. (That is, insurers could revert to their pre-Obamacare practices.) In a 2019 analysis, the Kaiser Family Foundation estimated that 54 million non-elderly adults had preexisting conditions serious enough that they would likely be outright declined health insurance, absent these protections. Millions more would find insurance unaffordable, even if they still qualified for it. Medicaid coverage would shrivel, too. Republicans claim to have a plan to protect people with preexisting conditions. In fact, Republicans don’t have any health-care plan, period. Health coverage has already declined in recent years, thanks to backdoor sabotage of an imperfect but critical law. Front-door sabotage may be imminent, and America isn’t prepared.

These comments apply to everyone except perhaps the independently wealthy. When you vote in the 2020 election, remember that in the week following election day (November 3rd) the Supreme Court will decide on a lawsuit filed against the ACA (Obamacare) by 20 Republican Secretaries of State. The Republican Congress of 20116-2018 didn't have the cojones to scrap Obamacare itself, so the GOP thought it would try a backdoor operation. The 20 GOP Secretaries of State filed their lawsuit against Obamacare in highly conservative federal court district in Texas where they knew they would win. And after they did "win", other states and activist groups appealed the Texas ruling. It has now reached the Supreme Court.

As you cast your ballot, remember that the Republicans are trying their best to remove your basic medical protections, and they have no plan at all to replace Obamacare. They intend to throw you to the wolves. In effect, healthcare insurance companies, hospital corporations, and pharmaceutical houses could set their various prices to whatever they wished, deny insurance to whomever they wished, and demand payment up front for a hospital admittance. All of this is what the Republicans don't want you to know. Shhhhhhh. The RV Rule of Thumb #6: 'Republicans will always favor corporations over the individual.' The GOP exists to please their magnanimous corporate campaign donors (which includes healthcare insurance companies, hospital service corporations, and pharmaceutical corporations.)

 

[Greenbeard]

Trump and the GOP creep closer to realizing their goal of burning down the American health care system.

 

[Mr Person]

Knocking out ACA would have a horrible backfire effect for the GOP, but I cannot wish for it as it would rip insurance from tens of millions and let insurers go back to cheating hundreds of other millions just when they needed their insurance.

It's beyond ****ed up that the right makes health care into a wedge issue. Every other first world nation has some form of health care involving at least universal basic health care at an affordable cost. There's a mix of systems, with individuals paying for different shares of their care. But every last one of them is better and cheaper. Trumpists will cut off their nose to spite their faces, if maybe a liberal might look aghast at the act.




We're screwed

 

[Mashmont]

How RBG’s death could trigger a devastating blow to the U.S. health-care system

These comments apply to everyone except perhaps the independently wealthy. When you vote in the 2020 election, remember that in the week following election day (November 3rd) the Supreme Court will decide on a lawsuit filed against the ACA (Obamacare) by 20 Republican Secretaries of State. The Republican Congress of 20116-2018 didn't have the cojones to scrap Obamacare itself, so the GOP thought it would try a backdoor operation. The 20 GOP Secretaries of State filed their lawsuit against Obamacare in highly conservative federal court district in Texas where they knew they would win. And after they did "win", other states and activist groups appealed the Texas ruling. It has now reached the Supreme Court.

As you cast your ballot, remember that the Republicans are trying their best to remove your basic medical protections, and they have no plan at all to replace Obamacare. They intend to throw you to the wolves. In effect, healthcare insurance companies, hospital corporations, and pharmaceutical houses could set their various prices to whatever they wished, deny insurance to whomever they wished, and demand payment up front for a hospital admittance. All of this is what the Republicans don't want you to know. Shhhhhhh. The RV Rule of Thumb #6: 'Republicans will always favor corporations over the individual.' The GOP exists to please their magnanimous corporate campaign donors (which includes healthcare insurance companies, hospital service corporations, and pharmaceutical corporations.)

Communism has never worked in the history of mankind.

 

[TobyOne]

This is dumb. Getting rid of Obamacare will simply roll health care coverage to what it was like in 2008. It worked fine for most people.

 

[Greenbeard]

This is dumb. Getting rid of Obamacare will simply roll health care coverage to what it was like in 2008. It worked fine for most people.

Except under Obamacare:

Tens of millions gained coverage.

• Since Obamacare Became Law, 20 Million More Americans Have Gained Health Insurance

Health care cost growth slowed down and more health care providers shifted toward more efficient business models.

• Medicare’s cost surprise: It’s going down
• Health Spending Growth Slowing, More on Pace with Economic Growth
• Employers’ Health Care Cost Growth Has Plateaued
• Medicare ACO Results for 2018: More Downside Risk Adoption, More Savings, and All ACO Types Now Averaging Savings

Families enjoyed better financial security.

