I agree with you right up until the end. ACA is part of the problem because instead of addressing those issues you allude to, ACA actually expands the scope of them by forcing more people into the system.
EK I understand that. What you're trying to overlook though is that healthcare is far more expensive than $75 and is not optional unless you have a death wish or are looking forward to bankruptcy.
Examples:
Broken foot, compound fracture, 2 days in the hospital with surgery, $40,000
Broken leg, 4 days in the hospital with surgery, $100,000
MRI $5000
Sprained Ankle: $1600
Cancer treatment: Hundreds and hundreds of thousands of dollars.
Not going to doctor:
Breast Cancer: Death
Colon Cancer: Death
Prostate Cancer: Death
Nobody should be "gambling" with their health. Everyone needs healthcare. The above examples are things I have direct experience with. I don't know what percentage of Americans can afford those bills without insurance but it's not going to be many.
The moment Americans realize that your health is super important the moment we'll probably go to single payer and start funneling people into free clinics for preventative care. Until then though we have the ACA.
The problem isn't the ACA. It's the waste in our healthcare system that is still not being addressed.
I'm no zealot, I simply see no other option being presented. Whereas with single payer, we can look to other countries and other programs that do work.
So while it might not be may not be ideal, it beats the unimagined.
And as far as options, they aren't wanted by most here.
Where's here? And how do you know they aren't wanted?
I see a few vocal opponents, but that's about it. And that's par for just about every issue brought up in this community, as well as in this country...
Not everyone needs healthcare and one can choose how to cover the cost of healthcare that they need.
The ACA removes both of those choices.
It is forcing the insurance requirement on you to pay for your care.
It is forcing you to get the insurance even if it is not needed.
It cost me $75 cash to see my MD
But I would have to pay $600/month under the ACA to not see him and an additional $20+ to see him.
The need for insurance is a gamble that one takes.
For myself the $7200 / year is better spent on a $2000 catastrophic coverage with a $10K deductible.
I am not provided with that option
It is forcing you to get the insurance even if it is not needed.
It is forcing the insurance requirement on you to pay for your care.
For myself the $7200 / year is better spent on a $2000 catastrophic coverage with a $10K deductible.
I agree with you right up until the end. ACA is part of the problem because instead of addressing those issues you allude to, ACA actually expands the scope of them by forcing more people into the system.
Read my reply that starts with "We can't do this."
http://forums.anandtech.com/showpost.php?p=35623037&postcount=100
Based on the current cost climate, this is the best that we can currently do that will provide immediate relief of the problem - the sick not being covered.
Healthcare costs are high and it would be a monumental task, especially with such a divided government, to change healthcare costs so that they are more reasonable.
The costs are too high BUT people still need immediate coverage. We can't change the costs overnight (or even within the next decade), so we HAVE to have everyone pump money into the system in order to have everyone covered. Once everyone is covered and we reach this minimum level of stabilization, we can work to get the costs handled.
Again, low hanging fruit. I agree that the solution isn't perfect, but it is the realistic one. We can't just go for the fruit at the top of the tree because we don't even have a ladder yet. Actually, it's more like we don't even know *how* to build a ladder. All we can do is stand and pick whatever fruit we can reach.
Let us pick the fruit we can reach so we may feed ourselves for now, and in the meantime we must continue to work furiously to develop and create that ladder.
People naturally want a revolutionary change in things that fixes everything. But the reality is that most things need to be evolutionary, not revolutionary.
We weren't divided when Obamacare was passed; the D's had enough votes to pass single payer if their party would stand in lockstep on it.
This isn't a D or an R issue. Its a health care profits issue and you're a fool if you don't realize the industry is heavily invested in both sides.
Governmental lobbying will have to be reformed before we can make real progress.
We weren't divided when Obamacare was passed; the D's had enough votes to pass single payer if their party would stand in lockstep on it.
This isn't a D or an R issue. Its a health care profits issue and you're a fool if you don't realize the industry is heavily invested in both sides.
Governmental lobbying will have to be reformed before we can make real progress.
