Repealing the ACA under Trump

[knapplc]

Here's Ben Sasse's exchange with Trump, and some insightful analysis by a concerned citizen.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

...and the twitter link if you're interested.

 

[zoogs]

TG...I think to a certain extent, you are right. Problem is, we aren't even doing a good job of that.

 

What the Republicans need to flat out admit one way or the other....Is access to healthcare by everyone in society important to them?

 

They need to be flat out asked that and not let off the hook until they actually answer it with a yes or no answer.

 

And....a "yes" with a follow up of....if we free up the world of healthcare, everyone in la la land will somehow instantly have all the healthcare they need and the ability to pay for it....is not acceptable.

 

If their answer is "NO", then we know where the debate really is and we can have that debate.

If the answer is "YES", then they need to, in detail, explain how their program is going to work to accomplish that.

 

Bingo. Perfectly stated, IMO. Know where the debate is and honestly advance your case.

[Danny Bateman]

Great article that fleshes out the cost argument that JJ makes frequently.

 

[BigRedBuster]

That is TOTALLY unacceptable.

[Danny Bateman]

I'm with you guys, too. The costs are definitely too high. I like that the article mentioned the ACA's attempt to transition away from fee for service (FFS) to a value based system. This shouldn't be overlooked. We've talked about it in some of my classes when we discuss insurance and I think it's a really important initial step to try to cut down on volume in the healthcare system. Used to be doctors, PTs, etc. could get paid for the number of procedures or treatments they provided, which encouraged wasteful decisions. The ACA tried to push us away from that towards one were we get paid a set sum for X amount of visits and have to accomplish our goals within that timeframe. It was really important to get the ball rolling on that because FFS is/was a big problem.

 

But yeah, costs are too high. The problem is there are so many lobbies that will line up to try to stifle a move to take down those prices. I know we rail against it, but we need to appreciate just how monumental a task it is to take them on and put out a real plan that would address the cost problem. Obviously Trump has failed for numerous reasons. Whomever does eventually try to fix this issue will take an absolute beating for it.

 

I for one have accepted that the implementation of such a system is going to cut into my future salary, but I'm more than willing to make that concession if it fixes our healthcare system for the long-term.

[ZRod]

 

I grew up hearing horror stories about Canada healthcare and European healthcare. I now hear mostly about how they're model systems compared to the U.S.... I think it really depends on the sources and their motivations. The former were a lot of very conservative bent folks unsurprisingly, and it's become increasingly clear that universal coverage is simply not something they're interested in.

I still hear how bad they are from Republicans.

Living 40 miles from the border and frequently traveling to Canada for buisness, I sometimes talk to the factory workers about things like healthcare. Canadians, I think, generally like what they have for healthcare. Their only gripes are the sometime long waits for evaluations or procedures, and their high tax rates. That is offset by their piece of mind that if they need it, they will recieve adequate healthcare.

[JJ Husker]

I guess that's kind of been my point and position all along. As it stands now all these guys are doing is shifting dollars back and forth between the rich and the poor. If we take that whole pie and cut it down to where it's 50% or less total (not a wild cut to overall healthcare costs IMO), wouldn't it be much easier deal with? It sure would make covering more people at a lower cost easier. Fix the main problem and all these other apportionment issues become infinitely more manageable. Don't fix them and nothing that amounts to anything good is even possible.

[NM11046]

 

 

I grew up hearing horror stories about Canada healthcare and European healthcare. I now hear mostly about how they're model systems compared to the U.S.... I think it really depends on the sources and their motivations. The former were a lot of very conservative bent folks unsurprisingly, and it's become increasingly clear that universal coverage is simply not something they're interested in.

I still hear how bad they are from Republicans.

Living 40 miles from the border and frequently traveling to Canada for buisness, I sometimes talk to the factory workers about things like healthcare. Canadians, I think, generally like what they have for healthcare. Their only gripes are the sometime long waits for evaluations or procedures, and their high tax rates. That is offset by their piece of mind that if they need it, they will recieve adequate healthcare.

 

Agreed. From the Europeans I hear similar, the wait and the fact that they don't always get the level of expertise that they might get if they could choose their own doctors. Now I think they could probably pay and go to their own doctors if it was that important to them.

[BigRedBuster]

[GSG]

This Website Will Mail Your Ashes To The GOP If Trumpcare Kills You. Really.

 

Could be useful!

[JJ Husker]

 

 

 

I grew up hearing horror stories about Canada healthcare and European healthcare. I now hear mostly about how they're model systems compared to the U.S.... I think it really depends on the sources and their motivations. The former were a lot of very conservative bent folks unsurprisingly, and it's become increasingly clear that universal coverage is simply not something they're interested in.

 

I still hear how bad they are from Republicans.

Living 40 miles from the border and frequently traveling to Canada for buisness, I sometimes talk to the factory workers about things like healthcare. Canadians, I think, generally like what they have for healthcare. Their only gripes are the sometime long waits for evaluations or procedures, and their high tax rates. That is offset by their piece of mind that if they need it, they will recieve adequate healthcare.

Agreed. From the Europeans I hear similar, the wait and the fact that they don't always get the level of expertise that they might get if they could choose their own doctors. Now I think they could probably pay and go to their own doctors if it was that important to them.

If it was that important to them? I mean sniffly noses and ingrown toenails aren't the issue here.

