Miscellaneous And Off Topic Subjects

[Wild Hoss]

How much is his life worth? I sure as he'll better see a good case before I have to pay a little higher premium on my end. Fuck that shit. That's something that people like you never want to talk about.

Is his life worth a minuscule portion of your premium you mean? IMO, yes. You may feel differently, and that's fine. He's a pretty good dude though.

More to the point, I was giving an anecdote about how a person who benefited from the ACA was a hard-working, tax-paying, middle-Murica blue-collar fellow, and not some lazy, urban tax-absorbing slob. IOW, life sometimes doesn't fit into neat, preconceived stereotypes.

[SeattleLionsFan]

Good discussion I think overall....

I think the AHCA is deeply flawed and flawed in such a way that people, like Hoss's uncle, will die. And they will die so that really obscenely rich people can get richer. I understand there are trade offs, but that's not one I particularly want to make.

One thing that is missing is WHAT does this bill solve, and HOW does it make people's live richer, better and more productive? To me that is completely unclear.

[entropy]

[ame]https://twitter.com/realnfltrump/status/860185946855272453[/ame]

A great account to follow for some levity.


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[froot loops]

In retrospect the ACA negotiations were way too bipartisan and they didn't need to be. How fucking naive were they, they actually had the votes to push crap through yet they wasted their time dealing with those POS on the other side. Senior GOP people on each side were in meetings alll along the process. They had numerous Republican amendments. They had 79 hearings, they waited for a CBO, they changed it a lot for bipartisan purposes. Some of the issues came from watering it down. It was repaid with zero GOP votes.

Contrast it to now. The Republicans took no input from anybody other than the jerks in the HFC. They debated the bill for a single hour so they can rush over to the White House to take selfies with Ivanka Trump. People are rightfully worried about pre-existing conditions and they are running out on the floor to the Rocky theme song and beer bashing in the Rose Garden.

[froot loops]

Here is an article in the Post that illustrates my point above, it is complete with quotes from 2009 from the GOP hammering the process.

https://www.washingtonpost.com/amphtml/powerpost/republicans-are-following-the-playbook-they-attacked-in-obamacare-debate/2017/05/04/d6e9d6ea-30cd-11e7-9dec-764dc781686f_story.html

[iam416]

The ACA and AHCA are half measures. Neither addresses the problem. One is a failure and one will be a failure, if passed. At this point, it's full measures only: either strip it all down and go to a market-based system or go to single-payer. Allow the the scarce resources to be allocated on market principles or allow the scarce resources to be allocated by the government. Given how Obamacare has changed the perception of healthcare in this country, I can't imagine anything other than single payer coming to fruition in 5-10-15 years.

There are probably some other half measures they can take to try to lower the costs of healthcare. Drug approval comes to mind. Not taxing medical devices comes to mind. Finding a way to get more doctors to increase supply comes to mind.

But, as it currently stands, we consume healthcare without regard for cost. That can't stand. It won't.

The AHCA, of course, won't pass the Senate without serious revision. So, we'll see how that goes. I'm remarkably skeptical that anything will come out of the Senate.

[SeattleLionsFan]

I understand what you ar saying talent, and agree about them being half measures, but what problems is the AHCA supposed to solve and how does it make people's lives better? Even as a half measure. I am missing that....

[froot loops]

If you make over 200k, it massively helps your bottom line.

[iam416]

SLF:

I said neither the ACA nor AHCA "addresses the problem." So, I'm not sure how I'm supposed to answer your question when I think I already have!

Anyway, they're both half-measures, but you can see how they're measured by the way people talk about them. The ACA is championed as increasing coverage from 2008. It's never championed in terms of efficiency or cost (well, it was at the outset, but that canard was quickly exposed). The AHCA will probably be pushed in terms of lowering costs (if it actually does) and keeping "access" (whatever access/coverage shit they push will, as with the ACA's cost shit, be exposed).

The problem for the AHCA and conservatives is that coverage is all that matters. And that's why we'll end up with single payer. You can't undo coverage, politically. So no matter how flawed the plan the answer is never to go back to medieval times such as 2008. The political answer has to be more coverage. Obama and the Ds knew what they were doing. That's why the Rs fought it tooth and nail. The coverage ratchet effect was entirely foreseeable and entirely real.

But socialized medicine is coming. Probably just in time for me to get put on a year-long wait list for new hip!