And how hard is it to reform lobbying? VERY. In the meantime people are dying and going bankrupt.
The ACA had to happen in its current configuration because:
1. It can pass.
2. It helps, quickly.
So why didn't the Democrats come up with a health care plan based on health care prepared by those who know what they are doing and presenting to the public something which has legs and has been vetted by someone other politicians? Then it wouldn't be Democrats vs Republicans but politicians vs caregivers. That would work in the Democrats favor.
"by those who know what they are doing"
Who are these people you speak of?
It's really a circus issue. There's an extremely complicated system that needs prudent, intelligent reform. To fix things you want to give it to guys in a clown car. That's going to help.
And how hard is it to reform lobbying? VERY. In the meantime people are dying and going bankrupt.
The ACA had to happen in its current configuration because:
1. It can pass.
2. It helps, quickly.
We weren't divided when Obamacare was passed; the D's had enough votes to pass single payer if their party would stand in lockstep on it.
This isn't a D or an R issue. Its a health care profits issue and you're a fool if you don't realize the industry is heavily invested in both sides.
Governmental lobbying will have to be reformed before we can make real progress.
No. Our government runs one of the largest single payer health care systems in the world (DOD).
1 is true. 2 remains to be seen.
Health care providers of all kinds, advocates, actuaries, legal experts for legislative language, experts in the Constitution to make sure whatever is proposed passes muster. People who are recognized by their peers as ethically, intellectually, and creatively superior. Give them funding and official standing. Give them a mandate to determine where we are, what we can do, and what are the pluses and minuses. Do what its needed to minimize unintended consequences. You need to understand that we're going to have to do the equivalent of building a spaceship while we're already traveling to Mars. What is done has to be is change but don't break.
The ACA is a quick and dirty way to buy us time to focus on meaningful reform
That's where I believe you are wrong. I think you have found a diversion, a way to kick the can down the road. It will be years before this opportunity comes again.
Well then let me ask you this:
What's your idea for getting suffering uninsured people immediately insured or provide them with immediate affordable healthcare?
Let me put it this way:
We needed something that could pass, could have a chance of working and helping people, and could be implemented quickly with existing entities (insurance companies).
That's why the ACA was devised in this manner. Anything else would have been too hard to pass and too slow to implement.
The ACA is a quick and dirty way to buy us time to focus on meaningful reform.
So no one ever goes to dangerous places to help others and all providers are blood sucking vampires. You think we get paid whatever we ask, that there has never been managed care, and we all have villas on the Riviera. Even advocates for the public must be corrupt. There can't be ways to make things more efficient because caregivers all want to eat your babies.Money. People want money.
You don't go to the industry whose primary objective is capital gain and ask these "professionals" how to decrease their prices for their customers when they see no compelling reason to do so.
The reason healthcare costs are so high is because there *is* no competitive marketplace and providers charge whatever the heck they want.
So no one ever goes to dangerous places to help others and all providers are blood sucking vampires. You think we get paid whatever we ask, that there has never been managed care, and we all have villas on the Riviera. Even advocates for the public must be corrupt. There can't be ways to make things more efficient because caregivers all want to eat your babies.
OK give it to the virtuous gods who gave you Iraq/NSA/Gitmo/the shutdown because you believe in them. You have your mind made up as to how things are never once having seen how things work.
I'm done.
Analyze the financial documents of provider institutions. That's all I'm saying. The numbers and money don't lie.
Until you do you're missing the evidence and will continue to blindly support the wrong places.
My good friend who has been a nurse at a certain hospital for a decade talks about how the hospital is barely getting by and how it loses so much money all the time and how it gives so much money away to charity. When you look at the financials you see that's clearly not the case. It's in it to make money and it clearly shows on paper.
Edit: You do know that with all other factors in a business held constant, *lowering* operating profits means an *increase* in salaries, right?
No. Nonono. Simply no.
The ACA was passed in the manner it was because:
A) its what the insurance industry would allow
B) Obama was losing his lame ducks in Congress
"We've got to do something now" is a diversion. If there was such an immediate need for this law, why the multi-year rollout?