Is the "Repeal of Obamacare" partisan driven political semantics?

Smeagol · Jan 3, 2017

I've always believed Obamacare was a less than perfect solution to the expensive and for some cost prohibitive access to healthcare in America. That said, I believed it was better than doing nothing at all with the sincere hope and belief it would be amended over time.

Good:

- Coverage of pre-exisiting conditions
- Allowing children to stay on their parents plans into their mid-20s
- Group rate healthcare marketplace for those without employer-based coverage
- Low income subsidies that might sound "socialist" on paper but is far cheaper that the subsidies we pay when the uninsured show up at the ER with no ability to pay
- Portability, that allows people to change jobs without needing to be concerned about losing healthcare, although its still complicated and possibly costly
- The individual mandate. Great idea we republicans came up with and should tout our bragging rights. Nobody is exempt from getting sick. Everybody needs healthcare.

Bad:

- Employer-based. Nothing else in life from groceries to housing to the cars we buy gives our employer the power to choose where we shop, choose to live or what car we drive. This trapping destroys the consumer-driven free-market economy of healthcare. The only reason we accept it is that's the way its always been done.
- Since it is still employer-based for now having the 49 employees or less exemption, forces employers who are trying to keep costs down to either not hire any more than 49 people or come up with creative ways to hire more than 49 while staying exempt such as making some employees independent contractors and/or setting up separate businesses that are really separate departments of the same business.
- Making non-compliance too easy. Proof of health coverage should be required to get utilities turned on, open a bank account, get your driver's license/tag renewed.
- Health insurance. IMHO its an unneeded middle man of non-medical professionals who for the benefits of getting their cut, tell you what medicals services your doctor says you need you can't have. I prefer individually mandated direct memberships with hospital groups.

Whether a democrat was elected President or a republican, Obamacare needed to be was going to be adjusted.

Smeagol · Jan 3, 2017

Sorry, took too long to finish to poll. Asking could both Clinton's and Trumps changes to Obamacare be accurately labeled "amendments to Obamacare" or "a repeal of Obamacare?"

I'm of the opinion those on the right, are more interested in hurting Obama's legacy than anything else are are calling it a "repeal" despite keeping most of the same things Hillary would have kept. Solid conservative values to some...petty or worse to others. On policy, pretty much the same net affect however.

Ikari · Jan 3, 2017

Smeagol said:
I've always believed Obamacare was a less than perfect solution to the expensive and for some cost prohibitive access to healthcare in America. That said, I believed it was better than doing nothing at all with the sincere hope and belief it would be amended over time.

Good:

- Coverage of pre-exisiting conditions
- Allowing children to stay on their parents plans into their mid-20s
- Group rate healthcare marketplace for those without employer-based coverage
- Low income subsidies that might sound "socialist" on paper but is far cheaper that the subsidies we pay when the uninsured show up at the ER with no ability to pay
- Portability, that allows people to change jobs without needing to be concerned about losing healthcare, although its still complicated and possibly costly
- The individual mandate. Great idea we republicans came up with and should tout our bragging rights. Nobody is exempt from getting sick. Everybody needs healthcare.

Bad:

- Employer-based. Nothing else in life from groceries to housing to the cars we buy gives our employer the power to choose where we shop, choose to live or what car we drive. This trapping destroys the consumer-driven free-market economy of healthcare. The only reason we accept it is that's the way its always been done.
- Since it is still employer-based for now having the 49 employees or less exemption, forces employers who are trying to keep costs down to either not hire any more than 49 people or come up with creative ways to hire more than 49 while staying exempt such as making some employees independent contractors and/or setting up separate businesses that are really separate departments of the same business.
- Making non-compliance too easy. Proof of health coverage should be required to get utilities turned on, open a bank account, get your driver's license/tag renewed.
- Health insurance. IMHO its an unneeded middle man of non-medical professionals who for the benefits of getting their cut, tell you what medicals services your doctor says you need you can't have. I prefer individually mandated direct memberships with hospital groups.

Whether a democrat was elected President or a republican, Obamacare needed to be was going to be adjusted.

