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Posted: 24 October 2013 11:48 AM   [ Ignore ]
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Isn’t it ironic that the most ardent opponents of the Affordable Care Act are now complaining that people can’t sign up fast enough?

(found on Facebook)

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Posted: 24 October 2013 01:24 PM   [ Ignore ]   [ # 1 ]
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I agree Lois. They are also the ones complaining the most about its other flaws but most of the short comings of the ACA are due to compromises that had to be made to get the necessary republican votes.

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Posted: 24 October 2013 01:33 PM   [ Ignore ]   [ # 2 ]
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I figure this is a good time to be a conspiracy theorist:  The real reason for the troubles is that the Extreme Right hired the Diebold company to hack into and screw up the ACA computer programs.  LOL

Occam

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Posted: 25 October 2013 10:22 AM   [ Ignore ]   [ # 3 ]
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The real “tell” in all this is that the major parts of the ACA are Republican ideas. They hate ACA because they’re racists plain and simple. And lefties hate it because, well, it’s Republican legislation.

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Posted: 25 October 2013 11:46 AM   [ Ignore ]   [ # 4 ]
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Every government program has roll-out issues.
I’m sure Social Security and Medicare were all big clusterflux when they first came out.
With all the attendant detractors and doomcriers.

Hopefully this ACA is just another hiccup on the road to universal, singlepayer healthcare.

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Posted: 26 October 2013 01:11 AM   [ Ignore ]   [ # 5 ]
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macgyver - 24 October 2013 01:24 PM

I agree Lois. They are also the ones complaining the most about its other flaws but most of the short comings of the ACA are due to compromises that had to be made to get the necessary republican votes.

And just imagine how watered down the health care reform law would have been if it had actually received at least one Republican vote.
wink

The PPACA received no votes from Republicans.  It’s watered down because of compromises with Democrats (such as Ben Nelson of Nebraska and Bill Nelson of Florida).

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Posted: 26 October 2013 01:28 AM   [ Ignore ]   [ # 6 ]
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CuthbertJ - 25 October 2013 10:22 AM

The real “tell” in all this is that the major parts of the ACA are Republican ideas. They hate ACA because they’re racists plain and simple. And lefties hate it because, well, it’s Republican legislation.

A conservative think-tank comes up with a insurance marketplace plan combined with an individual mandate and PRESTO:  It’s all Republican idea.  That plan never had strong support among Republicans. The plan we’ve got is crony capitalism at its worst and a thinly-disguised effort to embed welfare-state dynamics in the insurance industry nationally.  It’s a very liberal bill—as liberal as the Democrats who pushed it through Congress (to the point of passing it via reconciliation) could make it.

Here’s a history refresher.

http://healthcarereform.procon.org/view.resource.php?resourceID=003712

The main problem I have with that version is that it neglects to mention that the CBO projects deficit reductions based on a boatload of taxes and unrealistic projections about cuts to Medicare spending (pretending the doc fix doesn’t happen more-or-less annually).  It’s a built-in disadvantage of the CBO’s use of current law as a baseline.  And the Democrats took full advantage of it to peddle the idea that the law is a deficit-cutter.

But the vote history is spot-on.

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Posted: 26 October 2013 10:39 AM   [ Ignore ]   [ # 7 ]
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Bryan - 26 October 2013 01:11 AM
macgyver - 24 October 2013 01:24 PM

I agree Lois. They are also the ones complaining the most about its other flaws but most of the short comings of the ACA are due to compromises that had to be made to get the necessary republican votes.

And just imagine how watered down the health care reform law would have been if it had actually received at least one Republican vote.
wink

The PPACA received no votes from Republicans.  It’s watered down because of compromises with Democrats (such as Ben Nelson of Nebraska and Bill Nelson of Florida).

Your right Bryan. It would have been even worse. Had it required republican support we would have nothing at all.

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Posted: 26 October 2013 10:45 AM   [ Ignore ]   [ # 8 ]
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Bryan - 26 October 2013 01:28 AM
CuthbertJ - 25 October 2013 10:22 AM

The real “tell” in all this is that the major parts of the ACA are Republican ideas. They hate ACA because they’re racists plain and simple. And lefties hate it because, well, it’s Republican legislation.

