A man you can bait with a Tweet

[BigRedBuster]

I think what we're tussling over is what is the domain of "reasonable" turf on this issue. For example, I won't literally force people to agree with me on everything, but I might assert that so-and-so stance is outside the realm of sanity. That's in effect the same thing: 'sure, you can think that, but you'd be delusional to do so.'

 

I haven't said the ACA is the cause of increases.

Just to emphasize, since I think my frustration is getting the better of me here: I think you are a smart, reasonable guy with reasonable concerns. Let's review:

 

- You don't think the ACA is causing healthcare increases. Agree. agree but it's not helping lower them

- You think healthcare in the US has a serious cost problem that needs to be fixed. Agree.

- You think the ACA does nice things with expanding coverage, but doesn't go very far in addressing the cost problems above. Agree. (I'd also say coverage problems remain, too)

- You think the AHCA is a terrible solution and point to EU costs as a model. Agree, and agree. I point to EU costs as examples to compare our costs too. At this point, I'm wide open to suggestions as to how to get there. All this does is show there is a major problem. It doesn't necessarily give the solution.

 

So, this is what I find incongruous. If for the topic of healthcare we agree on ALL of these points, why is it that you continue to hold the ACA in such low esteem? To me, it looks like you have a lot more in common with proponents of single payer (i.e, move to the left of ACA) and yet you speak the same language about the bill as proponents of moving far, far, far to the right. Incongruity. That's all.

 

Why do you hold so much interpretation pressure on the fact I believe "the ACA is a bad bill"? it seems like you take those 6 words and extrapolate way more than is possible from 6 words. Just because I don't like the bill (as it is today) doesn't mean I'm some right wing idiot that should jump on board with what the Republicans offer. That's party politics that I refuse to play.

[zoogs]

Your notes in red I (mostly, at least?) agree with also.

 

That's the thing: you're clearly not 'some right wing idiot' (your words! )

 

It's not that I'm offended by all this. I'm just puzzled that the the way you're looking at this parallels people you appear to completely disagree with. Those people push some pretty dishonest information about the ACA (again, referring back to the 'death spiral', etc lines). That stuff, IMO, needs to be pushed back against vigorously -- if not to keep alive the political energy required to avoid sliding to the right on healthcare, then in the simple spirit of accuracy.

 

To be clear, the ACA =/= healthcare entirely. There existed many problems facing our healthcare system. We took a small step towards fixing some of them. There are more steps to be taken. And it's becoming clear to me that this battle boils down to rhetoric: continue to take steps through government, or (by deriding every government approach as bad and inadequate) veering far in the other direction.

[BigRedBuster]

It's not that I'm offended by all this. I'm just puzzled that the the way you're looking at this parallels people you appear to completely disagree with. Those people push some pretty dishonest information about the ACA (again, referring back to the 'death spiral', etc lines). That stuff, IMO, needs to be pushed back against vigorously -- if not to keep alive the political energy required to avoid sliding to the right on healthcare, then in the simple spirit of accuracy.

 

Stop linking these together. Just because I don't like liver and onions and my son doesn't like liver and onions....doesn't mean both of us wish we had pickled beets.

 

 

This is no different than when I would tell people I can't stand Trump and they would instantly jump to the conclusion that I was a Clinton fan.

[Moiraine]

zoogs, I like the ACA but there's nothing wrong with calling it a bad bill if your expectations were that it live up to its name.

 

I like a lot of things about the ACA but it didn't make healthcare affordable unless you qualify for a subsidy. That part just doesn't bother me though.

 

 

Again, if they want to make it affordable, they need to force the drug companies to pay a tax if they overcharge in the U.S. I have a feeling most of the drugs are developed and tested in the U.S. If anything, logic says they should be cheaper here.

[BigRedBuster]

zoogs, I like the ACA but there's nothing wrong with calling it a bad bill if your expectations were that it live up to its name.

 

I like a lot of things about the ACA but it didn't make healthcare affordable unless you qualify for a subsidy. That part just doesn't bother me though.

 

 

Again, if they want to make it affordable, they need to force the drug companies to pay a tax if they overcharge in the U.S. I have a feeling most of the drugs are developed and tested in the U.S. If anything, logic says they should be cheaper here.

There is a strong chance that the US is being over charged to help off set what some things cost in other countries.

 

Meaning, if a drug costs $200 in Canada and $2,000 in the US, the realistic price for the drug might be $500.

[zoogs]

It's not a casual link, BRB. It's based on your commitment to defining the ACA wholesale for phrama/procedure costs. Plenty of people agree that this is a problem. Only some of them are eager to lay this all at Obamacare's feet, and those are the people who want pickled beets. Hence, parallels.

 

So, no, I'm not saying that's you. And I'm not asking you to be uncritical.

 

It just seems like the way you look at the ACA is a vestige of party lines to which you no longer belong. These break down when we get to the details, and yet they somehow sum back to "Bad ACA". In my view, it should be "Bad system we've inherited. Let's keep iterating improvements." It's hard to stop speaking the language. And there are important consequences to everyone adopting the former versus the latter.