Obamacare wasn't that great, IMO. I think it was more a giveaway to the insurance corporations than anything else, and because (as you point out) it was employer based. I think it ended up causing some more problems. It needed to be overhauled, but the talk of scrapping it and such is certainly partisan driven. It's not about fixing it, or making it right, but just getting rid of it all together.

IMO, what we need is something more akin to single-payer.

calamity · Jan 3, 2017

Smeagol said:
I've always believed Obamacare was a less than perfect solution to the expensive and for some cost prohibitive access to healthcare in America. That said, I believed it was better than doing nothing at all with the sincere hope and belief it would be amended over time.

Good:

- Coverage of pre-exisiting conditions
- Allowing children to stay on their parents plans into their mid-20s
- Group rate healthcare marketplace for those without employer-based coverage
- Low income subsidies that might sound "socialist" on paper but is far cheaper that the subsidies we pay when the uninsured show up at the ER with no ability to pay
- Portability, that allows people to change jobs without needing to be concerned about losing healthcare, although its still complicated and possibly costly
- The individual mandate. Great idea we republicans came up with and should tout our bragging rights. Nobody is exempt from getting sick. Everybody needs healthcare.

Bad:

- Employer-based. Nothing else in life from groceries to housing to the cars we buy gives our employer the power to choose where we shop, choose to live or what car we drive. This trapping destroys the consumer-driven free-market economy of healthcare. The only reason we accept it is that's the way its always been done.
- Since it is still employer-based for now having the 49 employees or less exemption, forces employers who are trying to keep costs down to either not hire any more than 49 people or come up with creative ways to hire more than 49 while staying exempt such as making some employees independent contractors and/or setting up separate businesses that are really separate departments of the same business.
- Making non-compliance too easy. Proof of health coverage should be required to get utilities turned on, open a bank account, get your driver's license/tag renewed.
- Health insurance. IMHO its an unneeded middle man of non-medical professionals who for the benefits of getting their cut, tell you what medicals services your doctor says you need you can't have. I prefer individually mandated direct memberships with hospital groups.

Whether a democrat was elected President or a republican, Obamacare needed to be was going to be adjusted.

Yep. It has good and bad aspects to it. So, all the hoopla over it is probably more about partisan posturing than anything of substance.

KevinKohler · Jan 3, 2017

The affordable care act did not address one single aspect of high health CARE costs.

chuckiechan · Jan 3, 2017

I am hoping it will be overhauled gradually. No big super duper grand do-all schemes like the way Obamacare was created - "corn husker kickbacks", "seat at the table", and so on. Social Security passed with bipartisan support, and the re engineered Obamacare must be done this way too. There aren't that many democrats willing to plant their feet in defending Obamacare, regardless of their public statements.

Slow and steady, bit by bit is how this should be done.

Starting with getting my man boob out of the mammogram machine! OUCH!

ataraxia · Jan 3, 2017

KevinKohler said:
The affordable care act did not address one single aspect of high health CARE costs.

Rising healthcare costs are due primarily to advancing technology: new drugs, new procedures, new imaging technologies, etc... These things, and all the biomedical research and development costs that go into them, are what keep increasing healthcare costs. The only way to finally contain these costs is to stop medical science and technology. If we went back to cutting people's veins and bleeding them into a basin for whatever ailed them, medical costs would go way down.

KevinKohler · Jan 3, 2017

ataraxia said:
Rising healthcare costs are due primarily to advancing technology: new drugs, new procedures, new imaging technologies, etc... These things, and all the biomedical research and development costs that go into them, are what keep increasing healthcare costs. The only way to finally contain these costs is to stop medical science and technology. If we went back to cutting people's veins and bleeding them into a basin for whatever ailed them, medical costs would go way down.

So...when you go to a hospital, and they charge you 50 dollars for an aspirin that cost them .06 cents to buy, it's because it's really high tech?

Visbek · Jan 3, 2017

Yes, the repeal of the ACA is basically just political posturing.

