Agreed, a universal healthcare system will very likely fail unless there is cooperation from the entirety of the government, and the overall civilian population, not to mention initial implementation being critical, and the system itself being fair to rich and poor alike (not forcibly screwing over one group for the sake of another).I'm not opposed to universal healthcare in some form, I just view Obamacare as being #1 - unjust and #2 - untenable.
I was going to write something about how it could be done, and how some of the cost issues could be addressed, but frankly it really comes down to this :
The people in Washington are neither capable nor motivated to draw up something that works. It doesn't matter if its Republican or Democrat, anything they come up with will be laced with corporate payoffs and special interest bribes.
Since healthcare is critical and quite personal to people's well being, I don't think they should do a damn thing except repeal Obamacare. At least, not until we get some new people there who demonstrate an ability to successfully implement functional polices.
Obamacares Fatal Flaw
http://www.project-syndicate.org/pr...care-reform-could-unravel-by-martin-feldstein
Martin Feldstein
Professor of Economics at Harvard University and President Emeritus of the National Bureau of Economic Research
29 October 2013
CAMBRIDGE Obamacare, officially known as the Patient Protection and Affordable Care Act, is the health-insurance program enacted by US President Barack Obama and Congressional Democrats over the unanimous opposition of congressional Republicans. It was designed to cover those Americans without private or public health insurance about 15% of the US population.
Opponents of Obamacare have failed to stop it in the courts and, more recently, in Congress. The program was therefore formally launched on October 1. Although it has been hampered by a wide range of computer problems and other technical difficulties, the program is likely to be operating by sometime in 2014.
The big question is whether it will function as intended and survive permanently. There is a serious risk that it will not.
The potentially fatal flaw in Obamacare is the very same feature that appeals most to its supporters: the ability of even those with a serious preexisting health condition to buy insurance at the standard premium.
That feature will encourage those who are not ill to become or remain uninsured until they have a potentially costly medical diagnosis. The resulting shift in enrollment away from low-cost healthy patients to those with predictably high costs will raise insurance companies cost per insured person, driving up the premiums that they must charge. As premiums rise, even more relatively healthy individuals will be encouraged to forego insurance until illness strikes, causing average costs and premiums to rise further.
With this in mind, Obamacares drafters made the purchase of insurance mandatory. More specifically, employers with more than 50 employees will be required after 2014 to purchase an approved insurance policy for their full-time employees. Individuals who do not receive insurance from their employers are required to purchase insurance on their own, with low-income buyers receiving a government subsidy.
But neither the employer mandate nor the personal requirement is likely to prove effective. Employers can avoid the mandate by reducing an employees workweek to less than 30 hours (which the law defines as full-time employment). But even for full-time employees, firms can opt to pay a relatively small fine rather than provide insurance. That fine is $2,000 per employee, much less than the current average premium of $16,000 for employer-provided family policies.
Not providing insurance and paying the fine is a particularly attractive option for a firm if its employees have incomes that entitle them to the government subsidies (which are now available to anyone whose income is below four times the poverty level). Rather than incur the cost of the premium for an approved policy, a smart employer can pay the fine for not providing insurance and increase employees pay by enough so that they have more spendable cash after purchasing the subsidized insurance policy. Even after both payments, employers can be better off financially. News reports indicate that many employers are already taking such steps.
But the biggest danger to Obamacares survival is that many individuals who do not receive insurance from their employer will choose not to insure themselves and will instead pay the fine of just 1% of income (rising permanently after 2015 to 2.5%). The preferred alternative for these individuals is to wait to buy insurance until they are ill and are facing large medical bills.
That wait-to-insure strategy makes sense if the medical condition is a chronic disease like diabetes or a condition requiring surgery, like cancer or a hernia. In either case, the individual would be able to purchase insurance after he or she receives the diagnosis.
But what about conditions like a heart attack or injuries sustained in an automobile accident? In those cases, the individual would not have time to purchase the health insurance that the law allows. If they are not insured in advance, they will face major hospital bills that could cause serious financial hardship or even cause them not to receive needed care. Anyone contemplating that prospect might choose to forego the wait-to-insure strategy and enroll immediately.
But private insurance companies could solve that problem by creating a new type of emergency insurance that would make enrolling now unnecessary and allow individuals to take advantage of the wait-to-insure option. Such insurance would cover the costs that a patient would incur after a medical event that left no time to purchase the policies offered in the Obamacare insurance exchanges. Emergency insurance might also cover the cost of care until the open enrollment period for purchasing insurance at the end of each year (if political pressure does not lead to the repeal of that temporary barrier to insurance).
This type of insurance is very different from existing high-deductible policies. Given the very limited scope and unpredictable nature of the conditions that it would cover, the premium for such a policy would be very low. It would not satisfy the broad coverage requirements that Obamacare mandates, forcing individuals to pay the relatively small penalty for being uninsured and to incur the subsequent cost of buying a full policy if one is needed later. But the combination of emergency insurance and the wait-to-insure strategy would still be financially preferable for many individuals, and the number would grow as premiums are driven higher.
Employers with a large number of full-time employees could encourage their existing insurance companies to create the emergency policies. They might even choose to self-insure the emergency risk for their employees.
The wait-to-insure option could cause the number of insured individuals to decline rapidly as premiums rise for those who remain insured. In this scenario, the unraveling of Obamacare could lead to renewed political pressure from the left for a European-style single-payer health-care system.
