US-Politics The Resistible Rise of Donald J. Trump

[TrackerNeil]

Agreed. A single payer system with some tort reform would have worked much better.

I would have loved to have a single-payer system; unfortunately, it was not politically possible in 2009-2010, and still isn't today. One day, I'm sure, it will be; until then I'm glad we've got a system a lot better than the one we had.

[Mr. Chatywin et al.]

The Affordable Care Act is not bipartisan legislation and there is no bipartisan agreement as to how to "fix" it. 

Well considering it's a conservative idea, I'd argue it could be, sans the hyper-partisanship.

[Mr. Chatywin et al.]

I would have loved to have a single-payer system; unfortunately, it was not politically possible in 2009-2010, and still isn't today. One day, I'm sure, it will be; until then I'm glad we've got a system a lot better than the one we had.

Hell, it might be possible if Republicans gain full control of the government and are crazy enough to repeal the ACA outright without a backup plan.

Or if Trump becomes president.......

[Larry of the Lawn]

I would have loved to have a single-payer system; unfortunately, it was not politically possible in 2009-2010, and still isn't today. One day, I'm sure, it will be; until then I'm glad we've got a system a lot better than the one we had.

I apologize in advance for asking some super-broad questions here, but you seem to be more familiar with the ACA than most, so I'm just indulging some curiosity here.

What would introducing a single-payer system do to the insurance industry?  I imagine the insurance lobby is an awfully difficult obstacle to circumvent on that road.  I realize this is a loaded question and probably not something with an easy answer.  Mostly asking because I always see (and for the most part agree with) people trotting out "well, single payer wasn't possible, this is the best we could get," as either a defense of the ACA or explaining why it's here.  Maybe a better question would be, what would the road from the ACA to single-payer look like, and what kinds of changes to the ACA are we likely to see over the next 5-10 years to address changes in the health care industry/costs?

 

@  Nestor, yeah, you're right, I know the ACA is mostly just looking for young people to contribute to overall costs by mandating coverage.

@Fez, I'm sure there is a process.  I was on the CT exchange, but honestly was overwhelmed with the entire process, especially once my financial situation took a turn for the worse, so I guess that's on me.

[Mr. Chatywin et al.]

Sorry to triple post, but I meant to ask this earlier. Will normalizing relations with Cuba help to lower health care costs? They have a much cheaper health care system, and it's one of the better ones in the world. Medical tourism has been a thing for a while, but I'd be willing to bet a lot of people would be willing to fly to Cuba who wouldn't have been willing to fly to India.

[NestorMakhnosLovechild]

Well considering it's a conservative idea, I'd argue it could be, sans the hyper-partisanship.

Right. Over 20 years ago, one major conservative think tank proposed something similar to Obamacare. A piece of legislation was introduced with the backing of a few prominent Congressional Republicans, in competition with other health care reform legislation proposed by the Republican house. It never received widespread support. It never received the backing of even a majority of Congressional Republicans. It never got out of committee to even come to a vote.

Now, 20 years later, any conservative who doesn't agree with a minority position the conservative movement had two decades ago is somehow a hyper-partisan hypocrite for rejecting it. Give me a break. 

[TrackerNeil]

I apologize in advance for asking some super-broad questions here, but you seem to be more familiar with the ACA than most, so I'm just indulging some curiosity here.

What would introducing a single-payer system do to the insurance industry?  I imagine the insurance lobby is an awfully difficult obstacle to circumvent on that road.  I realize this is a loaded question and probably not something with an easy answer.  Mostly asking because I always see (and for the most part agree with) people trotting out "well, single payer wasn't possible, this is the best we could get," as either a defense of the ACA or explaining why it's here.  Maybe a better question would be, what would the road from the ACA to single-payer look like, and what kinds of changes to the ACA are we likely to see over the next 5-10 years to address changes in the health care industry/costs?

As to your question, I imagine that a single-payer system would greatly reduce the reach of private insurance, but might not destroy it. After all, the UK has both the NHS and private insurance.

Your second question is an excellent one, and I'm afraid I can only speculate, but here goes. When the Affordable Care Act was enacted, it very nearly included a public option--thanks to Joe Lieberman for squelching that.   Anyway, my understanding is that adding a public option to the existing framework could conceivably be accomplished via reconciliation, which means no filibuster could stop it. So the next time the Democrats control DC, one could easily imagine them adding a public option to the ACA.

Imagine that the PO is popular, so popular that it starts to attract the majority of people on private exchanges. You could see private insurance companies pulling out of those exchanges, driving more and more people into the PO, until the majority of ACA-covered folks are there. After awhile, someone's going to ask, "Why are we maintaining both Medicare and a public insurance option?" From there it could be a short trip to Medicare-for-all, which is essentially a single-payer system.

Again, I'm speculating here, and I imagine that concrete examples could be found in other nations that have moved away from private insurance. However, I don't think anything I am saying here is outrageous or even unlikely, at least eventually. Good question, though!