The reality is that backing off of the ACA's key provisions -- guaranteed issue, individual mandate, Medicare expansions, exchanges -- will terminate coverage for millions of Americans; and that no matter what changes anyone makes, premiums will continue to rise.

It looks like Republicans will pass a toothless resolution to repeal the ACA, and then delay a replacement for years. It's also not clear if the replacement will gut the ACA, or be a minor modification.

KevinKohler · Jan 3, 2017

chuckiechan said:
I am hoping it will be overhauled gradually. No big super duper grand do-all schemes like the way Obamacare was created - "corn husker kickbacks", "seat at the table", and so on. Social Security passed with bipartisan support, and the re engineered Obamacare must be done this way too. There aren't that many democrats willing to plant their feet in defending Obamacare, regardless of their public statements.

Slow and steady, bit by bit is how this should be done.

Starting with getting my man boob out of the mammogram machine! OUCH!

Exactly. You don't restore an old car in a day. No...do eat that elephant one pound at a time. Replace the brakes. See what else is wrong. Replace the shocks and springs. Fix the alignment. See what else is not working. So on and so forth.

American · Jan 3, 2017

Ikari said:
Obamacare wasn't that great, IMO. I think it was more a giveaway to the insurance corporations than anything else, and because (as you point out) it was employer based. I think it ended up causing some more problems. It needed to be overhauled, but the talk of scrapping it and such is certainly partisan driven. It's not about fixing it, or making it right, but just getting rid of it all together.

IMO, what we need is something more akin to single-payer.

Wow, how very libertarian.

Ikari · Jan 3, 2017

American said:
Wow, how very libertarian.

Yup.

.

American · Jan 3, 2017

Ikari said:
Yup.

.

Libertarianism (Latin: liber, "free") is a collection of political philosophies that uphold liberty. Libertarians seek to maximize autonomy and freedom of choice,

From Wiki. There is zero choice in single payer.

Mithros · Jan 3, 2017

KevinKohler said:
The affordable care act did not address one single aspect of high health CARE costs.

Do you mean like the pay for performance programs in Obama Care where compensation to doctors becomes outcome based rather than procedure based. Granted these cost savings measures were aimed at the medicare side of the fence and not the private side, but they are in there.

The In-Patient Value-Based Purchasing Program, began in 2012- reduces Medicares diagnosis-related group payments to all hospitals, then redistributes the savings based on hospital performance.
The Hospital Readmissions Reduction Program, phased in 2012-2014 penalizes hospitals with high 30day readmission rates.
The Physician Value-Based Payment Modifier, phased in from 2015-2017, adjusts the existing value based payment modifier.

joG · Jan 3, 2017

Smeagol said:
I've always believed Obamacare was a less than perfect solution to the expensive and for some cost prohibitive access to healthcare in America. That said, I believed it was better than doing nothing at all with the sincere hope and belief it would be amended over time.

Good:

- Coverage of pre-exisiting conditions
- Allowing children to stay on their parents plans into their mid-20s
- Group rate healthcare marketplace for those without employer-based coverage
- Low income subsidies that might sound "socialist" on paper but is far cheaper that the subsidies we pay when the uninsured show up at the ER with no ability to pay
- Portability, that allows people to change jobs without needing to be concerned about losing healthcare, although its still complicated and possibly costly
- The individual mandate. Great idea we republicans came up with and should tout our bragging rights. Nobody is exempt from getting sick. Everybody needs healthcare.

Bad:

- Employer-based. Nothing else in life from groceries to housing to the cars we buy gives our employer the power to choose where we shop, choose to live or what car we drive. This trapping destroys the consumer-driven free-market economy of healthcare. The only reason we accept it is that's the way its always been done.
- Since it is still employer-based for now having the 49 employees or less exemption, forces employers who are trying to keep costs down to either not hire any more than 49 people or come up with creative ways to hire more than 49 while staying exempt such as making some employees independent contractors and/or setting up separate businesses that are really separate departments of the same business.
- Making non-compliance too easy. Proof of health coverage should be required to get utilities turned on, open a bank account, get your driver's license/tag renewed.
- Health insurance. IMHO its an unneeded middle man of non-medical professionals who for the benefits of getting their cut, tell you what medicals services your doctor says you need you can't have. I prefer individually mandated direct memberships with hospital groups.

