The Trump administration just came out in full-throated support of Killing ACA and allowing insurance companies to deny you insurance because you are sick.
https://www.cnn.com/2019/03/26/politics … index.html
I have no issue with this. Currently I have no insurance, and there's NO WAY I'd expect an insurance company to take on my preexisting conditions. Honestly, think about that. If I wreck my car, can I then expect an insurance company to give me a policy that will cover the previous wreck? Of course not.
Insurance companies won't cover people after age 65. Why? Because most of us are going "down hill", we're certain to begin having significant problems. No insurance company could make money on our policies.
I'm all for universal coverage if we keep government out of it and make it voluntary.
So, you don't mind having the tax payer pay for your healthcare when you have an emergency and can't afford it.
The US has had in place, for a long time, provision that in cases where a person's life depends upon it, the taxpayer helps out.
I've never had an objection to this, and still don't today.
If you have an emergency, and have health insurance, you have no problem.
But if you have decided NOT to buy insurance until after it is needed, you DO have a problem, and it is one that you caused yourself. Don't expect others to pick up the cost for your failure to act.
It seems forgotten that insurance is just that; insurance. A method of sharing catastrophic costs among many, not just a way to cut your out of pocket costs. If you don't want to share those costs, and don't buy insurance until you are suddenly facing huge bills, don't expect any help from others sharing those costs after you refused to share theirs.
Obamacare, and even single payer with govt. picking up all health care costs, is nothing more than a requirement that you have insurance. No choice; you WILL pay for insurance. The socialist utopia, then; citizens will do as legislators demand they do, without any say in the matter.
Looking strictly at those who can't afford it, and have a traumatic accident or heart attack and need lifesaving help.
And those people have lifesaving help available, and always have. It is the emergency room of the local hospital.
But those people are not those that the pre-existing condition matter is addressing; rather it is those that CHOOSE not to purchase insurance (especially now, with Obamacare available to all) until after they find they have cancer or some other high cost ailment and want society to pay their costs.
But Wilderness, that is the point "Don't expect others to pick up the cost for your failure to act." - The tab IS picked up by the taxpayer in the end either with higher taxes or higher insurance premiums. The hospitals and doctors who have been stiffed by people who can, but chose not to buy insurance, will pass on their losses to somebody else.
This is just the way it is and why I support the insurance mandate or be taxed an appropriate amount. Some people don't do the right thing and YOU end up paying for it.
The unrealistic alternative is we stop require hospitals and doctors to provide emergency care for people with no insurance, but can afford it, and simply let them die or remain injured.
Your states REQUIRE you to have auto insurance - why aren't you objecting to that?
I'm sorry, but neither my state nor anyt other, REQUIRES everyone to carry automobile insurance. Only those that travel on public roads and thus endanger other people, and then only to protect others. Any insurance required here does NOT protect the insured person.
A very basic difference, then, from required medical insurance simply because one is alive. An obvious, very clear, difference that liberals do not seem to have the ability to discern...or perhaps simply do not wish to acknowledge, for it is difficult to believe they really can't tell the difference between optional auto insurance to protect others and legally required health insurance to protect the insured. Any child of 6 years could understand the difference.
The alternative is bankruptcy in case of a severe illness or accident, especially for people who aren't paying for health insurance.
All of those costs get passed on to the rest of us who do pay for insurance in the form of higher premiums.
As fewer people have health insurance (pre-ACA), fewer people are paying into the system, which drives premiums higher.
Just two days ago, I met someone who got hit by a car pre-ACA and had a $430,000 hospital bill because he had a weak insurance policy.
We are all paying for his bill with our premiums because he went bankrupt.
Bozo Trump is Burnt TOAST and the Mueller Report along with the SDNY which has him listed as essentially what experts consider an "Un-Indicted Co-Conspirator" to felony crimes of conspiracy against the USA as reported by the press, spells intense legal jeopardy: It's just a matter of time for this crook and he can't get away with it and escape the law forever, his constant INSANE Attacks on our Health-Care System and Rule of LAW will spell his doom and removal and the Communist Russian Republican Senate will FALL Demonstrably in 2020 for aiding this dictator wanna' be nut case:
I wonder if Melani, Bozo's daughter or whatever had comprehensive health insurance when she needed medical attention in the hospital not too long ago? If it's good enough for her it's good enough for ALL Americans and we are DEMANDING Health-Care for ALL:
I can't go as far as "Health Care for All".
I stop at "accessible, affordable health care for all and if needed, subsidized. In other words, ACA with some improvements.
My Esoteric: It doesn't really matter which avenue Progressive Democrats take to cover ALL Americans as long as ALL Americans get the coverage they need, Comprehensive Insurance that protects against ALL Illnesses and Pre-Existing Conditions as Obama-Care the Affordable Care Act currently provides for millions of Americans, and guess what? That would even include coverage for his own last remaining followers despite themselves:
It was inevitable, the unstable 72 year old in our oval office has been attempting to sabotage our health-care system since he assumed power with the assistance of his comrade Vladimir Putin and there's every indication that he will not stop attempting to decimate our health-care here in the USA until the entire health-care system collapses and that's nothing short of INSANE:
HOORAY, it is about time! Obama"care" is a disaster. The government shouldn't be in healthcare. Let healthcare be an individual thing. Healthcare was fine before the Obumler interfered with it! Good riddance I say!