 

I agree, by the way. "Affordable Care Act" is a bad name in the expectations it sets. Also, BRB, that's an interesting point you raise about US overcharging being used to effectively subsidize other countries. Possibly! I don't think there's a way around this other than more government involvement. But, yeah, ultimately: healthcare is going to be an expensive thing. We should work to make it less so as best we can. Right now we're still on a more basic question: is healthcare a right?

[BigRedBuster]

It's not a casual link, BRB. It's based on your commitment to defining the ACA wholesale for phrama/procedure costs. Plenty of people agree that this is a problem. Only some of them are eager to lay this all at Obamacare's feet, and those are the people who want pickled beets. Hence, parallels.

 

So, no, I'm not saying that's you. And I'm not asking you to be uncritical.

 

It just seems like the way you look at the ACA is a vestige of party lines to which you no longer belong. These break down when we get to the details, and yet they somehow sum back to "Bad ACA". In my view, it should be "Bad system we've inherited. Let's keep iterating improvements." It's hard to stop speaking the language. And there are important consequences to promoting the former versus the latter.

 

I agree, by the way. "Affordable Care Act" is a bad name in the expectations it sets. Also, BRB, that's an interesting point you raise about US overcharging being used to effectively subsidize other countries. Possibly! I don't think there's a way around this other than more government involvement. But, yeah, ultimately: healthcare is going to be an expensive thing. We should work to make it less so as best we can. Right now we're still on a more basic question: is healthcare a right?

Good Lord dude....I'm the one who has shunned party lines on this issue.

 

To the bold. I have never said that Obamacare is THE CAUSE of the costs issues. Those issues have been a problem for a very very long time. The problem is, it does nothing to address the problem while at the same time, forcing people to buy the product.

 

The frustration in this entire conversation with me is that you keep linking me to arguments I have never made simply because I say "the ACA is a bad bill". Those 6 words have somehow made you jump to one hell of a lot of conclusions as to what political group (Party) I belong to.

 

Sorry if it offends anyone that I believe it's a bad bill. It is a bad bill. That doesn't mean it doesn't do some good things. It's very frustrating that someone can't say "it's a bad bill" because it offends one side that thinks it's "working well".

[Danny Bateman]

zoogs, I like the ACA but there's nothing wrong with calling it a bad bill if your expectations were that it live up to its name.

 

I like a lot of things about the ACA but it didn't make healthcare affordable unless you qualify for a subsidy. That part just doesn't bother me though.

 

Again, if they want to make it affordable, they need to force the drug companies to pay a tax if they overcharge in the U.S. I have a feeling most of the drugs are developed and tested in the U.S. If anything, logic says they should be cheaper here.

 

There are plenty of things they could do to make it more affordable. It's all dependent on perspective.

 

BRB's assessment is that it failed at his key metric, which was making insurance more affordable. As you've said, it was successful in that regard, just for mostly lower income folks.

 

The ACA was originally supposed to have higher subsidies, for which more of the middle class would've been covered, but that was scrapped as a concession to make the bill more fiscally palatable for conservatives.

 

That's one option. Red states expanding Medicaid would move low income folks out of the individual market and into Medicaid, which would drive down costs. Single payer to subvert the private market altogether, at least on a basic level. Bringing down prescription drug prices is another great option.

 

But this only affects the consumer side of the equation. BRB has also argued that the costs associated with the healthcare system itself, separate from insurance costs, are an issue.

 

The ACA was unequivocally a smash success for those who were too poor for afford care prior.

[zoogs]

Look, we have a Republican president, a Republican House, and even a Republican Senate for goodness sake. We voted this in. A good part of that, I believe, is that on a basic level there are enough people in this country that basically subscribe to the general notion of "ACA BAD".

 

Thus, my hope is that we seriously evaluate our top-level notions. You're all good critical thinkers here. Even still we all rely on "good/bad" categorization; it's hard not to. It makes it difficult, for example, to criticize Obama on some fronts where he really deserves it. What I am interested in is finding disconnects and hashing them out.

 

If you ask me, you do not appear to believe the ACA is a bad bill -- you only insist on saying so. And that's my frustration. What you and I do believe is that healthcare costs still suck and we need to take steps to do something about it. This doesn't make the ACA the enemy, and making it so only puts what look to me to be common ultimate goals further out of reach. Fair?

 

The problem is, it does nothing to address the problem while at the same time, forcing people to buy the product.

See, this sounds like a critique of the individual mandate. But expanded coverage (incl. for pre-existing conditions) is something you like. How does that work? There are many "Obamacare forces people to buy stuff" arguments. These people, largely, are not interested in imposing coverage requirements on insurers.

 

Is the individual mandate a problem in your eyes? How does that relate to Big Pharma and drug costs? How are people who are forced to buy this product compromised, cost wise, by the ACA relative to drug/procedure costs in a world where they aren't insured at all?