But it might also provide an opportunity for a better plan: eliminate the current enormously expensive tax subsidy for employer-financed insurance and use the revenue savings to subsidize everyone to buy comprehensive private insurance policies with income-related copayments. That restructuring of insurance would simultaneously protect individuals, increase labor mobility, and help to control health-care costs.
This is a lie. You parrot what you hear on Limbaugh and act like it's accurate.
I can personally tell you my premium went DOWN 38%, WITHOUT subsidies. With them it's easily cut in half.
You are a liar. Every single person I've spoken to who makes less than 90k/yr has had their premiums go down. You are either lying about being rich or lying about the premiums you were offered for the same coverage. That, or you're just incredibly ignorant and are getting these ideas from the conservative echo chamber that is Fox News/Hannity/Limbaugh.
It really amazes me that a bunch of people sit around all day listening to their own views being spit back at them and somehow thats entertaining.
So I'm a liar.
This is the most cost effective plan for me and my son. It has the lowest deductible and the lowest monthly payment. However because of the coverage, I am guaranteed to hit max out of pocket bringing my yearly cost to $16,616.
I'm not rich but I'm not below poverty level either. I make OK money but since I'm a single dad, I don't have piles of cash laying around.
So please again tell me how I'm lying. I'll be waiting.
Something else I have seen no answer to on the penalty part.
The law apparently says the penalty 'tax' is 1% of your income, PER PERSON, in the household. So, if you are a couple with a household income (married filing jointly) of $70,000, 1% is $700.
Does this mean that since there are two of you, the tax is $1400?
If yes, then once again, separately your penalty 'tax' would be $700 total while if you stay married and in the same house your penalty 'tax' is $1400.
Is this correct? Again, I haven't seen anyone address what seems to be a dangerous flaw that disparages marriage and encourages single parenthood etc etc.
I think the OP is confusing changing insurance plans with losing health care. But I do agree that no one should lose health care as a result of any future reform, and we should evaluate any repeal or replacement of Obamacare on that metric.
Not quite, the whole problem is that some 16 million people cannot keep the plans they currently have and are forced into plans that are far more expensive (unless their income is like 20K or under).
Middle class tax hike is not people wanted out of Obamacare...
I like that standard too, for any future health care law changes, if anyone has to pay more for coverage, like people with per-existing conditions, we should not do it.
i've yet to see a fair apples to apples comparison of coverage and costs by anybody in this thread. :whiste:
So far this seems like a bitchfest with no real data comparisons. It's either OMG I can't afford $XXX but I've never had ins. so there is nothing to compare to. Or my current plan cost me only $100/mo and the new plans that met minimum requirements will cost $250/mo. Or people trying to compare marketplace coverage to heavily subsidized employer based plans without disclosing how much the employer is covering.
In my case my current employer based plan for a family of three would qualify as a low deductible silver plan on the open marketplace. It costs me roughly $600/mo or $7200/yr with my employer kicking in $1250/mo or $15000/yr. for a total of $1850/mo or $22,200/yr.
According to healthcare.gov a low silver plan with the same level of coverage in Texas on the open market costs $1200 per month for a family of three. So I obviously won't be giving up my heavily subsidized employer based plan.
But if my company offered to let me opt out of the company plan and give me a reduced subsidy of say $10k per year and let me pick my own plan on the open market I would jump all over it and both I and the company would come out ahead.
Why the fuck would anyone want to keep these shitty insurance plans?
The new law will provide better coverage for around the same price.
Lots of these plans being cancelled are those that charged a premium to cover people with preexisting conditions. The law nullifies these policies. Others had insurance that only had limited coverage. The law does away with all of that.
So once again, who gives a shit besides partisan hacks? I for one only care about healthcare coverage improving and our standard of living increasing.
This is a lie. You parrot what you hear on Limbaugh and act like it's accurate.
I can personally tell you my premium went DOWN 38%, WITHOUT subsidies. With them it's easily cut in half.
At this point, maybe, but GOP will have to come up to an answer to this issue if they ever plan to repeal ACA. There will be a lot of people who will have coverage due to Obamacare that they won't want to give up.
You're very quick with accusing others of lying. May want to be a bit more patient before going that route. It also takes away from a good discussion - not that anyone wants any of that.
The quotes I've got from my insurance company along with the Healthcare.gov site are quite a bit up from last year. A comparable plan is 3x higher. Also, this is not that unusual - for many people, especially those who pay for their own insurance, their premiums are up. In some cases, by quite a bit. This is reasonable considering everyone has to chip in.
You know what's really destroying our system? Our current system.
You're very quick with accusing others of lying. May want to be a bit more patient before going that route. It also takes away from a good discussion - not that anyone wants any of that.
The quotes I've got from my insurance company along with the Healthcare.gov site are quite a bit up from last year. A comparable plan is 3x higher. Also, this is not that unusual - for many people, especially those who pay for their own insurance, their premiums are up. In some cases, by quite a bit. This is reasonable considering everyone has to chip in.
The Republicans are in a tough spot. If they repeal Obamacare they will essentially be taking ownership of the healthcare system absent Obamacare, and that system is already a train wreck.
Well if they did it right they could kick the Dems to the curb, but again they are politicians who can only think of political solutions given by politicians with political gain being the primary goal.