1. The US does not even rate in the top 9 nations in adjusted life expectancy.
2. The US compensation for general physicians is 41% greater than then next most expensive country, Germany
3. The US pharmaceutical prices are 54% more expensive than the next highest country, Switzerland.
4. The US spends 60% more on governance and administration of healthcare than the next highest country, Germany.
Free market works best.
We need competition.
don't eat junk
get rid of Monsanto
and pharmaceuticals ...
take care of yourself and thrive.
Of course I support Trump. He's far and away the greatest POTUS of my lifetime, and he puts America and Americans first, the opposite of what a globalist would do. Next question.
Actually, Bozo Trump is the WORST, Weakest, Most Incompetent, Mentally Unstable and Clearly Delusional Pseudo President who needs to be REMOVED from our oval office by congress ASAP before any more damage can be done:
In what far off distant planet is Bozo trump putting Americans first? Decimation of our farmers and industry with his insane Tariff Wars, Intentionally Sabotaging our health-Care system with his unholy maniacal threats and attempts to STRIP millions of AMERICANS from our health insurance which endangers our families while we must assume Queen Melanie was fully covered during her recent hospital stay, threatening to SLASH Social Security and Medicare by TRILLIONS, two programs which are vital to the very existence of our retired senior citizens who actually worked for a living and EARNED these benefits, and MAJOR Cuts to our public school system?
By Bozo Trump putting Americans first I suppose you actually mean putting the Filthy Rich on Wall Street first with his "Corporate Welfare tax Cut Scheme" and the rest of us being driven into poverty or worse paying for it right? Because here in the REAL World, trying desperately to undermine everything "we the people' have worked hard for does not fall into that "America First" or creepy little "MAGA" hat category:
As a Canadian all I can say is thank God that I am Canadian and we have universal health care. It isn't always a perfect system but as a disabled person I know that I won't be thrown under the bus simply because I am who I am. I didn't ask to be hit by a rare disease and I sure do appreciate not being punished because I was.
Universal health care is not all that scary. The US can take a little of the massive amount of money they spend on military funding and there should be ample to subsidize a good medical program. If Trump figures he can use that money to build his wall then why could that money not be used instead to provide health care for all. Good health care actually decreases medical costs in the long run because screening for illness and early diagnosis generally bring a better long term result.
Hello Ladymermaid, I have heard similar thoughts about paying for Universal Health Care by reducing the Defense Budget, (your "... take a little of the massive amount of money they spend on military funding..."), or taking money away from "The Wall," but the numbers just don't add-up.
General estimates are that Universal Healthcare, (in the U.S.), would cost an additional $2.5 - $2.8 Trillion dollars annually. Our total Defense Budget is only $700 Billion - $989 Billion, (depending on who you ask).
Taking ALL of our defense spending would not cover even half of the increased costs.
We have a capitalistic form of Universal HealthCare now with ACA.
Everyone pays something into the sytem. The insurance companies are profitable. Millions of people are no longer going bankrupt. Millions more have insurance.
It's a successful "Republican" solution to a major problem.
"... a capitalistic form of Universal HealthCare..."
That is an interesting way of describing it promisem.
The bottom gets free healthcare, the top gets expensive healthcare, and the middle gets unaffordable healthcare. That doesn't sound much like the Universal healthcare of this discussion.
Perhaps if you rewrote your statement to something like; "a form of Capitalistic Universal Catastrophic healthcare it would be more accurate.
If the system allows anyone to get health care, it's universal.
I'm not aware of anyone getting free health care, even the people I know who are making low wages. The fact that it's a progressive system is nothing new in our economy. That's how taxes work.
"I'm not aware of anyone getting free health care, even the people I know who are making low wages."
Then you need to take a hard look at what hospitals charge, every customer, for emergency services. Some do indeed get it for free.
My statement was within the context of the discussion about health insurance. There is no "free health insurance" from the government.
Otherwise, yes, your point about "free health care" is an exception because of a law that says a hospital can't turn away someone in an emergency. That's a little different than just walking in and demanding help for any reason.
"Hospitals are not shy about trying to collect from uninsured emergency patients. Their efforts can involve the hospital’s internal billing department, collection agencies, and even lawsuits. The collection process can be unpleasant: wages may be garnished and liens may be instituted on property. Hospitals, like any business, do not like getting stiffed on the tab, no matter what the law says."
https://law.freeadvice.com/malpractice_ … tients.htm
Coincidentally, I know someone who was in that situation: low-paying job, no insurance, had an emergency, got "free" care, couldn't pay the huge bill and was forced into bankruptcy.
Mr. Anderson, totally agree w/your premise. The poor gets free healthcare, thanks to our tax dollars. The rich gets expensive healthcare-of course, they can afford the highest quality healthcare while the healthcare of the middle or middling classes is becoming more & more expensive to maintain! It is the middle or middling class that is getting the healthcare shaft. Hell, the middle or middling class is getting shafted or screwed in every way it seems!
No one gets free health care. The system requires even poor people to pay for premiums based on a percentage of their income.
https://www.thehortongroup.com/resource … rease-2019
Perhaps we are talking about different things promisem.
A representative number being tossed around is that 20 million people became newly insured through the ACA.
Another representative number is that 13.6 million of those were Medicaid Expansion enrollees. The Medicaid Expansion was part of the ACA.
Medicaid coverage is free - no premiums. (generally)
It appears the majority of newly ACA-insured people are free Medicaid enrollees. So how does your statement that " ... even poor people to pay ..." address those representative facts?
I did look at your link and it appears to be addressing premium subsidy coverage. Not the totality of ACA coverage. What am I missing?
