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The Truth About Obamacare


Shady

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The Washignton Post "Fact Checker" wades in on President Obama's promise about health care plans:

The president’s statements were sweeping and unequivocal — and made both before and after the bill became law. The White House now cites technicalities to avoid admitting that he went too far in his repeated pledge, which, after all, is one of the most famous statements of his presidency.

The president’s promise apparently came with a very large caveat: “If you like your health care plan, you’ll be able to keep your health care plan — if we deem it to be adequate.”

Four Pinocchios !!!

pinocchio_4.jpg

http://www.washingtonpost.com/blogs/fact-checker/wp/2013/10/30/obamas-pledge-that-no-one-will-take-away-your-health-plan/

Edited by bush_cheney2004
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I read this article and I think I found the most poignant part of it where it says more or less that the costs will go up "because people cannot be denied coverage based on pre-existing conditions" I hope you don't die because of a lack of treatment because of a pre-existing condition. Even if that condition is having your head up your ass.

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Regardless of typical vaccuous statement by Obama and others, I think it was completely obvious that the goal of Obamacare (ACA) was to shift the costs of healthcare from people who use healthcare (the sick) to people who don't use it (the young and healthy who previously bought no insurance of very cheap insurance). That cheap plans for young healthy people would disappear is an inevitable result. Obamacare is, in general, just another program to transfer wealth from the young generation to the aging one, just like social security and medicare. Whether or not that is viewed as a good thing depends mostly on one's political leanings.

In any case, it is plain that the American health care system has major issues, and the ACA doesn't really fix those issues, it just forces more people to participate in the existing system, and eliminates the cheapest options for people to whom they were previously available. The fundamental problems of the American healthcare system remain. It will continue to be the world's most expensive system (per capita) and will continue to deliver results that are not first rate, on average, as well as continuing to harm the economy. The linking of healthcare to employment drastically reduces labor force mobility, the litigatious nature of American healthcare will continue to keep costs inflated, and the additional layer of dozens of insurance companies that each have to make a profit, pay their employees, maintain their infrastructure, etc, will continue to consume a large portion of healthcare dollars.

Real healthcare reform in America should have started from the following three basic goals:

- Decouple healthcare from employment

- Eliminate the insurance company middleman (~$200 billion/year in spending for these companies to exist)

- Reform laws to reduce liability costs for doctors and hospitals (~$75 billion/year in spending on liability insurance)

Frankly, a universal single payer system (though a political non-starter in America), funded at the level that America currently funds healthcare per capita, could have achieved all three of the above goals and delivered the best healthcare in the world. At the current American level of spending on healthcare, there would be NO "death panels" in a single payer system, because enough money is spent to guarantee that there would always be enough capacity for every procedure to be done, without limit and without wait. That's just how much money America already burns on healthcare. But, it's America, and so sensible solutions will generally lose out to costlier and less efficient alternatives, because American politics sucks and because America has tens of trillions of dollars to burn (even when in debt).

Edited by Bonam
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Regardless of typical vaccuous statement by Obama and others, I think it was completely obvious that the goal of Obamacare (ACA) was to shift the costs of healthcare from people who use healthcare (the sick)

Thats quite literally the purpose of insurance PERIOD. CongressCare (remember this is not Obamas bill and has almost none of things he pushed for in it) at BEST helps to reduce the freerider problem. The US already has public UHC it just doesnt kick in until you are REALLY sick and end up in an ER.

Real healthcare reform in America should have started from the following three basic goals:

- Decouple healthcare from employment

- Eliminate the insurance company middleman

- Reform laws to reduce liability costs for doctors and hospitals

I agree with all three of those points, but I would add a fourth. They need to break the back of medical unions that masquerade as medical associations, and disolve the massive spider web of laws that prevent competition at the hospital/city/state/world level. This is what really is putting upward pressure on costs.

Frankly, a universal single payer system (though a political non-starter in America), funded at the level that America currently funds healthcare per capita, could have achieved all three of the above goals and delivered the best healthcare in the world.

Thats true but even countries with single payer UHC are seeing 5-10% inflation in medical costs. Messing around with who the payer is, will only do so much. We need to figure out a way to load up the supply side and create an abundance of medical services. Educate hundreds of thousands of new doctors and healthcare workers, or import them. The problem is medical associations control the certification process and the ammount of residency slots, and they also represent doctors, so its in their interests to create the artificial scarcity that drives up costs.

