Affordable Care Act / ObamaCare

[carlfense]

Are you trying to re-write history Yos or do you not know what Pelosi actually said?

[carlfense]

So, please tell us, the unwashed masses, what the penalty is for not complying under the mundane ACA.

I knew that it was limited to a fine.

['SkersRule]

You're doubling down? Well . . . ok.

 

I think you are tying to explain why the ACA is bad . . . but all you talk about is the federal deficit, China, lefties, and teats.

 

Your argument will be more convincing if you actually discuss the law in question instead of your regurgitated talking points. The information is out there. You don't have to resort to this type of post. Then again, if you research the law you might not be able to make fantastic claims about people being thrown in jail for not submitting to tyranny. The reality of the law is far more mundane than the breathless criticism that is bandied about.

 

I know because never in the history of the USA has anyone ever been jailed or killed without due process. Oh wait, maybe the American Indians, Japanese during WWI, and Muslims today have a different view. That's a little off track to be sure but your absurd "faith" in this government's following the law and not abusing it is naivety defined.

 

Leaving that aside, my objections to Obamacare stand: there are absurd penalties for not "buying in" and we cannot afford this.

 

You may disagree with me but I am not wrong here.

[krill]

Leaving that aside, my objections to Obamacare stand: there are absurd penalties for not "buying in" and we cannot afford this.

 

So basically you are ok with paying an extra $1,000 a year or so to cover the cost of health care for the uninsured, some of whom can buy insurance but choose not to, and you're absolutely convinced that the CBO projection that the ACA will cost ~$600 billion over 10 years, with an offset of $800 billion in reduced spending and new taxes is completely inaccurate?

 

You may disagree with me but I am not wrong here.

 

I disagree.

[carlfense]

I know because never in the history of the USA has anyone ever been jailed or killed without due process. Oh wait, maybe the American Indians, Japanese during WWI, and Muslims today have a different view. That's a little off track to be sure but your absurd "faith" in this government's following the law and not abusing it is naivety defined.

Same argument, different post. Indians. Japanese. Muslims. "Faith in government." Not a word about the ACA. Again.

 

Leaving that aside, my objections to Obamacare stand: there are absurd penalties for not "buying in" and we cannot afford this.

How is the penalty absurd? We cannot afford to not do something. The status quo was unsustainable. The ACA is not perfect. No legislation ever is. That said, it's better than the alternative. (Side note: one thing that I don't think many ACA opponents realize is that if it's struck down by the Supreme Court the likelihood of a single payer system in the next 10-20 years skyrockets.)

 

You may disagree with me but I am not wrong here.

It's hard to tell what your specific objections are to the ACA because you haven't listed them. It's hard to tell if I disagree or if you are wrong when your references to the ACA are mostly about teats, Chinese, Japanese, FDR, the New Deal, lefties, Muslims, and Indians.

['SkersRule]

Leaving that aside, my objections to Obamacare stand: there are absurd penalties for not "buying in" and we cannot afford this.

 

So basically you are ok with paying an extra $1,000 a year or so to cover the cost of health care for the uninsured, some of whom can buy insurance but choose not to, and you're absolutely convinced that the CBO projection that the ACA will cost ~$600 billion over 10 years, with an offset of $800 billion in reduced spending and new taxes is completely inaccurate?

 

You may disagree with me but I am not wrong here.

 

I disagree.

 

I am convinced that whenever some politician talks about how a piece of legislation will "save money" that he or she is full of sh**. And that's based on government's track record.

 

Disagree all you want.

['SkersRule]

Same argument, different post. Indians. Japanese. Muslims. "Faith in government." Not a word about the ACA. Again.

 

Kind of like your blatant disregard of our budget deficit and how we can't afford our current budget? And yet you seem to think that we can afford to spend even more on some ridiculous utopian, socialist, pie-in-the-sky, healthcare fantasy?

 

How is the penalty absurd? We cannot afford to not do something. The status quo was unsustainable. The ACA is not perfect. No legislation ever is. That said, it's better than the alternative. (Side note: one thing that I don't think many ACA opponents realize is that if it's struck down by the Supreme Court the likelihood of a single payer system in the next 10-20 years skyrockets.)

 

Right, the status quo of spending far more than we collect in tax revenue is unsustainable.

 

It's hard to tell what your specific objections are to the ACA because you haven't listed them. It's hard to tell if I disagree or if you are wrong when your references to the ACA are mostly about teats, Chinese, Japanese, FDR, the New Deal, lefties, Muslims, and Indians.

 

Simply put, I have no faith in government regardless of which party is running the show. Every time government steps in to try and "fix" something they only make it worse.

[carlfense]

As soon as you connect the ACA to a ballooning deficit I will address it. Until that connection is made you might as well point out that I haven't addressed Japanese internment.

['SkersRule]

As soon as you connect the ACA to a ballooning deficit I will address it. Until that connection is made you might as well point out that I haven't addressed Japanese internment.