Medicaid expansion is not part of the ACA other than getting a notification that you might qualify for state Medicaid instead of ACA if your income is at the poverty level.
Otherwise, Medicaid is a state initiative. Some states expanded Medicaid and some did not.
That said, Medicaid participants do pay a fee unless they are so disabled or destitute that they can't pay at all. Again, that's a state issue and not connected to "free health insurance" from ACA.
If you want to get into a separate discussion about Medicaid, we'll have to break down each and every program and fee schedule by state.
https://www.healthcare.gov/medicaid-chi … n-and-you/
My other link was only meant to show that ACA participants pay health insurance premiums -- in addition to deductibles, co-pays and co-insurance.
So if you don't like ACA, how do you propose to replace it?
We seem to have different ideas about what the ACA is.
A government commission has this to say about it:
"Medicaid and the Affordable Care Act
The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) establishes new avenues to coverage for low- and moderate-income individuals. As enacted, the law required states to extend Medicaid eligibility to adults with incomes below 138 percent of the federal poverty level (FPL), although the June 2012 Supreme Court ruling in National Federation of Independent Business v. Sebelius effectively made the expansion optional for states. For more information, see Medicaid expansion to the new adult group."
.Source: MACPAC.gov (Medicaid and CHIP Payment and Access Commission
That sounds like the Medicaid Expansion program was part of the ACA.
Also, that the proponents of the ACA constantly promote the 20+ million people that could now get coverage seems to imply they think those 13.6 million new Medicaid enrollees are part of the ACA.
If the Medicaid Expansion program is not part of the ACA, (contrary to what the government says), then only 6.4 million citizens received new coverage under the ACA. Do you agree with that number?
I couldn't find any sources that said Medicaid recipients had to pay a fee,
but I did find this:
"Given that Medicaid and CHIP enrollees have limited ability to pay out-of-pocket costs due to their modest incomes, federal rules prohibit states from charging premiums in Medicaid for beneficiaries with income less than 150% FPL, "
Source: 10 Things to Know about Medicaid: Setting the Facts Straight
If you have data that shows Medicaid recipients pay a fee I would be glad to look at it.
As for your argument that the New Medicaid Expansion program, (which makes up the bulk of new ACA-touted coverage enrollees), is not part of the ACA - I will go with the text of the Act, the Court decision, and the government's program administrating agency. They say it is.
Yes, we do.
I stand corrected about the right of states to expand Medicaid within the ACA law itself. Whether they do so has nothing to do with the "free" ACA health insurance in your earlier comment.
Otherwise, Medicaid is meaningless to anyone who applies for insurance through the ACA exchange except for possibly getting a notification that they might be eligible for Medicaid if their state expanded it.
I didn't say all Medicaid recipients pay for their coverage as you imply. I clearly said they can avoid paying if they are too disabled or destitute to pay for it. Your own quote shows that states charge Medicaid clients if their FPL is above 150%.
But we seem to digress badly from the original topic, which was free insurance from the ACA. Again, if you don't like it, what do you propose to put in its place?
If we are going to disagree promisem, we should at least be clear on what the disagreement is.
You said this:
"That said, Medicaid participants do pay a fee unless they are so disabled or destitute that they can't pay at all." [my emphasis]
Now you say that I implied you said ALL Medicaid recipients pay for their coverage. What I actually said was:
"I couldn't find any sources that said Medicaid recipients had to pay a fee, but I did find this:"
As for charging any Medicaid recipient that exceeds the 150% poverty level threshold ... I haven't double-checked, but I don't think they are charged Medicaid fees either. I think they are disqualified from the program. Did you find a source that says something else?
Concerning straying from the topic; I think we are still on topic--relative to your comment that prompted our exchange:
"We have a capitalistic form of Universal HealthCare now with ACA.
Everyone pays something into the sytem. The insurance companies are profitable. Millions of people are no longer going bankrupt. Millions more have insurance." [again, my emphasis]
I think we are still talking about who pays and who doesn't.
Even though you have repeated your question of what I would propose as a replacement, I don't think it would be productive to offer you any answer. We can't even agree on what the ACA is, so how could any answer I give satisfy your question?
You claim we are on topic about Medicaid, but you brought it up, not me. Then you quote my comments about ACA which started this entire debate.
Medicaid has nothing to do with my original point about "free" insurance from ACA or "We have a capitalistic form of Universal HealthCare now with ACA".
The subject is ACA, not Medicaid.
Here are the facts about what ACA actually is and is not:
People use the ACA exchange ONLY to see if their income is low enough and premiums are high enough that they might get some tax credits.
Even if they get credits, they still have to pay some money for premiums as well as pay for deductibles, co-pays and co-insurance.
Anyone who wants credits through ACA has to pay for their insurance from for-profit companies, so it is capitalistic. Anyone can participate, so it is universal.
Medicaid is NOT insurance that people buy through the ACA exchange. If I qualify for Medicaid, I don't get it from ACA. I get it from the state.
This is not my opinion. These are actual facts. So there can be no disagreement about what ACA is.
At least we have defined what our disagreement is.
I say the Medicaid Expansion program was part of the ACA, (The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended), as summarized by the government's own agency--
Medicaid and CHIP Payment and Access Commission--supports my contention.
Your own statement confirms you view it as part of the ACA: "I stand corrected about the right of states to expand Medicaid within the ACA law itself."
Yet, you continue to see the Medicaid Program as not a part of the ACA. Surely you can see how that puzzles me?