A conservative think-tank comes up with a insurance marketplace plan combined with an individual mandate and PRESTO:  It’s all Republican idea.  That plan never had strong support among Republicans. The plan we’ve got is crony capitalism at its worst and a thinly-disguised effort to embed welfare-state dynamics in the insurance industry nationally.  It’s a very liberal bill—as liberal as the Democrats who pushed it through Congress (to the point of passing it via reconciliation) could make it.

Here’s a history refresher.

http://healthcarereform.procon.org/view.resource.php?resourceID=003712

The main problem I have with that version is that it neglects to mention that the CBO projects deficit reductions based on a boatload of taxes and unrealistic projections about cuts to Medicare spending (pretending the doc fix doesn’t happen more-or-less annually).  It’s a built-in disadvantage of the CBO’s use of current law as a baseline.  And the Democrats took full advantage of it to peddle the idea that the law is a deficit-cutter.

But the vote history is spot-on.

Bryan, quite frankly the private insurance industry really has no business in health care except as a conduit for a national program. The days of private insurance companies providing a hap hazard patchwork of options available to only those who are employed by a generous employer, and the government filling in for the old, poor, or disabled need to come to an end. This patchwork approach has resulted in fragmented, ill apportioned, misused, over used, and under used care with large segments of the population getting no care at all.

The only way to fix this is with some sort of central oversight and private industry can not provide that.

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Posted: 26 October 2013 12:03 PM   [ Ignore ]   [ # 9 ]
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Bryan - 26 October 2013 01:28 AM

  And the Democrats took full advantage of it to peddle the idea that the law is a deficit-cutter.

But the vote history is spot-on.

What’s so important about the deficit?
There you go again with this deficit thing.  How does the deficit effect me or anyone else?
I’ve never felt any direct impact of a budget deficit. Trade deficit? yes, budget deficit? no.

What exactly does a budget deficit do?  Put’s pressure on government for new and more taxes?
Probably.
I can’t ever remember anyone saying, “god, this budget deficit thing is killing me!  I can’t afford new shoes!”

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Posted: 26 October 2013 12:22 PM   [ Ignore ]   [ # 10 ]
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macgyver - 26 October 2013 10:45 AM

Bryan, quite frankly the private insurance industry really has no business in health care except as a conduit for a national program. The days of private insurance companies providing a hap hazard patchwork of options available to only those who are employed by a generous employer, and the government filling in for the old, poor, or disabled need to come to an end. This patchwork approach has resulted in fragmented, ill apportioned, misused, over used, and under used care with large segments of the population getting no care at all.

Who pays for it?

The fundamental problem here is an economic one.  Third-party payment (insurance or gov’t single-payer) strongly encourages increased demand for services.  Turning the system into single-payer does not solve the fundamental problem unless you set limits on payment (yes, that’s called rationing).

The only way to fix this is with some sort of central oversight and private industry can not provide that.

Both systems could easily fix the problem with rationing (using the term loosely, since price rationing isn’t the same as gov’t rationing).  The ultimate reform (which admittedly is highly unlikely) involves minimizing third-party payment and publicizing health care prices so that health-care consumers can make informed decisions about spending their money.  HSAs are great concept, one which the ACA has greatly damaged.

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Posted: 26 October 2013 12:41 PM   [ Ignore ]   [ # 11 ]
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Bryan - 26 October 2013 12:22 PM

Who pays for it?

The fundamental problem here is an economic one.  Third-party payment (insurance or gov’t single-payer) strongly encourages increased demand for services.  Turning the system into single-payer does not solve the fundamental problem unless you set limits on payment (yes, that’s called rationing).

And the system that we used to have was by largely Laissez-faire capitalism.  That had fundamental problems too.
Millions and millions of people were uninsured because they couldn’t meet the demand for payment.
Yes, that’s called rationing!!!
At least under this system everyone get’s insurance.  We’ll see what if any rationing takes place.
Under the old system, rationing did take place.  Millions and millions of people didn’t get insurance period. That’s rationing out the supply
so that only those who can afford insurance get insurance.

Is this going to be a segue into “Death Panels” for you Bryan?
I’d love to hear you bloviate about Death Panels.  That would be entertaining!

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Posted: 26 October 2013 12:51 PM   [ Ignore ]   [ # 12 ]
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Plus a side note about rationing.
I would love to see rationing in place anyways. 
What better way to reduce costs?
Smart rationing could slowly inculcate the medical professions so that after a couple of decades
frivolous medical treatments and hypochondria could be weeded out and made administratively obsolete for the most part.

