Repealing the ACA under Trump

[NM11046]

Did you listen to this BRB? Care to recap, I don't have 50mins today but am curious ...

[BigRedBuster]

I had it on in the back ground while I was working. Some things I caught.

 

a) The ACA did some good things but didn't address some of the biggest issues in healthcare and that is the cost of actually getting services.

 

b) A solution was discussed and had good support. When when that solution was described as a "single player plan" it lost support. When it was described as "universal healthcare" it lost even more support..........the plan didn't change....the name did. The author notes that this is evidence of how much party politics has played in this.

 

c) One problem is that when insurance gets involved, the cost actually goes up.

 

d) Another problem is the entire mentality around healthcare is wrong. Too often we think more, fancier, newer procedures or medication is best when the older (cheaper) treatment did just fine. But, healthcare providers have a built in motivation to push the newer stuff.

 

e) How often do we go to the doctor and he orders a test to CYA and we say..."no, I don't want that". We have a fear that if the doctor thinks we need it, then we should get it. This gives providers no motivation to hold back on ordering stuff.....insurance is going to pay for it anyway.

 

 

I welcome anyone to listen to it more intently and correct me if I took things wrong.

[Danny Bateman]

e) How often do we go to the doctor and he orders a test to CYA and we say..."no, I don't want that". We have a fear that if the doctor thinks we need it, then we should get it. This gives providers no motivation to hold back on ordering stuff.....insurance is going to pay for it anyway.

 

I actually watched a clip of a PBS documentary not too long ago that examined this in detail.

 

It's called Money and Medicine. You can find the entire thing here.

 

Anyway, one of the points they drove home was that increased testing and number of procedures was not correlated to better health outcomes. In fact, many times, less is more. Patients many times don't know this, of course, and as a result wind up paying much more for a bunch of things that are unnecessary in terms of actually getting them better.

[knapplc]

The ACA did some good things but didn't address some of the biggest issues in healthcare and that is the cost of actually getting services.

 

 

If we want that, we have to fundamentally change America. I'm for it, but more than half of Congress isn't. This is several elections away from a reality, and would necessitate a major shift in attitude from Republican voters. The ACA didn't address costs because it could not.

[Danny Bateman]

This seems like a really stupid negotiating tactic, if you can call it that.

 

[JJ Husker]

 

The ACA did some good things but didn't address some of the biggest issues in healthcare and that is the cost of actually getting services.

 

If we want that, we have to fundamentally change America. I'm for it, but more than half of Congress isn't. This is several elections away from a reality, and would necessitate a major shift in attitude from Republican voters. The ACA didn't address costs because it could not.

Unfortunately, I don't think the cost problem is not being dealt with because of one party. The reason it is not being sufficiently dealt with falls on both sides of the aisle. Money, donors and power is what controls repubs and dems alike. Fixing the cost problem is not in any of their best interests, at least not with how things currently work in DC. We need better people and fundamental changes within our government before they will begin to attack that problem. Term limits would be a good start. I'd like it to be a problem with only the repubs because then it would seem surmountable. It's easy for a handful to pay it lip service when they know nothing is about to change. It's quite another to get enough votes to actually change it. They've got re-election, fundraising, maintaining their elite status quo and demonizing the opposite party to be concerned with.

[knapplc]

That is partially true, but at least democrats are trying to fix the problem. Republicans are very obviously in the pocket of business and have zero solutions for the common man.

 

Serious question: what viable fix to this problem have Republicans offered in the last twenty years?

 

At some point we have to stop pretending both parties are equally to blame. Both are flawed. One is clearly more flawed than the other. Pretending both are equally flawed only perpetuates the problem.

[zoogs]

Yes. There have been plenty vociferous critics of the ACA as proposed and implemented. There's diversity of thought here both in how to proceed and how things should have gone. And I think a basic understanding that no solution will ever be without flaw and compromise. These people align themselves with the party closest to their goals and hold that party to account.

 

On the other hand, there's the critics whose sole motivation is to discredit the other party. From this day to the ending of the world, those happy many! These people are all about maintaining the brand.

 

Probably none of us here are actually credible policy analysts. Thus, we digest the arguments presented to us -- and it's not hard to tell which arguments come from which type of source. "Both parties" is a clear case of the latter. It's damage control. It's the kid who gets caught doing something bad and whines that other kids do bad things, too.

[BigRedBuster]

That is partially true, but at least democrats are trying to fix the problem. Republicans are very obviously in the pocket of business and have zero solutions for the common man.

 

Serious question: what viable fix to this problem have Republicans offered in the last twenty years?

 

At some point we have to stop pretending both parties are equally to blame. Both are flawed. One is clearly more flawed than the other. Pretending both are equally flawed only perpetuates the problem.

It seems odd to claim one party has so many more problems when they just took control of the entire government.

 

Both parties have major problems but they are different problems.