I also think it does fit the description of free healthcare -- within the scope of your description of the ACA as being a Capitalistic form of Universal Healthcare, as provided by the ACA, and as noted in my first response to your comment.
I know repetition is tedious, but at that cost, here is your comment that I responded to...
""We have a capitalistic form of Universal HealthCare now with ACA.
Everyone pays something into the sytem. "
... noting that your statement didn't say insurance coverage, it said universal healthcare with the ACA.
I think it is clear to see that the discussion was about free healthcare from the ACA - until your latest clarification that you were talking about "insurance," not healthcare coverage.
But even with your addition of the "insurance" qualifier, since Medicaid healthcare coverage is supplied by a healthcare insurance provider company, (the difference, of course, is who pays those provider companies), then is it a stretch to say that the ACA Medicaid Expansion program is also providing healthcare insurance through the ACA?
You say there can be no disagreement about what the ACA is - because of your facts. Does that mean my "facts" are wrong, or just that your facts trump mine because you need them to in order to validate your original point?
Sorry bud, but I think what you say is not your opinion, really is just your opinion. I don't see any of your facts contradicting the information I have supplied. They only seem to be one part of the picture that you want to be accepted as the whole picture.
You disputed free healthcare, (or now, healthcare insurance), through the ACA. I have provided facts that show the Medicaid Expansion program is both a part of the ACA, and is free, (to the user), healthcare. I have also shown that this free healthcare is provided by healthcare insurance companies, re. your "insurance" qualifier.
Back to the "on topic" aspect, your claim was that there is no free healthcare insurance within the ACA. I think our exchanges have shown us to be right on your original point.
I agree the tedium and repetition are rising, especially on the subject of Medicaid, which feels like a deflection that has nothing to do with my original comments about ACA.
So which of "my" facts about ACA are wrong:
1. People use the ACA exchange ONLY to see if their income is low enough and premiums are high enough that they might get some tax credits.
2. Even if they get credits, they still have to pay some money for premiums as well as pay for deductibles, co-pays and co-insurance.
3. Anyone who wants credits through ACA has to pay for their insurance in a MARKET from for-profit companies, so it is capitalistic. Anyone can participate, so it is universal.
4. Medicaid is NOT insurance that people buy through the ACA exchange. If I qualify for Medicaid, I don't get it from ACA. I get it from the state.
Now that you say "we" have defined our disagreement, you are free to tell me how you will get rid of ACA and replace it with something better.
Now, besides the added qualifier of "insurance," you are conditioning your statement with "ACA exchanges." Neither were in your original comment or your first couple of replies.
If an applicant was told by the ACA exchange that they qualified for Medicaid and it directed them to their state Medicaid office would that qualify as getting healthcare coverage from the ACA exchange? I am not sure, but I am sure that relative to how it applies to your first comments, Medicaid is part of the ACA.
Further, the state does not administer the healthcare its participants receive, it mere qualifies and pays for participants. Those participants receive their healthcare coverage through for-profit healthcare insurance providers. In my state of Maryland, there are three healthcare insurance providers that participate in the Medicaid program. Applicants get to choose their provider. The most popular being a company called Priority Partners. You can visit their site to confirm that they are a for-profit healthcare insurance coverage provider.: https://www.ppmco.org/
It appears that to agree with your perspective we must ascertain that being directed to Medicaid through an ACA exchange message, (I wonder if the exchange might send you directly to your state's offices?), and agree that Medicaid healthcare provision is not healthcare insurance coverage provision.
I don't know the answer to the first, and I cannot agree to the last. I believe I have shown information that proves otherwise.
As for your listed facts:
1. Are you saying people only look to see what they might qualify for or be able to choose from? You even capitalized "ONLY" to emphasize your point. As I understand it you can actually sign on to a plan through the exchange. So I do think #1 is wrong as stated.
2. Relative to non-Medicaid coverage, this seems correct.
3. I think this is also correct.
4. I think this one is wrong. Using my state as an example; Three for-profit healthcare insurance providers participate in Md.'s Medicaid program. We could call three a market, couldn't we? After all some state's don't have that many choices in their providers "market."
Apparently, the basic difference is who pays for the healthcare insurance coverage received. Whether the state totally, (Medicaid), or the Feds, (partially).
Nope, still too far apart to offer a viable answer. It seems to me that you have changed your original statement to now be focused, and determined, by the ACA's exchanges instead of the Act itself.
I was never addressing the exchanges, I was addressing the Act, and I think I have supplied support that validates my contention - without any added qualifiers or conditions.
My bottom line is that the ACA does provide a segment of our citizens with free healthcare insurance coverage. Because it is the Medicaid Expansion program that does this is irrelevant since it is still a part of the ACA. For this point, Medicaid Expansion is synonymous with free, and it is documented as a part of the ACA.
That is how "Medicaid," which you object to considering in your contention, became a focus of refuting your point.
(I am not sure, but I think I might have read you previously referring to something like this as 'moving the goal posts')
The govt doesn't totally pay for all the expanded "Medicaid" in every state. Some states were approved for different programs that require monthly payments or copays. See HIP in Indiana.
Some people pay for Medicaid expansion policies so it's not always synonymous with free...just an aside.
Well damn hard sun, I should know better than to trust what the government says.
""Given that Medicaid and CHIP enrollees have limited ability to pay out-of-pocket costs due to their modest incomes, federal rules prohibit states from charging premiums in Medicaid for beneficiaries with income less than 150% FPL, "
Source: 10 Things to Know about Medicaid: Setting the Facts Straight"
As I followed the trail of the Healthy Indiana Plan, (HIP), it seems that you are realistically correct, but perhaps technically wrong. It appears that Indiana's program is a custom version of Medicaid Expansion that received waivers and special exemptions to reduce their threshold to 100% for free coverage.