Now you’re talking savings!!

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Posted: 26 October 2013 12:56 PM   [ Ignore ]   [ # 13 ]
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VYAZMA - 26 October 2013 12:41 PM
Bryan - 26 October 2013 12:22 PM

Who pays for it?

The fundamental problem here is an economic one.  Third-party payment (insurance or gov’t single-payer) strongly encourages increased demand for services.  Turning the system into single-payer does not solve the fundamental problem unless you set limits on payment (yes, that’s called rationing).

And the system that we used to have was by largely Laissez-faire capitalism.

Baloney.  The insurance industry has long been heavily regulated at the state level.

That had fundamental problems too.

Yeah, I think I’ve already mentioned that.  It’s the third-party payment problem.

Millions and millions of people were uninsured because they couldn’t meet the demand for payment.

And part of the reason they couldn’t meet the demand for payment was because state regulators demanded a minimum coverage menu, which increased costs to the consumer.

Yes, that’s called rationing!!!
At least under this system everyone get’s insurance.  We’ll see what if any rationing takes place.

You’re talking single-payer?  Look to Canada and the U.K.  Examples abound.

http://www.ncbi.nlm.nih.gov/pubmed/10139963

Under the old system, rationing did take place.  Millions and millions of people didn’t get insurance period. That’s rationing out the supply
so that only those who can afford insurance get insurance.

I believe I already covered this.  It’s called “price rationing” and its a misuse of the word “rationing” to apply it in this case without the modifier “price.”

Is this going to be a segue into “Death Panels” for you Bryan?


It’s exactly what Sarah Palin was talking about when she made her “death panel” statement on Facebook.  She specifically referenced the economic analysis of Thomas Sowell in the immediate context.  She was not saying the PPACA established any particular body to make individual treatment decisions for anyone.  She was saying that government control inevitably placed the government in the position of effectively making those decisions and that the consequences would fall chiefly on society’s most vulnerable (children and the elderly).  With great honesty and integrity, liberals and the press misrepresented Palin’s point.

I’d love to hear you bloviate about Death Panels.  That would be entertaining!

You’ll have nothing to rely on in response apart from ridicule.  You might was well not reply at all if you can’t respond without using fallacious argumentation.

I’ll be the one entertained.

(oops, responded to VYAZMA by accident; no wonder it wasn’t up to mckenzie’s standard)

[ Edited: 26 October 2013 01:08 PM by Bryan ]
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Posted: 26 October 2013 01:21 PM   [ Ignore ]   [ # 14 ]
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Bryan - 26 October 2013 12:56 PM

Baloney.  The insurance industry has long been heavily regulated at the state level.

Who regulates who?  The insurance industry is the biggest lobbying interest in the US.  Pretty sure.
Yeah, who regulates who?  Heavily regulated…. LOL
If you mean by itself under the guise of government I’ll go along with you.
You think this is rhetoric?  You think that’s hyperbole?
Are you the shill?  The pitch guy?  Or do you actually believe this crap you spew?

Yeah, I think I’ve already mentioned that.  It’s the third-party payment problem.

Oh let me get this straight, you gotta system whereby you can reduce the costs so much that everyone can afford medical services out of pocket?  Is that it?

And part of the reason they couldn’t meet the demand for payment was because state regulators demanded a minimum coverage menu, which increased costs to the consumer.

Oh, ok. If you say so.

You’re talking single-payer?  Look to Canada and the U.K.  Examples abound.

ughhh!  That old game? Everybody has health coverage in Canada or the UK!!!
Your turn next…let me guess?  People have to wait 10 years to get flu shots right?

I believe I already covered this.  It’s called “price rationing” and its a misuse of the word “rationing” to apply it in this case without the modifier “price.”

Oh.  So the thing you’re afraid of is rationing?
The thing I’m afraid of is people without any health services access!!
We got that clear now.  Sorry I hijacked the term “rationing”!

It’s exactly what Sarah Palin was talking about when she made her “death panel” statement on Facebook.  She specifically referenced the economic analysis of Thomas Sowell in the immediate context.  She was not saying the PPACA established any particular body to make individual treatment decisions for anyone.  She was saying that government control inevitably placed the government in the position of effectively making those decisions and that the consequences would fall chiefly on society’s most vulnerable (children and the elderly).  With great honesty and integrity, liberals and the press misrepresented Palin’s point.