 

The Dems have offered solutions to health care where republicans have not. You are correct about that.

 

However, still nobody has offered solutions to cost. That is a bilateral failure.

[JJ Husker]

That is partially true, but at least democrats are trying to fix the problem. Republicans are very obviously in the pocket of business and have zero solutions for the common man.

Serious question: what viable fix to this problem have Republicans offered in the last twenty years?

At some point we have to stop pretending both parties are equally to blame. Both are flawed. One is clearly more flawed than the other. Pretending both are equally flawed only perpetuates the problem.

I don't think the parties are equally flawed, not even close. Lately the repubs have been running away with the trophy in that area. What perpetuates the problem is pretending that one side actually cares more than the other and that things would be hunky dory if they just got their way. There may be a lot of things that's true for, but addressing the real cost problems of healthcare is not among them.

 

Yes, the dems have attempted to improve healthcare and the repubs have not offered any solutions and have opposed the dems at every available opportunity. But don't be fooled by the wizard behind the curtain that is telling you anything they did in the ACA will actually fix the cost problem or that either side has any impetus or desire to get to the root of the problem. The repubs didn't block any attempts to fix costs because there weren't any, they didn't have to. Would you vote to cut off your own legs? Because that is what true healthcare cost reforms would be like for congress.

[knapplc]

No, what perpetuates the problem is continually voting for the most flawed party, even if we recognize it's more flawed. That party stays in power because at the local, state & federal levels, people keep putting them in power.

 

We don't need term limits, we need an electorate who cares more about country than party.

[knapplc]

 

That is partially true, but at least democrats are trying to fix the problem. Republicans are very obviously in the pocket of business and have zero solutions for the common man.

 

Serious question: what viable fix to this problem have Republicans offered in the last twenty years?

 

At some point we have to stop pretending both parties are equally to blame. Both are flawed. One is clearly more flawed than the other. Pretending both are equally flawed only perpetuates the problem.

It seems odd to claim one party has so many more problems when they just took control of the entire government.

 

Both parties have major problems but they are different problems.

 

The Dems have offered solutions to health care where republicans have not. You are correct about that.

 

However, still nobody has offered solutions to cost. That is a bilateral failure.

 

 

One party has a knife wound. One has a gunshot wound. It's very obvious, and I don't know why this is even a matter of debate. The "both have problems" line minimizes the critical nature of the problems we're seeing in the Republican party and it needs to stop.

[JJ Husker]

No, what perpetuates the problem is continually voting for the most flawed party, even if we recognize it's more flawed. That party stays in power because at the local, state & federal levels, people keep putting them in power.We don't need term limits, we need an electorate who cares more about country than party.

I don't disagree with this except it still is not what perpetuates the problem with our government. The real problem is both sides have their constituents convinced the other side is the problem. It keeps us split. It prevents us from addressing the fundamental problems and the politicians love it and thrive on it. It prevents bilateral support which is needed for big hairy issues. If we threw out every last republican, the healthcare cost problem would still not be sufficiently addressed because it would negatively impact those in power. The problem is being perpetuated by people who havent realized the whole system is corrupt and broken but rather continue to blame one side or the other. The fact that one side is currently worse than the other just makes the illusion that much easier to hold on to. I can't state it any more clearly and I'm sorry if we disagree.

[Moiraine]

You're both right.

 

 

The real problem is the amount of control the huge corporations are allowed to have and that includes their influence on politicians on both sides.

[BigRedBuster]

 

 

That is partially true, but at least democrats are trying to fix the problem. Republicans are very obviously in the pocket of business and have zero solutions for the common man.

 

Serious question: what viable fix to this problem have Republicans offered in the last twenty years?

 

At some point we have to stop pretending both parties are equally to blame. Both are flawed. One is clearly more flawed than the other. Pretending both are equally flawed only perpetuates the problem.

It seems odd to claim one party has so many more problems when they just took control of the entire government.

 

Both parties have major problems but they are different problems.

 

The Dems have offered solutions to health care where republicans have not. You are correct about that.

 

However, still nobody has offered solutions to cost. That is a bilateral failure.

 

 

One party has a knife wound. One has a gunshot wound. It's very obvious, and I don't know why this is even a matter of debate. The "both have problems" line minimizes the critical nature of the problems we're seeing in the Republican party and it needs to stop.

 

No, it doesn't need to stop. Squelching discussion about it won't force changes in the Democratic party that is needed so they can regain some power in Washington. Nominating the most pathetic candidate they possibly could is a symptom of those problems. Ironically, the Republican problems (and they are major) exacerbates the Democratic problems because they just look down their noses at those pathetic Republicans and don't look internally as to their own problems. Then, they go get beat in elections.

 

The Republicans are pathetic right now. However, during this time, the Dems should be dominating. They aren't coming anywhere close to that because the top has an elitist attitude and they are out of touch with one hell of a lot of Americans.