Even so, your point is a fair "aside." I don't think it negates my point, but it does show there are gray areas.
Indeed states were granted exemptions for this 150% rule and actually have people under poverty making copays and or monthly health premiums.
It's still part of the Medicaid Expansion program though with funds coming from the ACA, as you've been pointing out. I helped push it through with letters for an advocacy firm. I think I'm technically correct.
https://www.governing.com/topics/health … -Plan.html
This deal happened. No, it doesn't entirely negate your point, but it does establish that Medicaid is not always free.
Thanks for the corrective input. I was lazy. I stopped when I found what I needed in the ACA itself. I should have looked for exceptions to be sure I was factually secure.
In all fairness, I was just pointing out a relatively minor point made in the scope of your argument.
I'm not always the best at providing the reasoning for assigning high value to certain data, even when I have done my research, and sometimes I just get lazy as well. Sometimes I need to be challenged, and this forum can be good for that. It's also good for taking my focus away from work, lol. Such is life.
You are certainly right that these forums can be challenging, and, speaking for myself, these forums sometimes also provide a welcome escape from daily stresses.
In some instances where some men might head to the workshop for escape, I head to these forums. ;-)
1. For what other purpose do they go to the exchange? If they don't qualify for the credits, they buy insurance anywhere they want.
4. Is Walmart a market where people buy and sell even though it's only one business?
Anyplace where people buy and sell is a market, therefore capitalistic.
"If an applicant was told by the ACA exchange that they qualified for Medicaid and it directed them to their state Medicaid office would that qualify as getting healthcare coverage from the ACA exchange?"
No. It's simply a referral. It's no different than a referral from one doctor's office to another.
"ACA does provide a segment of our citizens with free healthcare insurance coverage. Because it is the Medicaid Expansion program that does this is irrelevant since it is still a part of the ACA."
Yet again, can you buy Medicaid through ACA? No, you cannot. The thread is about ACA. My comments were about ACA.
The fact that Medicaid -- which is a state program -- is mentioned in the federal ACA law has nothing to do with getting insurance from the ACA.
Bluntly, you won't even acknowledge that Medicaid is a different "entity" than ACA. That's a pretty big problem at your end of the debate.
It looks like more tedious cut & paste repetition is in order promisem.
The thread topic was the repeal of the ACA, the Act, not the exchanges.
My Esoteric's OP stated: "The Trump administration just came out in full-throated support of Killing ACA and allowing insurance companies to deny you insurance because you are sick."
Your first comment in this thread included this:
"As fewer people have health insurance (pre-ACA), fewer people are paying into the system, which drives premiums higher."
"Just two days ago, I met someone who got hit by a car pre-ACA and had a $430,000 hospital bill because he had a weak insurance policy.
That looks like you were talking about the Act itself, not the exchanges.
Then you later said: "That's why ACA requires everyone to pay something when millions weren't paying anything before."
Surely you must be talking about the Act, I don't see a mention of the "how you get coverage" function of the exchanges.
Then there is your comment that I first responded to. You said: "We have a capitalistic form of Universal HealthCare now with ACA."
Aren't you still talking about the Act?
Then you said this:
"If the system allows anyone to get health care, it's universal."
"No one gets free health care. The system requires even poor people to pay for premiums based on a percentage of their income."
Was it rash on my part to think that when you say "system" in this context you are talking about the Act itself?
Then our exchanges began in earnest with you saying this:
Medicaid expansion is not part of the ACA other than getting a notification that you might qualify for state Medicaid instead of ACA if your income is at the poverty level. "
You later stated you were incorrect in that statement. Relative to its inclusion in the Act itself.
Do you see where our exchanges are at this point?
Once you acknowledged that Medicaid Expansion was indeed a part of the Act, you began adding qualifiers. First, it was that you were talking about "insurance coverage, and Medicaid Expansion was not "insurance" coverage it was state-provided.
Then when it was shown that Medicaid Expansion was indeed healthcare insurance coverage you added the condition that ACA now meant ACA exchanges, and only meant insurance through the exchanges.
Unfortunately, I must say, just as bluntly, that when your contentions were shown to be incorrect you just changed them, qualified what you really meant - you moved the goal posts. ... and here I can agree with you, " That's a pretty big problem at your end of the debate." (although I would have said "discussion")
As an ending note to one of your last thoughts; none of my responses have been about Medicaid, they have been about the Medicaid Expansion program, and to be as concise as you expect, no one gets insurance from the ACA, they get it from a mechanism created by the ACA. One being the Exchanges, the other being the Medicaid Expansion program.
If that were not true, then what does that say about the claims of the ACA proponents of providing 20+ million uninsured people with insurance, when by your logic the "ACA," via the exchanges, only provided less than 7 million new people with coverage?
Your reply doesn't answer my questions or address the #1 and #4 factual errors on your part that I listed in my previous comment.
Instead, it comes across as an attempt to bury me with intentionally inaccurate interpretations and misdirections of my own comments to avoid admitting that you, who has never used ACA, knows a lot less about it than me, who has used it and helps friends, relatives and neighbors use it.
I'm shocked and disappointed you can't even admit that a marketplace is capitalistic.
With that final comment, I am done discussing this with you.
You may be done promisem, but I am not.