Its a blatant conflict of interest for trade associations that represent their own membership to control the certification process. An example of this (one of thousands) is the college of radiologists successfully lobbying for laws forcing radiology assessments to be done in the same hospital where the scans are taken. These scans could be electronically sent to anywhere in the world to be read... But in the US you often cannot even send them to another hospital in the same city... never mind one in another city or another state or another country.

Edited by dre
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Thats quite literally the purpose of insurance PERIOD.

I understand and agree. But nonetheless there is some debate in the US over whether this is desirable or not.

I agree with all three of those points, but I would add a fourth. They need to break the back of medical unions that masquerade as medical associations, and disolve the massive spider web of laws that prevent competition at the hospital/city/state/world level. This is what really is putting upward pressure on costs.

If these associations can be demonstrated to be impeding fully qualified physicians and nurses from being able to work in the field, then that should certainly be investigated. At the same time, I don't know about breaking the back of medical associations. These associations serve a useful purpose. Certification of people entering the profession should be done by other doctors who are capable of evaluating their work, not government bureaucrats ticking off a checklist. The way professional associations operate could perhaps be looked at, but I think that they are the right place to keep some responsibility and power, not in a government bureaucracy that would be tasked with doing what they currently do.

On the other hand, I of course fully agree with getting rid of laws that prevent competition.

Thats true but even countries with single payer UHC are seeing 5-10% inflation in medical costs. Messing around with who the payer is, will only do so much.

The existence of insurance companies (their infrastructure costs, paying their employees, their profits, etc) sucks up around ~10% of US healthcare dollars. That is a huge cost that simply does not need to be there. Getting rid of middleman is always a great way to save money. Yes, a 10% decrease is "only so much", but it's much enough not to discount.

We need to figure out a way to load up the supply side and create an abundance of medical services. Educate hundreds of thousands of new doctors and healthcare workers, or import them. The problem is medical associations control the certification process and the ammount of residency slots, and they also represent doctors, so its in their interests to create the artificial scarcity that drives up costs.

More doctors would be great. At the same time, standards for the quality of people that are doctors should not be lowered. Importing hundreds of thousands of skilled medical workers is difficult, both to find them in the first place, and, even if they could be found, depleting their source countries of that many skilled medical workers could create major problems elsewhere.

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If these associations can be demonstrated to be impeding fully qualified physicians and nurses from being able to work in the field, then that should certainly be investigated. At the same time, I don't know about breaking the back of medical associations. These associations serve a useful purpose. Certification of people entering the profession should be done by other doctors who are capable of evaluating their work, not government bureaucrats ticking off a checklist. The way professional associations operate could perhaps be looked at, but I think that they are the right place to keep some responsibility and power, not in a government bureaucracy that would be tasked with doing what they currently do.

The problem is that these "associations" not only control the cerfication process they negotiate on behalf of their members for CHA compensation. Its the most blant conflict of interest imaginable. These two functions should be completely separated.

The existence of insurance companies (their infrastructure costs, paying their employees, their profits, etc) sucks up around ~10% of US healthcare dollars. That is a huge cost that simply does not need to be there. Getting rid of middleman is always a great way to save money. Yes, a 10% decrease is "only so much", but it's much enough not to discount.

I agree. But my point is the 10% you are talking ammounts to less than two years inflation in costs overall. Even if all the insurers suddenly decided to go NON PROFIT costs 3 years from now would still be higher than they are now. Thats not a reason to avoid tackling the problem you mention... But at best thats only a small component of the problem.

On the other hand, I of course fully agree with getting rid of laws that prevent competition.

Well for starters there the Canada Health Act. If you wanted to get your triple bypass done in the US or India, or Thailand they would not cover you. Hard to imagine a law that does more to prevent competition than one that says "Nobody can compete"! :)

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So this is "Canadian style" health care? Or just a Canadian style web site ?

“When I heard that the troubled Obamacare Web site was built by a Canadian company, of course I felt personally responsible,” says the Montreal-born Barry Blitt, who drew next week’s cover, “Reboot.” “I’ll be happy when the glitches are all worked out and everything’s running smoothly, so I can put this all behind me,” he concludes.

CVS_TNY_11_11_13_580.jpg

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I challenge you to launch something of that scale and have it work as expected at launch. I am not making apologies for how they all handled this. But the people who gave her the book are idiots.

No, they're not idiots at all. They're tax payers trying to hold politicians accountable, for a project that had run 300% over budget already, and still doesn't work. Despite having 3 years to produce it. Your excuses are pathetic.

They're also probably tax payers that actually believed that if they liked their insurance and wanted to keep it, they'd be able to.

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