 

Surely you're not saying that untimely and substandard care are acceptable tradeoffs for moving to universal care. That the rich should be able to buy their way to top notch care, while the poor are stuck with something else entirely. This is my biggest concern with the prospect of universal single payer care.

 

People are quick to point out how our system sucks compared to so many others but then you hear about these delays in treatment and lower quality care. It makes me wonder which narrative is actually correct. There's no doubt our costs are too high. I'd like to attempt to fix that before we throw the baby out with the bathwater.

[BigRedBuster]

 

 

 

 

I grew up hearing horror stories about Canada healthcare and European healthcare. I now hear mostly about how they're model systems compared to the U.S.... I think it really depends on the sources and their motivations. The former were a lot of very conservative bent folks unsurprisingly, and it's become increasingly clear that universal coverage is simply not something they're interested in.

I still hear how bad they are from Republicans.

Living 40 miles from the border and frequently traveling to Canada for buisness, I sometimes talk to the factory workers about things like healthcare. Canadians, I think, generally like what they have for healthcare. Their only gripes are the sometime long waits for evaluations or procedures, and their high tax rates. That is offset by their piece of mind that if they need it, they will recieve adequate healthcare.

Agreed. From the Europeans I hear similar, the wait and the fact that they don't always get the level of expertise that they might get if they could choose their own doctors. Now I think they could probably pay and go to their own doctors if it was that important to them.

If it was that important to them? I mean sniffly noses and ingrown toenails aren't the issue here.

 

Surely you're not saying that untimely and substandard care are acceptable tradeoffs for moving to universal care. That the rich should be able to buy their way to top notch care, while the poor are stuck with something else entirely. This is my biggest concern with the prospect of universal single payer care.

 

People are quick to point out how our system sucks compared to so many others but then you hear about these delays in treatment and lower quality care. It makes me wonder which narrative is actually correct. There's no doubt our costs are too high. I'd like to attempt to fix that before we throw the baby out with the bathwater.

 

This is my biggest concern also with a single payer plan.

 

We had a relative from Europe come visit once. She was talking about all the great things about their healthcare. The one thing that was a negative is the long wait. Her mother needed a major surgery and had to wait something like 6 or 9 months. In the US, she would have been in having surgery relatively very soon.

 

NMs comments are really odd. If we aren't going to care if wealthy people can just go buy better healthcare, then why are we having this conversation. Right now, that's a pretty big deal in the US.

[RedDenver]

Surely you're not saying that untimely and substandard care are acceptable tradeoffs for moving to universal care. That the rich should be able to buy their way to top notch care, while the poor are stuck with something else entirely. This is my biggest concern with the prospect of universal single payer care.

 

People are quick to point out how our system sucks compared to so many others but then you hear about these delays in treatment and lower quality care. It makes me wonder which narrative is actually correct. There's no doubt our costs are too high. I'd like to attempt to fix that before we throw the baby out with the bathwater.

Keep in mind that there's always going to be better and worse cases, so we have to look at statistical measures.

 

The quality of care in the US isn't all that great as we have better asthma and cancer survival rates than most other OECD countries, but lower life expectancy, higher infant mortality, and greater prevalence of chronic conditions.

 

Wait times are definitely a concern in healthcare, but the US is a mixed bag as Norway, Canada, Sweden, UK, and Australia have longer wait times; Switzerland, France, and New Zealand are about the same; and Netherlands and Germany (Germans average almost zero! wait time and a lower per capita cost) have lower wait times (from Figure 1.5 in this massive report).

 

If you put that all together, the US is paying way more for roughly equal quality and wait times, and we have a vastly unequal system dependent on ability to pay for care.

[ZRod]

See, this is what is so crazy about this whole thing. In the past, we would have found a way to do it better or just as good for cheaper. Today though, out leaders could give two sh#ts about finding a way. They sit comfortably in their positions and can't figure out why anyone else has an issue with the status quo. There is no motivation to be the best, or show everyone elae how it should be done.

[jsneb83]

 

Surely you're not saying that untimely and substandard care are acceptable tradeoffs for moving to universal care. That the rich should be able to buy their way to top notch care, while the poor are stuck with something else entirely. This is my biggest concern with the prospect of universal single payer care.

 

People are quick to point out how our system sucks compared to so many others but then you hear about these delays in treatment and lower quality care. It makes me wonder which narrative is actually correct. There's no doubt our costs are too high. I'd like to attempt to fix that before we throw the baby out with the bathwater.

Keep in mind that there's always going to be better and worse cases, so we have to look at statistical measures.

 

The quality of care in the US isn't all that great as we have better asthma and cancer survival rates than most other OECD countries, but lower life expectancy, higher infant mortality, and greater prevalence of chronic conditions.

 

Wait times are definitely a concern in healthcare, but the US is a mixed bag as Norway, Canada, Sweden, UK, and Australia have longer wait times; Switzerland, France, and New Zealand are about the same; and Netherlands and Germany (Germans average almost zero! wait time and a lower per capita cost) have lower wait times (from Figure 1.5 in this massive report).

 

If you put that all together, the US is paying way more for roughly equal quality and wait times, and we have a vastly unequal system dependent on ability to pay for care.

I have a friend who used to live in Germany, and that was what she was saying as well. She said she would go to her prenatal visits and be in and out in less than 45 minutes.