Inaccurate interpretations? I quoted you promisem. How can that be "inaccurate?"
Hell, I even included most of the context of your quotes. How is that "misdirection?"
Your assumption that I have not used the exchange is also incorrect. Although it is probably true you know more about the exchange than I do, but as already pointed out, the exchanges weren't a point of this discussion until you needed them to be.
And speaking of being inaccurate, where did I deny a marketplace is capitalistic? Feel free to offer a quote if you have one more response in you.
As for my "factual errors" that you listed... I looked back and couldn't see where you were able to list any dispute of the facts I presented. I will do my own legwork on this if you will just point me to which of your comments factually disproved the information I cited. Your opinion doesn't count, I did see instances where you thought your opinion trumped documented facts.
As to your questions; Don't folks also buy, (or sign-up for), insurance coverage through the exchange? That is my answer to #1. And I do not think, (but don't know), that folks sign-up for Medicaid Expansion through the exchanges, but as repeatedly noted, the exchanges aren't the only mechanism to get health insurance coverage through the Act, and they weren't the topic of our discussion. That's my answer to #4
You accused me of "intentionally inaccurate interpretations and misdirections." and claim you refuted my "facts." That's simply a personal challenge promisem.
Step-up and support your accusations. That should be when you are done discussing this. Hell bells, you can even enlist support from other forum members. Maybe they see something I don't. hard sun contributed a valid clarification on one point, so you may not have to do this on your own.
But you do have to stand behind your accusations.
If we used 200 TIMES what Trump wanted for a wall it would not pay for half of what would be spent on health care in the US. And that does not consider additional spending as we encourage more illegals to sneak into the country and use the services.
If we spent the entire military budget, every dime of it, we could cover less than a third of what we spend on healthcare.
It is this kind of fanciful thinking, a utopia that does not exist, that makes it so difficult to have a real discussion on the topic.
https://www.forbes.com/sites/danmunro/2 … 77312476a9
https://www.forbes.com/sites/danmunro/2 … 4a169676a9 (Notice that this is several years old; the actual cost is much higher now.
It's amazing what the left thinks we can afford. Add to those the costs of the GND, at a price tag of, what? Low end cost of$600 thousand pretty household over 10 years, free college at a cost of $47 billion a year.
Add it all up and we'd be bankrupt, ultimately uneducated and living in 3rd World conditions. There'd be college for none and health care for none and it would probably have zero effect on our collective carbon footprint. What with all of the campfires burning inside our little dirt huts.
You keep repeating an untruth, Wilderness, so I will keep repeating the truth. Because, as a group, illegals who enter America are more law-abiding (once they are here), work harder, and pay more taxes than, as a group, people who are born here, THEY are a NET economic boon to America.
The way your logic works is, using your family as an analogy, you ONLY consider the expenses your family incurs while ignoring the income they bring in to pay for those expenses.
Interesting that you can say this since we have no real data for all illegal immigrants. We can't even cine hip with a number of how many are here. We just have questimates for the ones we know exist and, quite frankly, I have found nothing to support your claim.
Ladymermaid: YES, be thankful, be VERY Thankful Canadians have a Young, Vibrant & STRONG Intelligent Leader in attractive Justin Trudeau who actually cares about Canadians and this ailing planet, unlike the USA where we got stuck with a Russian Assisted Weak, Incompetent, Narcissistic all consuming 72 year old frump who appears to spend his time in our oval office trying mightily to enrich himself and Wall Street, emulate the strangest looking dictators, and of course dodge prison and impeachment:
I will say right now that I do have an understanding of health care but I'm not an expert. Isn't the idea of insurance companies is to make money not to be a charity service? If an insurance company allows all kinds of pre-existing conditions then they not make money, what happens after that is bankruptcy.
One form of charity is helping people pay for their health insurance when they can't afford the entire bill.
The other form of charity is paying the entire bill of someone who isn't paying for any health insurance and goes bankrupt.
That's why ACA requires everyone to pay something when millions weren't paying anything before.
It's nonetheless coercion - that's not a role delegated to the federal government. Our constitution forbids the feds from doing this very thing. The cause is noble, yes, but find another way to get it done.
I agree it's coercion, just like income taxes and all other laws. But no one seems to know how else to get it done other than a Canadian system.
I've noticed that many of the sharpest minds in society consistently suggest making government bigger, more imposing, in order to address problems. Maybe these folks are not so sharp after all.
We need boundaries. Laws to restrict / reduce GREED.
Or its okay to let people die.
For instance, due to DISMANTLING the Glass-Steagall Act during the '80s and '90s, the nation suffered a serious recession, the largest financial meltdown since the stock market crash of 1929.
The act had prohibited bankers from using depositors’ money to pursue high-risk investments.
"The Glass-Steagall Act, part of the Banking Act of 1933, was landmark banking legislation that separated Wall Street from Main Street by offering protection to people who entrust their savings to commercial banks."
https://www.history.com/topics/great-de … eagall-act
I thought that repealing it was a poor decision.
It would be a good idea to reinstate it, rather than go the way of socialism.
The youth see GREED and want to counter balance THAT with a new type of government!
Keep the government we have, just use the ability we have to make helpful and wise boundaries/laws.
Somehow we have maintained a fairly consistent level of federal spending as a % of GDP since WWII (except during major recessions). It's a useful tool for managing the size of government.
What we haven't maintained is a consistent level of taxation, which is why we are running up a huge national debt and have a crumbling infrastructure.