[JJ Husker]

Yes. And nowhere have I approached a claim that healthcare costs in the U.S. aren't exorbitant. In fact, I have referred specifically to this problem as real in several of my recent posts.Thus, I have NO idea why you insist on this "you have your head in the sand" stance.

It doesn't need to be repealed. It needs to be fixed or added to.

This. Are we forgetting that legislation is always work in progress? That nobody, literally, is advocating the ACA as the end all be all, well, we don't need to work on healthcare issues ever again bill?But because there still exist baseline, fundamental problems in healthcare in the US, we must all agree that the ACA is a "bad bill". OK.

I don't think anybody needs to agree that it's a bad bill. I don't think it's "bad", I just think it completely ignored the main problem of rapidly escalating costs. Much of it was needed and is great, but IMO, those things should've been of secondary concern. The cost problem has to be addressed before we will ever be able to quit talking about healthcare being a problem.

[NM11046]

So cost is more important an issue than citizens being protected El Diaco? Not poking the bear - just looking for clarity. I think perhaps the priorities of these two issues may be different depending on perspective (and sadly maybe party lines to some extent).

[JJ Husker]

zoogs- Here's an analogy that may help.

 

You have a 1990 something car. It's got a bunch of dings in it, needs paint, the tires are bald but the real problem is the engine makes a bad noise when it does run but usually it won't start or run at all. You take it to the shop, explain all the issues and ask them to fix it. So the repair shop does some body work, paints it and puts new tires on it....then they tow it back to your house (because it won't start or run) and hand you the bill for it. Is that a good repair or a bad repair?

 

The body work, paint job and tires are awesome....but you can't drive the damn thing.

The things they fixed are great but it's still unusable because they didn't fix the most dire problem.

[zoogs]

I don't think anybody needs to agree that it's a bad bill. I don't think it's "bad", I just think it completely ignored the main problem of rapidly escalating costs. Much of it was needed and is great, but IMO, those things should've been of secondary concern. The cost problem has to be addressed before we will ever be able to quit talking about healthcare being a problem.

Yes. Well, I wouldn't say ignored -- more like there were only so industries they chose to get on.

 

I didn't pay attention at the time. Reading about it now, there was plenty of consternation about which industry players were getting friendly deals here and which weren't. On the one hand, I find it disappointing it didn't accomplish more -- a lot more. On the other, it's fairly impressive that it did manage to secure the backing of so many important groups. It couldn't have passed without them, but they contributed to the compromises as well.

 

The body work, paint job and tires are awesome....but you can't drive the damn thing.

The things they fixed are great but it's still unusable because they didn't fix the most dire problem.

I'd modify this analogy to make it so that the engine is running poorly and will need to be addressed at some point, but you also have the problem of being out of gas in the middle of nowhere. However, you do have money for gas. Therefore, you fill up gas, and drive towards a mechanic.

 

I don't feel it's possible to make comprehensive progress towards cost control without the basic expectation that healthcare is a right, and without really bringing up coverage numbers. Maybe I'm wrong there.

[JJ Husker]

So cost is more important an issue than citizens being protected El Diaco? Not poking the bear - just looking for clarity. I think perhaps the priorities of these two issues may be different depending on perspective (and sadly maybe party lines to some extent).

 

IMO I believe it is more important. The whole deal has to be sustainable for any of it to work long term. The cost problem is bad enough that it simply cannot be ignored. I do not believe party lines are affecting my outlook at all because there is currently no party I even remotely agree with.

 

I will acknowledge that a lot of my opinion comes from my personal experience (imagine that...). I make a decent living but even at that it is a struggle to pay for health insurance and healthcare. Premiums run me about $20,000 per year and this previous year 2 of us hit our max out of pockets so that is another $11,000 +/- in expenses. Mine maxed out on basically just routine care and a colonoscopy. I make too much to get any help with the premiums or to be able to deduct any costs on my tax return. There are many people in the same boat who make even less than I do but get no subsidy and do not meet the threshold for deducting costs. Yeah, it would be worse if I could not get coverage at all due to pre-existing conditions or if my income were poverty level and I wasn't able to afford it at all but the current system really only works without strain for those in the top 2% or 3% of income. Maybe I happen to be in some freak income bubble but it sure seems like healthcare and health insurance expenses should not be the only difference between being financially very comfortable or being broke. I cannot believe this system is working very well for anybody that makes less than $150K or $200K per year. Isn't that most everybody? Or possibly I'm getting old and $150,000+/- just isn't what it used to be. I don't think it is reasonable that, if a person/family has one or two routine medical issues, it should consume 25% to 100%+ of their yearly income. In my mind, that makes the cost issue even more imperative than securing free coverage for a few more people who are still going to go broke if they have any medical issues.

[JJ Husker]

Ha. I just realized this discussion is taking place in the bait with a tweet forum rather than the ACA thread. Oh well....