What is not adequately discussed was why the republicant "plan" was so much worse. In order to appease the "moderate" republicants then all federal subsides had to be kept at (or above?) PPACA levels for the (15?) states that chose to expand Medicaid. Keep in mind that Medicaid is the most extreme (worst case?) scenario as far as government subsidized care is concerned - to the point that no co-pay or deductiblle is expected by the patient at all (except for the bizzare concept of incuring a debt to one's estate).
In other words, to fully fund 100% of the cost of medical care for a few (the approx. 15% to 18% of the US population below 134% of the FPL) places the most burden on others (the "rich" taxpayers) and leaves the least to help anyone that did not "qualify" for Medicaid (those making 134% to 400% of the FPL) but did "qualify" for PPACA subsidies. Once you have decided that you "must" keep expanded Medicaid and that you "must" cut the total subsidy cost (born by "rich" taxpayers) then that leaves only one group to "screw over" - those making 134% to 400% of the FPL.
Distribution of Total Population by Federal Poverty Level | The Henry J. Kaiser Family Foundation
Trump wants to blame Mitch. But, let's face it, it ain't Mitch's fault the repeal went down the toilet. Actually, if you ask me, the GOP never intended to repeal ACA, it was all just a ploy...and, that includes Don Cheeto.
If Don wanted to really repeal Obamacare, he would have worked it. Instead, he went golfing and tweeted out insults from the clubhouse.
The dems and John McCain are to blame for the failure of the repeal of ACA.
The middle class or the working class.
Yep, but the problem is not that the middle/working class "needs" a subsidy to "afford" medical care - the problem is why that became the case. That is largely because of government policy including other subsidies and/or tax breaks. When something becomes "free" or limited to a fixed percentage of one's income (the rest being subsidized) then those "customers" simply don't care how much the "provider" of that something charges. Insurance companies surely don't care since they make a profit based on a percentage of sales volume - thus, like real estate sales folks, a higher "market price" simply yields a higher profit with the same profit margin on the same sales volume (number of sales?).
Yeah, but with real estate when prices are high, one can decide not to buy until prices recede. Perhaps at times, the higher price for real estate can produce more of a profit or the same with a smaller market buying. But sooner or later an adjustment must be made. With mandatory health insurance, one basically has to take what is offered. If not, pay the fee or tax or whatever one wants to call it.
What happens is that the workers end up paying a portion or even perhaps all for those who do not work or are working and below the poverty line. Regardless, from a political view point, we were promised something better than the ACA. Repeal and replace with something better. But is something better even possible without taxing those who work more? Making them pay more for others.
Not debating, just curious. What do you mean there?- by simply increasing employee taxable pay and letting those employees "shop" for insurance.
I cited the numbers pre-Republican AHCA and the numbers after. Either believe the numbers or don't. That is entirely up to you. .
Keep ignoring the 29% hurt by the ACA and focus on the 18% helped. Enough is enough. You're blinded by your party and don't pay attention to those without a political party, who are independent enough to be able to make up their own mind. Not being told what to think.
Not debating, just curious. What do you mean there?
Business pays employee wages.
Business pays the lion's share of the yearly renewal for all employees who have elected to carry insurance with us, and it's covered at varying percentages based on single, spouse, child groups.
Business pays a medicare/aid tax on the first X dollars of their wages.
Business that doesn't offer insurance, I think, pays a penalty to the government per person (?) under ACA.
How does what you're referring to fit into that?
Something better is getting rid of letting employers pretend that part of their (untaxed) direct labor costs (employee compensation?) is not "really" employee income. That alone would raise a huge amount of additional federal revenue from both payroll (FICA) and income taxes - by simply increasing employee taxable pay and letting those employees "shop" for insurance. That new federal revenue could help to fund any manner of "better" subsidies, one of which would be to convert Medicaid expansion into a "public option" with participants required to pay both premiums (as a fixed % of their gross income) and "modest" annual deductibles (much like Medicare?). It would also make the (expanded) pool of Medicaid users large enough to not be ignored by many more care providers.
The current mission of the republicant congress critters seems to be to replace (rename?) PPACA with something that requires less federal revenue and yet covers (subsidizes?) at least as many folks - essentially mission impossible.
Exactly, mission impossible. Your idea makes sense. But you can bet that anyone with employer covered insurance would squeal like a banshee. That too may be mission impossible. The best solution wasn't the ACA. According to the polls back when it was first passed, 2009 and 2010, 80% of Americans were either happy or satisfied with their health insurance. Exactly how many didn't have health insurance is left open for debate. The range was between 8 million to 46 million. The Pacific Research Institute did a study and concluded that out of that 46 million being tossed around, 14 million were eligible for Medicare or Medicaid or some other government program, but were not enrolled. Another 13 made over 50,000 a year suggesting they could buy insurance if they so desired.
How much one believes those figures is another matter. If true that 46 million is cut to 19 million. The Institute estimated another 6 million were temporary uninsured, between jobs or just entering the work force. What I'm getting it, instead of setting the whole Health Insurance industry on its ear, a program such as the VA or something akin or additions to Medicaid probably could have solved the whole problem. We're talking 8-13 million.
If the mission was simply to cover (subsidize?) more folks there are many ways to do that. The problem is that does not address costs (other than to simply pay X% of the "market price"). IMHO, the only hope of cost control is to make those costs matter - that requires a direct connection between one's out of pocket cost for X and the actual cost of X.
If "single payer" (government "controls" costs) were the magic bullet then our K-12 costs would not be among the highest in the world while showing results that are middle of the road (at best). The same market forces are absent - it costs you no more (or less) to use (or not use) K-12 services - those (per pupil) costs just get increased (per tradition?) regardless of outcome. This spend more (no matter what) system is what ruins most federal programs (see the VA - 100% government medical care).
There is a reason why medical costs keep souring. It's greed. From pharmacies to hospitals to specialists. Everybody is ripping everybody off. No countries have the problem we do with soaring costs.I'm old enough to remember when each state ran their own school system. There were a big difference in the education received say in Massachusetts then and say Mississippi. But overall this nation was number one in the core subjects like science and math. Not 28th or 32nd or whatever we are now. The goal by pumping money and setting standards was to bring all state run systems up to par or relatively even. We Americans always think throwing money at a problem will solve it. That may work now and then, but I think it only makes the problem worst in most instances.
The VA's problem has always been getting into the system. I've know some who have tried for five or six years and failed. A buddy of mine who was stationed in Laos with me back in 1969/70 could never get in and died three or four years ago of agent orange. The problem, Laos was a secret war and our military records stated we were stationed in Thailand. But once in, the care given by the VA is usually excellent. Although one may have to wait weeks or months for an appointment.
But that is getting off track here. Cost is always a factor. So too is all this high tech medical equipment that helps us live 20 years longer than say the 1940's or 50's. Prescription drugs, miracle drugs also add to the cost. There isn't the old doc with his black bag going door to door anymore. Actually I remember when I was very young old Doc Stein coming by our house when I had the flu or chicken pox or measles or something. Someone has to pay for all of that new stuff.
Then too, our pharmaceutical industry ship their drugs overseas and charge less per dose to those countries than they do here in the states. We Americans in a way are subsidizing other countries so they can have the same drugs at less price than what we pay.
I never said I had an answer. I never worked in the medical field. Can we control costs without degrading medical service? I suppose we could cap the insurance industry, but once they start losing money, like any other business, they will hang up the closed sign.
I'm also getting the worst care I've ever gotten.
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