1.  You got balls quoting anything by Palin.
2.  I doubt that children would be most vulnerable in any kind of rationing scenario. I really do.
But that has a nice ring to it for ya doesn’t it?  Children and old people!
You are a hack!! Get a good argument already.

You’ll have nothing to rely on in response apart from ridicule.  You might was well not reply at all if you can’t respond without using fallacious argumentation.

I’ll be the one entertained.

Like the “Children and Old people” bit right Bry?

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Posted: 26 October 2013 02:20 PM   [ Ignore ]   [ # 15 ]
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Bryan - 26 October 2013 12:22 PM
macgyver - 26 October 2013 10:45 AM

Bryan, quite frankly the private insurance industry really has no business in health care except as a conduit for a national program. The days of private insurance companies providing a hap hazard patchwork of options available to only those who are employed by a generous employer, and the government filling in for the old, poor, or disabled need to come to an end. This patchwork approach has resulted in fragmented, ill apportioned, misused, over used, and under used care with large segments of the population getting no care at all.

Who pays for it?

The fundamental problem here is an economic one.  Third-party payment (insurance or gov’t single-payer) strongly encourages increased demand for services.  Turning the system into single-payer does not solve the fundamental problem unless you set limits on payment (yes, that’s called rationing).

The only way to fix this is with some sort of central oversight and private industry can not provide that.

Both systems could easily fix the problem with rationing (using the term loosely, since price rationing isn’t the same as gov’t rationing).  The ultimate reform (which admittedly is highly unlikely) involves minimizing third-party payment and publicizing health care prices so that health-care consumers can make informed decisions about spending their money.  HSAs are great concept, one which the ACA has greatly damaged.

Bryan you are making a common mistake that I hear economists make frequently. You are treating medical care like any other commodity or service. There are some important differences though.

1) We need to start with the premise that everyone has the right to basic health care. Unlike a car , or a computer, or a haircut, everyone in this country has a basic right to healthcare. We as a society have already made this decision so its not really up for debate. we have medicaid and medicare already in place which are supposed to fill the gaps in private insurance. We have laws forbidding ER’s from turning away the uninsured. We have as a society decided that no one should be denied care we just have a lousy system for ensuring that.

2) Unlike dishwashers and TV’s patients don’t have and never will have a very accurate way of evaluating the quality of the service they get. For this reason a system that falls back on free market forces of supply and demand will result in services being sold at discount prices that can’t support high quality care. It will be a race to the bottom. Providers know that patients are very poor judges of good quality medical care so they will cut corners and provide the cheapest service because thats what will attract the greatest volume of patients. Currently the government and insurers do at least some degree of vetting of credentials. Without that minimal safety net patients will be left to the wolves.

Ideally if you want to put the patient back in the decision making loop I would set up MSA’s for everyone. They have catastrophic coverage after the first $5,000 in costs and the MSA is there to pay for most of the first $5,000. Usually the first $5,000 is contributed to by the patient and the employer or the government with any unused funds remaining at the patients disposal for future medical costs or as an auxiliary retirement fund. This way the patient has some skin in the game for minor medical issues and they have the choice of going where ever they want, but they are covered for the big ones and have to stick to a program within their plan that has been vetted properly.

3) Rationing - Typically supply and demand creates a price structure that rations services to those who can afford it. Not a very effective method of rationing medical care in a fair and effective way though. The wealthy get everything they want including a lot of useless and sometimes harmful care and the poor miss out on crucial care. Removing that mechanism would I agree result in rampant overuse. So what’s the solution? Partly what I mentioned above but, the best solution is to also have a panel of experts using evidence based guidelines to decide what services are effective and which ones are not and then create a system where all effective services are covered when its justified and ineffective or unnecessary services are not covered at all. This eliminates over use of services by everyone. But his needs to be done centrally and nationally. Right now its done by individual insurance companies creating a patchwork of policies that dont make sense allowing some people to get coverage for silly things that dont work while others are denied basic services.

The individuals on the panel that makes these decisions should be appointed like a supreme court judge is so that they would be free from public and political pressure and special interest groups.

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