Whether a democrat was elected President or a republican, Obamacare needed to be was going to be adjusted.

One thing that was difficult about putting the employer into the loop was the impact on jobs. I have not looked at any studies, but increasing the transaction costs of employment always slows growth in jobs.
Also it is nice to have coverage of preexisting conditions and children. But that also makes it more expensive for everyone else.

Ikari · Jan 3, 2017

American said:
From Wiki. There is zero choice in single payer.

libertarianism is about the maximization of liberty. The People can maximize liberty through aggregate use of government in certain cicumstances. Using government, for instance, to pay less for healthcare with greater access to it, would be such a system.

In the end, likely we'd be looking at some hybrid system like many other places have. A base provided by government and additional provided through private for those who desire/can afford it.

But trying to reduce libertarian philosophy to the simplest of terms as you have done leads to misunderstanding the philosophy itself. It's why I say that most people do not fully appreciate the wide breadth and diversity libertarianism in general offers. For certain, a single-payer system can be copacetic with libertarianism in certain applications.

Cardinal · Jan 3, 2017

KevinKohler said:
The affordable care act did not address one single aspect of high health CARE costs.

No, it demonstrably did not. It does contain many of the fixes that especially plagued people who lost their employment or had independent plans. The ongoing question is what can the mechanism for containing the cost rises be?

Forbes Welcome

Cardinal · Jan 3, 2017

American said:
From Wiki. There is zero choice in single payer.

Single payer isn't legislation to ban private health care plans.

KevinKohler · Jan 3, 2017

Cardinal said:
No, it demonstrably did not. It does contain many of the fixes that especially plagued people who lost their employment or had independent plans. The ongoing question is what can the mechanism for containing the cost rises be?

Forbes Welcome

This is why I don't run for office, lol. The only things I can think of are all pretty draconian.

Cardinal · Jan 3, 2017

KevinKohler said:
This is why I don't run for office, lol. The only things I can think of are all pretty draconian.

Just out of curiosity, what are some of those draconian ideas? I'm genuinely curious because nobody has a clue what to do about rising costs. In the absence of any good ideas, I'm curious what the bad ones are.

American · Jan 3, 2017

Cardinal said:
Single payer isn't legislation to ban private health care plans.

There are zero choices except what the federal govt approves. It's crap.

American · Jan 3, 2017

Ikari said:
libertarianism is about the maximization of liberty. The People can maximize liberty through aggregate use of government in certain cicumstances. Using government, for instance, to pay less for healthcare with greater access to it, would be such a system.

In the end, likely we'd be looking at some hybrid system like many other places have. A base provided by government and additional provided through private for those who desire/can afford it.

But trying to reduce libertarian philosophy to the simplest of terms as you have done leads to misunderstanding the philosophy itself. It's why I say that most people do not fully appreciate the wide breadth and diversity libertarianism in general offers. For certain, a single-payer system can be copacetic with libertarianism in certain applications.

There's not a chance in hell that it will be cheaper.

Cardinal · Jan 3, 2017

American said:
There are zero choices except what the federal govt approves. It's crap.

In every country with single payer health care that I'm aware of, people have the choice to utilize private health insurance plans.

Cardinal · Jan 3, 2017

American said:
There's not a chance in hell that it will be cheaper.

And it wasn't getting any cheaper without Obamacare (see graph in post 17). And you got to be kicked off for being sick, denied for pre-existing conditions and pay more if you're a woman.

American · Jan 3, 2017

Cardinal said:
In every country with single payer health care that I'm aware of, people have the choice to utilize private health insurance plans.

https://en.wikipedia.org/wiki/Single-payer_healthcare

There is zero shopping for coverage, because only the government provides coverage.

Is the "Repeal of Obamacare" partisan driven political semantics?

Is the "Repeal of Obamacare" partisan driven political semantics?

Yes.

No.

I don't know.

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