[froot loops]

The medicaid expansion was not a failure, it was very effective, it's helped a lot of people and medicaid is very efficient. That is why you see a man like John Kasich fighting to save it. A lot more people signed up for the medicaid expansion than was predicted by the CBO. The people who got insurance under that are more happy than people who had to get insurance through the market exchanges. I don't think the CBO realized how many people were working above the poverty line but had no access to insurance.

The individual markets are a mess in a lot of areas, it didn't work out as well in practice as in theory. The markets work well in denser populations than rural populations. Market forces actually exist in California or Massachusetts, they don't in Tennessee.

Here is an important point that gets missed, big, big legislation is never going to get it right on the first crack. There needs to be addendums, additional legislation over time to fix the holes. That couldn't occur with the ACA. Anyone who has taken an intro to macro economics learns about unintended consequences.

If they would have been willing to patch things along the way, it would have been even more successful. But it may be right that it paves the way for single payer. I didn't think that before this week, but I may be wrong. Their foul, wretched behavior in the Rose Garden will extinguish any future attempts at bipartisanship by the Democrats on this issue.

[Wild Hoss]

Meh. Obama didn?t whistle up the ACA out of thin air; universal healthcare was at the fore of his candidacy, and the D platform of 2008 in general that won in dominant fashion. Health costs were exploding, coverage numbers were falling...it was a huge issue politically.

The Ds outkicked their coverage with the ACA, and reasons the ACA didn?t meet all the needs have been rummaged through in these page ad nauseum, but lets take a step back from snarking the state of healthcare pre-2008; it was dreadfully unpopular, and people wanted change.

The details of that change...well here we are. Maybe Single Payer is the only eventual outcome.

[hack]

In retrospect the ACA negotiations were way too bipartisan and they didn't need to be. How fucking naive were they, they actually had the votes to push crap through yet they wasted their time dealing with those POS on the other side. Senior GOP people on each side were in meetings alll along the process. They had numerous Republican amendments. They had 79 hearings, they waited for a CBO, they changed it a lot for bipartisan purposes. Some of the issues came from watering it down. It was repaid with zero GOP votes.

Contrast it to now. The Republicans took no input from anybody other than the jerks in the HFC. They debated the bill for a single hour so they can rush over to the White House to take selfies with Ivanka Trump. People are rightfully worried about pre-existing conditions and they are running out on the floor to the Rocky theme song and beer bashing in the Rose Garden.

Couldn't agree more. Obama wanted to restore Washington's old gentlemanly spirit of bipartisanship AND pass health care. He should have picked one or the other. The choice was obvious. Should have rammed through a stronger ACA.

Bottomline though, health care is one of the many areas in which America's economy is just one of many areas where you have to knock out the rent seekers if you want to do things for the benefit of people.

[entropy]

Talents questions have still been avoided....

I'd like to know in the single payer plan who decides what I get and when.


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[entropy]

It definitely is not a first choice. In order to do that I would have to build up a bit of a cushion and that does not exist in you have been as out of work as I have been. The folks are moving downstate and that will help out some, since they are willing to let me stay with them until things are better. So that will minimize expenses a great deal.

If that ever changes, let me know..


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[iam416]

The Ds outkicked their coverage with the ACA, and reasons the ACA didn’t meet all the needs have been rummaged through in these page ad nauseum, but lets take a step back from snarking the state of healthcare pre-2008; it was dreadfully unpopular, and people wanted change.

I don't think you need to pretend that healthcare was great in 2008, nor do you need to pretend Obama didn't win on that issue amongst other things. I do think it's fair to point out 2008 in response to the partisan hyperbole of death in the streets and such.

The problem people had in 2008 wasn't solely coverage, it was, IMO at least 50/50 costs and coverage. That was certainly my complaint. The ACA increased coverage making it shit near impossible to ever reduce costs. So, it's not going to happen. We will move to single payer and people will think it's "free". As if. The upside is that rich Canadians will no longer come to the US for healthcare. I consider that a huge win!

The real awesomeness will be when you couple Socialized Healthcare with increased immigration!

Froot:

I wouldn't do away with the medicaid expansion. States that have gone that route have done so relying on the Federal government and that provision. If you're going to do away with it, it has to be sunsetted over a much longer period of time than it is.

But, again, this all academic until the Senate weighs in.