And here again is strong evidence that the when tax rates are cut significantly, the size of government, along with the spending that maintains it, has to be cut. Reagan and Trump both made the same mistake by cutting taxes without cutting the size of government, though Reagan DID try to cut the size of government.
Actually, Hx, it doesn't, not 100%. For example, you are coerced into paying taxes you don't want to. You are coerced into giving up your property for Trump's wall.
It is up to the Supreme Court to decide when the federal gov't can "coerce" a citizen. And the Supreme Court decided that the law, then written, can coerce a citizen into having insurance. All states coerce their citizens into having auto insurance.
Since you agree it is a noble cause, that suggests you favor a single-payer system with the taxes needed to support it.
It always seems odd that this same tired argument is brought up; we pay taxes to support the needs of the nation and sometimes we disagree on how those taxes should be spent.
THEREFORE, it is fine to double the tax burden in order to have resources to give away to individuals that do not support themselves. It's almost as if pretending the two are equivalent makes it so.
But you, HX, by your own admission, is one who wants to leach off of society when you get sick or hurt because you won't buy insurance (even though you can support yourself (I presume).
You misunderstood - I need to be clearer.
I favor helping those who CAN'T buy insurance, and need help when a life threatening catastrophe strikes.
In my current situation, I have 3 choices:
1) Personally pay the exceptional monthly premiums for ACA insurance. Likely, I'd be using credit to pay for 5-6 months worth each year. I could do that for 2-3 years before I'd fall behind in my ability to pay those credit bills and I'd be forced into bankruptcy.
2) Go without insurance, handling the occasional medical charges myself, or with short term credit, hoping the catastrophe doesn't come. IF it does come, I'd utilize my excellent and extensive credit to pay for life saving work. That would lead, sooner than later, to bankruptcy.
Actually, I have a third option - use medical sharing insurance. I'm currently looking into this, and it MIGHT be better than what I'm doing now, not sure yet.
Sorry for not being clearer. I think Wilderness misunderstood as well.
There is no ACA insurance. There is only insurance from insurance companies that offer policies through the exchange.
The only purpose of the exchange is to confirm your income and whether you qualify for tax credits.
The credits lower your monthly premiums based on your ability to pay. If you have low to moderate income, you won't go bankrupt because the credits make sure you are paying only a reasonable percentage of your income on health insurance.
That's the whole point of the exchange: to stop the medical bankruptices that were skyrocketing before ACA arrived.
More clarification is needed: I could buy insurance, but choose not to because the cost, as I describe above, is IMO prohibitive for the benefit provided. Paying the premiums could, as I describe above, eventually ruin my credit.
In case of dire emergency, I'd anticipate paying for the services using my credit.
I favor helping those who're without means to pay for life saving services when needed.
Hope that helps!
As usual with you Wilderness, there is only about 1% of truth in what you say, the rest is pure distortion of facts.
I remember the first thing this OP person ever said to me here. It was about how he hated the United States of America, hated Capitalism, and wished the nation would fall into the dust. He's a liberal, of course he hates the USA, he hates all the people within, and why would anyone consider anything he says about anything, I always wonder.
Maybe the insurance companies should be forced to accept those with pre existing conditions.
Q. Make it a law NOT to deny (insurance policies) to those with pre existing conditions?
... but then the insurance companies will not want to go into business.
... or why not (want to go into business); they will still make money ... but just not as much (money/profit.) (?)
Is this statement true or false?
Greedy (free-market) insurance companies deny insurance for those with pre-existing conditions.
Yes "Greedy (free-market) insurance companies deny insurance for those with pre-existing conditions." WAS true when they were allowed to.
How come insurance companies are now wanting to join the ACA market place and are now making money at it? That started last year.
Perhaps many of the last remaining Trump followers like Kathryn might start to support Obama-Care the Affordable Care ACT if they understood that this law guarantees an insurance company CANNOT discriminate against an adult or child with a "Pre-Existing Condtion":
Obama-CARE also guarantees an insurance company CANNOT Cancel your policy without cause as they where able to do and did when it benefited them financially prior to the ACA: Communist Russian Republicans in Congress and Mr. Trump are trying desperately to CANCEL these critically important consumer protections and that's nothing less than Abominably EVIL and most Americans know it:
A history of why the US is the only rich country without universal health care
https://qz.com/1022831/why-doesnt-the-u … alth-care/
Interesting read here..it seems the government already spends over 2.5 times more per person on healthcare than other "developed" nations. And, this is before Romneycare came about:
https://www.pbs.org/newshour/health/hea … -countries
Universal health care keeps costs down.
While I hold your side, the refrain in return is "and taxes up". My question, without knowing the answer, is the tax burden included in the "2.5 times" calculation?
Unproven, but believed by many, is the quality of care goes down under universal coverage. Personally, I tend to believe it.
Given all of that, my preference is an improved ACA with a gov't option.
I have also seen that "2.5 times" tidbit before My Esoteric. And like you, I wondered about it but did not check it out. We are being lazy.
One of us should look into it, and, your thought about the effect on the quality of healthcare.
Since you insisted, go ahead, it's yours. ;-)
I haven't looked at the 2.5 yet, but since the other is more subjective, I will tackle that first. The going in position for the right-wing is that single-payer insurance leads to long waiting lines and poor quality health care compared to ours. Because most healthcare, they reason, delivered in America is "for-profit" it must be, de facto, better quality and faster.
I beg to differ.