• How the Affordable Care Act Drove Down Personal Bankruptcy: Expanded health insurance helped cut the number of filings by half

Health outcomes improved.

• Baby Survival Rates Improved in States With Affordable Care Act, Data Show
• Out-of-hospital cardiac arrests fell under the Affordable Care Act
• Medical care, health have improved for low-income adults under ACA
• ACA linked to reduced racial disparities, earlier diagnosis and treatment in cancer care
• Affordable Care Act Increased Rate of Early Cancer Diagnoses
• Uninsured cancer patients saw increased coverage for care following Medicaid expansion
• ACA credited with earlier diagnosis of gynecologic cancers in young women

Patient safety improved.

• Fewer Patients Have Been Dying From Hospital Errors Since Obamacare Started

All of which the GOP seeks to reverse. In addition to bringing back pre-existing conditions!

 

[TobyOne]

"Growth is slowing" doesn't mean its decreasing. And if you're measuring outcomes based on more people getting diagnosed, well yeah, more people are insured.

Obamacare took an industry of spiraling costs and did nothing about it except throw more sick people into the system. It insured more people, to be sure - but removing won't be a "devastating blow" - thats just silly nonsense.

Except under Obamacare:

Tens of millions gained coverage.

• Since Obamacare Became Law, 20 Million More Americans Have Gained Health Insurance

Health care cost growth slowed down and more health care providers shifted toward more efficient business models.

• Medicare’s cost surprise: It’s going down
• Health Spending Growth Slowing, More on Pace with Economic Growth
• Employers’ Health Care Cost Growth Has Plateaued
• Medicare ACO Results for 2018: More Downside Risk Adoption, More Savings, and All ACO Types Now Averaging Savings

Families enjoyed better financial security.

• How the Affordable Care Act Drove Down Personal Bankruptcy: Expanded health insurance helped cut the number of filings by half

Health outcomes improved.

• Baby Survival Rates Improved in States With Affordable Care Act, Data Show
• Out-of-hospital cardiac arrests fell under the Affordable Care Act
• Medical care, health have improved for low-income adults under ACA
• ACA linked to reduced racial disparities, earlier diagnosis and treatment in cancer care
• Affordable Care Act Increased Rate of Early Cancer Diagnoses
• Uninsured cancer patients saw increased coverage for care following Medicaid expansion
• ACA credited with earlier diagnosis of gynecologic cancers in young women

Patient safety improved.

• Fewer Patients Have Been Dying From Hospital Errors Since Obamacare Started

All of which the GOP seeks to reverse. In addition to bringing back pre-existing conditions!

 

[Craig234]

We can't really base the issue on removing 'your' healthcare, because while tens of millions of Americans would lose coverage, a majority would not. We need Americans to care about others, not to simply their own healthcare.

We can head Bernie's direction - more efficient, lower cost, universal healthcare; or we go the other direction, at best the status quo of incomplete, very expensive care, and possible even worse, with the ACA struck down by a corrupt right-wing court, and pre-existing conditions no longer protected and expanded Medicaid ended.

 

[Greenbeard]

Obamacare took an industry of spiraling costs and did nothing about it except throw more sick people into the system.

Not true at all! The Economist covered this well years ago: Shock treatment: A wasteful and inefficient industry is in the throes of great disruption

THE best-known objective of America’s Affordable Care Act of 2010—commonly known as Obamacare—was to ensure that the 40m-plus Americans who lacked health insurance could get it. Less widely appreciated, but at least as important, are the incentives and penalties the law introduced to make the country’s hideously expensive and poorly performing health services safer and more efficient. Economists are debating how much credit Obamacare should get for a recent moderation in the growth of health costs, and for a fall in the number of patients having to be readmitted to hospital (see article). Whatever the answer, many companies see the disruption unleashed by the reforms as the business opportunity of a lifetime.

One of the biggest shifts under way is to phase out the “fee for service” model, in which hospitals and doctors’ surgeries are reimbursed for each test or treatment with no regard for the outcome, encouraging them to put patients through unnecessary and expensive procedures. Since Obamacare they are increasingly being paid by results—a flat fee for each successful hip replacement, say. There are also incentives for providers which meet cost or performance targets, and new requirements for hospitals to disclose their prices, which can vary drastically for no clear reason.

The upshot is that there are growing numbers of consumers seeking better treatment for less money. Existing health-care providers will have to adapt, or lose business. All sorts of other businesses, old and new, are seeking either to take market share from the conventional providers, or to provide the software and other tools that help hospitals, doctors, insurers and patients make the most of this new world.

Obamacare is also encouraging the creation of all sorts of health-related advisory and intermediary companies that help care providers, insurers and patients save money.

Then health care cost growth fell to an all-time low, even as 20 million people gained insurance for the first time. A BFD! One that the GOP now seeks to reverse.