 

Duly noted. And until you connect our present fiscal reality with what Obamacare is going to cost we're at an impasse.

[carlfense]

You want me to make your argument for you?

 

Do your own research. Otherwise you won't be able to discuss the issues.

['SkersRule]

You want me to make your argument for you?

 

Do your own research. Otherwise you won't be able to discuss the issues.

 

I don't need you to make any argument for me. However, you seem to be unable to grasp the fact that we, as a country, are drowning in debt right now and can not afford to increase any more spending.

[carlfense]

And until you connect our present fiscal reality with what Obamacare is going to cost we're at an impasse.

You are the one who is trying to conflate Obamacare and the deficit. If you want to say that they are the same thing or that Obamacare will make the problem worse than you need to back it up with facts instead of your intuition and some vague set of unrelated historical events.

 

 

I don't need you to make any argument for me.

Glad to hear it. I'll patiently wait for you to do it yourself.

 

However, you seem to be unable to grasp the fact that we, as a country, are drowning in debt right now and can not afford to increase any more spending.

How many times have you said a version of this in this thread? A dozen times? More? And how many times have you actually connected the ACA to the deficit? Zero times.

[krill]

However, you seem to be unable to grasp the fact that we, as a country, are drowning in debt right now and can not afford to increase any more spending.

 

This is interesting to me in the sense that we cannot even agree on the most fundamental facts. Every credible estimate shows that the cost of doing nothing exceeds the cost of the ACA. Something is better than nothing by virtue of not being nothing is a terrible argument for something, and there are ample reasons to be skeptical of the ACA achiving its objectives, but cost of the legislation being greater than no action simply is not one of them.

 

I think of this as a similar conundrum as someone who is poor and working, but cannot afford to obtain reliable transportation. Say they have a 78' Cadillac that gets 10 MPG, drive an average of 1000 miles / month, and spending $2,000 / year in repairs. That puts their base cost of ownership at around $500 / month if fuel is $3.50 / gallon. Now let's also say they could get a new compact car that got 35 MPG, would cost $150 / month to finance, another $50 in additional registration fees and insurance, and would cost $1,000 / year to maintain. That puts the base cost of ownership at about $380 / month. On top of the owner cost, there is also cost to everyone with the Cadillac with higher air pollution and higher chance of vehicle failure that could cause an accident or otherwise stop traffic.

 

Just a very basic example of the cost of doing nothing being higher when it may seem antithetical for someone in poor financial shape to buy a new car. There may be other options too of course, but that doesn't make it untrue that a new car may cost less. Some of us believe that health care is a matter of national priorities in a fiscal sense. Germany, Austria, Switzerland, Denmark, the Netherlands, Belgium, Norway, Sweden, Finland, Australia, New Zealand, Taiwan, Singapore...all countries that have managed to do universal healthcare with a mixed market approach while maintaining acceptable fiscal policies, some far better than America. Why can't we?

['SkersRule]

 

This is interesting to me in the sense that we cannot even agree on the most fundamental facts. Every credible estimate shows that the cost of doing nothing exceeds the cost of the ACA. Something is better than nothing by virtue of not being nothing is a terrible argument for something, and there are ample reasons to be skeptical of the ACA achiving its objectives, but cost of the legislation being greater than no action simply is not one of them.

 

I think of this as a similar conundrum as someone who is poor and working, but cannot afford to obtain reliable transportation. Say they have a 78' Cadillac that gets 10 MPG, drive an average of 1000 miles / month, and spending $2,000 / year in repairs. That puts their base cost of ownership at around $500 / month if fuel is $3.50 / gallon. Now let's also say they could get a new compact car that got 35 MPG, would cost $150 / month to finance, another $50 in additional registration fees and insurance, and would cost $1,000 / year to maintain. That puts the base cost of ownership at about $380 / month. On top of the owner cost, there is also cost to everyone with the Cadillac with higher air pollution and higher chance of vehicle failure that could cause an accident or otherwise stop traffic.

 

It's interesting that you bring up the conundrum of a getting a new car versus keeping your old one, being poor, and having very limited options as to what you can do because I'm pretty much in that boat right now myself. I understand the comparison you're making and it sounds good initially. I don't want to get bogged down on the analogy but this is I believe relevant to the discussion. I think there are some serious issues which you are not taking into account. For example, over the Mermorial Day weekend I went to four different dealerships with the express purpose to buy a car. The interest rates for these four different cars were 36.9%, 29.9%, 41.9%, and 26.9% respectively. Basically what's happening is that these car dealerships generally own the finance companies and they collude together so that the consumer is literally left with no choice to go through them if they are unable to secure a lower interest loan through their bank or credit union. Correlating this to the ACA, health care facilities will also collude together to keep their prices artificially high essentially trying to gouge the government financially at every turn. Essentially the healthcare providers are the car dealerships in this analogy. I guess what I'm trying to say is that you car analogy seems to assume all players and circumstances are static and won't change. In reality people and the market will shift in response to what the goverment is trying to do through this ACA legislation. And that's the larger point, we simply can not take these saving projections or cost controls at face value and assume they are accurate because nobody knows exactly how the ACA, if upheld, will change the health care system. Further, one thing we do know for certain is that when government tries to set prices for healthcare services, providers will then charge people who want to pay cash substantially more than they charge someone paying with Medicare to try and make up for lost revenue. We see this happen everyday in healthcare facilities across this country. Add in the fact that same services cost different amounts depending on where you live, which facility you go to, and even what the business agreement is.