They often use Canada as an example of terrible care. Unfortunately for them, everything I can find on it, the Canadians really like their healthcare system. Yes, elective procedures, such as MRIs, can apparently have long waiting lines, but then I have found the same in America with by step-daughter.
The same is true for England, although I have heard more anecdotes about poor care there. But then again, Brits seem to love their system as well. So do the French and Germans. Apparently they don't mind paying the taxes that fund it either.
My bias probably stems from movies about mindless bureaucracies, it certainly isn't based on facts. But I also don't let my bias impact my desire to know the truth about a subject. I just recognize it and move on.
Here is a great article I found on the healthcare systems https://www.griffinbenefits.com/employe … urope-work
In France, workers spend about 21% of their income on healthcare, about 50% of it is picked up by employers (https://www.npr.org/templates/story/sto … d=92419273).
In America, that number seems to be 7% (although I look at the $4,612 annual healthcare cost with a jaundice eye, but will accept it for now) https://www.usatoday.com/story/money/pe … /34378157/
So what does that get you? According to https://www.commonwealthfund.org/public … igh-income
The U.S. continues to spend more on health care. In 2016, the U.S. spent 17.8 percent of its gross domestic product (GDP) (different from personal income) on health care, while the average spending level among all high-income countries was 11.5 percent of GDP.
The U.S. has lower rates of insurance coverage.
While health coverage in the U.S. has risen to 90 percent since enactment of the Affordable Care Act, every other high-income country has achieved coverage for at least 99 percent of its population.
The U.S. has mixed levels of population health. While Americans smoke less than people in other wealthy countries do, they have higher rates of obesity and infant mortality. Life expectancy in the U.S. is 78.8 years (and falling), nearly three years less than the average life expectancy in high-income countries.
Except for diagnostic tests, the U.S. uses health care services at rates similar to those of other countries.
Numbers of hospital visits and surgeries performed in the U.S. are similar to those in other countries.
However, the U.S. performs 118 MRI scans per 1,000 people, compared to an average of 82 MRIs per 1,000 people among all high-income countries.
The U.S. also performs a higher rate of CT scans: 245 per 1,000 people, compared to 151 per 1,000 people among all high-income countries.
The U.S. pays more for . . .
Doctors. The average salary for a general practitioner in the U.S. is $218,173, nearly double the average salary across all high-income countries. Specialists and nurses in the U.S. also earn significantly more than elsewhere.
Pharmaceuticals. The U.S. spends $1,443 per person on pharmaceuticals, compared to the average of $749.
Health care administration.
The U.S. spends 8 percent of total national health expenditures on activities related to planning, regulating, and managing health systems and services, compared to an average 3 percent spent among all high-income countries.
I have seen the same comments relative to Canada and the UK's national healthcare. I have nothing more than a gut perception of those points, and that has no authority, so I don't know the truth either.
Another criticism I have heard is a lack of motivation for medical advances and new drug inventions. That does seem plausible. I will split duty with you. I will see what I can find on that aspect and get back to you. (on another thread of course) ;-)
GA: The FACT is, ALL Canadians who want and or need Health-Care have it, unlike here in the USA where millions still are without it and Communist Russian Republicans with their Bozo Trump, are trying their level best to destroy our health-care system as we speak, just like our retirement programs: And the Health-Care in Canada is just as comprehensive and satisfactory with the same or higher quality as here in the USA:
We here in the crumbling USA should be so fortunate have a leader as STRONG, Intelligent and Compassionate as Justin Trudeau instead of a maniac 72 year old self absorbed circus clown who seems to find perverted enjoyment in trying to turn the USA into Russia:
Yes, valid question. The chart here does state "public and private" so, you'd think that would account for tax dollars spent on insurance as well.
Reading this, it seems all government spending is accounted for in this per-person data, which would strongly imply all tax dollars spent are included.
"Health care is financed through a mix of financing arrangements including government spending and compulsory health insurance (“Government/compulsory”) as well as voluntary health insurance and private funds such as households’ out-of-pocket payments, NGOs and private corporations (“Voluntary”). This indicator is presented as a total and by type of financing (“Government/compulsory”, “Voluntary”, “Out-of-pocket”) and is measured as a share of GDP, as a share of total health spending and in USD per capita (using economy-wide PPPs)."
by lauravan 6 years ago
What, if any, role should the government play in determining individuals' adoption of health insurance? If you think everyone should be required to have some form of health insurance, why? If you don't think it's necessary, why not? Consider the effects of pre-existing conditions, monopolies on...
by ElSeductor 9 years ago
Why are some people so eager to take away healthcare for people with pre-existing conditions?
by Allen Donald 5 years ago
I am!It's exciting that Republicans, after so many years of opposing Obamacare, have finally passed a piece of legislation to improve the healthcare system.I'm particularly excited about some of the provisions that allow insurers to raise premiums on the people who use healthcare the most while...
by Alternative Prime 6 years ago
Opening his mouth doesn’t appear to be a strong suit for poor ole’ backwards Jeb - Every time he yaps his trap his big “Special” brother George W looks like the intelligent sibling ~ How much trouble is that?If this numbskull wasn't so dangerous to the majority of Americans his involuntary...
by qwark 11 years ago
what a waste of time!It will never be "repealed."Read it damnit! All 2000+ pages and make, in bi-partisan manner, the necessary changes that will improve it!Qwark
by Christin Sander 10 years ago
How many people complaining about the healthcare bill actually know what's in it?I see a lot of people complaining and crying about how it will destroy America etc. What I don't see are logical arguments against it or any evidence that said people are making educated and informed opinions - and not...
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