 

http://www.nhhealthcost.org/priceServices.aspx

 

 

Just a very basic example of the cost of doing nothing being higher when it may seem antithetical for someone in poor financial shape to buy a new car. There may be other options too of course, but that doesn't make it untrue that a new car may cost less. Some of us believe that health care is a matter of national priorities in a fiscal sense. Germany, Austria, Switzerland, Denmark, the Netherlands, Belgium, Norway, Sweden, Finland, Australia, New Zealand, Taiwan, Singapore...all countries that have managed to do universal healthcare with a mixed market approach while maintaining acceptable fiscal policies, some far better than America. Why can't we?

 

One reason, because doctors, upon graduation from college, have huge school loans to repay. To a lesser degree so do nurses and everyone else along the health care delivery line. Back to doctors though, combine loans with insane malpractice insurance costs and doctors typically will start their careers 150-200K in the hole. Did you know that in Germany students go to medical school for free? People in other countries, like the ones you listed, have pretty much grew up with socialism their whole lives and so to them it is no big deal to do with less money charged for services. But that's not the American way is it? Why should an American company charge 1.00 for something that costs them .10 to produce when they can charge 4.50? That's slight bit of sarcasm by the way.

 

What really bothers me immensely, and it's a reason why I don't trust this legislation or the people who produced it, is that they crafted this legislation in secret, behind closed doors, with absolutely no one outside the liberal left having any input. There wasn't any discussion or consensus about this. This legislation was essentially the elite liberal left forcing multiple and rather probable bad laws on us simply because they could.

 

I will agree with you that something needs to be done to make healthcare more affordable. I'm just not convinced this Obamacare is it.

[krill]

Further, one thing we do know for certain is that when government tries to set prices for healthcare services, providers will then charge people who want to pay cash substantially more than they charge someone paying with Medicare to try and make up for lost revenue. We see this happen everyday in healthcare facilities across this country. Add in the fact that same services cost different amounts depending on where you live, which facility you go to, and even what the business agreement is.

 

I think you make a lot of good points, but there actually seems to be a growing trend of health care providers offering large discounts to those who pay in cash, even if they have insurance. There are many anecdotal stories on the web of people with insurance paying less in cash for common services than they would have using their insurance with copay's and coinsurance. It's good business for health care providers avoiding all the administrative overhead of insurance reimbursements. One aspect of the ACA I was disappointed with was that it seems to push health savings accounts aside to some degree, which was a good Republican idea to inject some degree of market force into health care and enable people to save for health care expenses tax free.

 

One reason, because doctors, upon graduation from college, have huge school loans to repay. To a lesser degree so do nurses and everyone else along the health care delivery line. Back to doctors though, combine loans with insane malpractice insurance costs and doctors typically will start their careers 150-200K in the hole. Did you know that in Germany students go to medical school for free? People in other countries, like the ones you listed, have pretty much grew up with socialism their whole lives and so to them it is no big deal to do with less money charged for services. But that's not the American way is it? Why should an American company charge 1.00 for something that costs them .10 to produce when they can charge 4.50? That's slight bit of sarcasm by the way.

 

Here I also agree with you, everyone should agree, that there is an acute problem in the supply of primary care physicians. Med school enrollment is up, but funding for graduate medical education (residency programs) is always a target for government budget tightening because it's expensive and difficult for taxpayers to see any benefit from. The ACA added funding for all of 900 new residency slots which won't even dent the projected shortfall in the field.

 

What really bothers me immensely, and it's a reason why I don't trust this legislation or the people who produced it, is that they crafted this legislation in secret, behind closed doors, with absolutely no one outside the liberal left having any input. There wasn't any discussion or consensus about this. This legislation was essentially the elite liberal left forcing multiple and rather probable bad laws on us simply because they could.

 

There was a group of about half a dozen Republican senators who started out working on health care reform in a bipartisan way and probably 95% of the bill was crafted in a fashion that was incredibly transparent by big bill standards (most of the hearings were on C-SPAN). As things dragged on though and money started being dumped into ads by interest groups it didn't take long for bipartisanship to become politically impossible. I thought it was tragic how the whole thing fell apart in such a bad way when there genuinely seemed to be hope of reform and proof that congress could still periodically function. There's no doubt that Democrats payed a heavy price for poor messaging and forging ahead with no bipartisan support, and while I thought they were right, I understand to some degree why many people were outraged. At the same time though you have to understand that it was a real coup for Republicans to get 95% of what they wanted, leave the table, and reap all the political reward from the fallout.