[Fez]

@Fez, I'm sure there is a process.  I was on the CT exchange, but honestly was overwhelmed with the entire process, especially once my financial situation took a turn for the worse, so I guess that's on me.

If you ever want to give it another shot, the term you want to use (in phone calls, emails, internet searches, whatever) is 'navigator.' Navigators are the people and organizations who are supposed to walk people step-by-step through everything you need to do to get enrolled with the best possible subsidy package; and you don't pay them anything, they are funded by state and federal grants. Since CT is one of the state-based exchanges/marketplace they were able to fund a pretty robust navigator network (there was limited federal funding for the states using healthcare.gov). And now that they have had a few years experience under their belts, I suspect they've gotten pretty good at the process. 

Its my understanding that CT divided the state into six geographic regions and assigned one navigator organization to each one. If you find out which one covers the county you are in and get in touch with them, they may be able to get you a much better deal than you thought. If you're ever interested.

Or maybe not. No guarantees.

[BloodRider]

Tracker,

It is as I said.  The ACA addresses the symptom not the problem.  Sharpely rising premiums (thank you Nestor) reflect that the problem is still there the high cost of healthcare.

C'mon Scott.  This is ill considered and beneath you.  healthcare =/= insurance.  I like to think you are aware of this.

[Ser Scot A Ellison]

BR,

C'mon Scott.  This is ill considered and beneath you.  healthcare =/= insurance.  I like to think you are aware of this

So, insurance premiums are going up because health insureors have their underwear in a bunch?  The increasing premiums bear no relation to the rising cost of healthcare?

[Shryke]

 

Uh... Health insurance premiums have increased dramatically across the board as a result of the Affordable Care Act. This is not even in dispute. In fact, this is specifically addressed in the article you linked to, which also links to ANOTHER article by the same author (Sarah Kliff) on why Obamacare premiums are spiking in 2016. From that article:

 

None of your articles seem to show that health insurance costs have risen as a result of the ACA because none of them seem to be comparing it to pre-ACA rate raises.

[Fez]

BR,

 

So, insurance premiums are going up because health insureors have their underwear in a bunch?  The increasing premiums bear no relation to the rising cost of healthcare?

You're ignoring my point Scot. Premiums only went up a large amount for the (relatively) small number of people who are in Obamacare insurance, and that happened due to the very specific reason that the rates were too low previously considered what the risk pools ended up being.

Everyone else with health insurance, who are just as affected by increases in health care costs, either saw no increase (Medicare enrollees) or saw an increase of only half as much (people with employer-sponsored coverage). If health care costs were the reason behind the Obamacare increases, everyone else would've had similar increases as well.

[Shryke]

Right. Over 20 years ago, one major conservative think tank proposed something similar to Obamacare. A piece of legislation was introduced with the backing of a few prominent Congressional Republicans, in competition with other health care reform legislation proposed by the Republican house. It never received widespread support. It never received the backing of even a majority of Congressional Republicans. It never got out of committee to even come to a vote.

Now, 20 years later, any conservative who doesn't agree with a minority position the conservative movement had two decades ago is somehow a hyper-partisan hypocrite for rejecting it. Give me a break. 

It also ended up being implemented by the 2012 Republican candidate for the Presidency. Who was also calling for something like it at the national level.

20 years ago and sooner then that too prominent Republicans were pushing this idea, among others. Once the Democrats proposed it, it became the worst thing ever. This should come as no surprise of course, since GOP leadership literally got together before Obama was even inaugurated and planned to oppose everything he did in order to try to make him a 1-term president. To ignore the extremely partisan dimensions of opposition to Obamacare is just silly.

[BloodRider]

BR,

So, insurance premiums are going up because health insureors have their underwear in a bunch?  The increasing premiums bear no relation to the rising cost of healthcare?

Are you incapable of not asking a loaded rhetorical question?  Do you even want answers, or are you grandstanding for a jury?  Do you find this rhetorical style disingenuous, dismissive and annoying, and do you see any irony in that?

I'll be your fool once again, and assume you do actually want an answer.  Even though, I know it has been posted here before, and it was just posted in this thread,  Suffice to say, in order of their asking, No and No - not in any significant way, at this time.

If you stopped to think this through, you might realize that covering people with pre-existing conditions cost the insurers money.  Remember these are new customers for the insurers.  So costs of each service can go down, but insurers are now covering more people, and they are more expensive.  It's math.

And yes, they are also milking their rent seeking positions.

[Bold Barry Whitebeard]

Are you incapable of not asking a loaded rhetorical question?  Do you even want answers, or are you grandstanding for a jury?  Do you find this rhetorical style disingenuous, dismissive and annoying, and do you see any irony in that?

I'll be your fool once again, and assume you do actually want an answer.  Even though, I know it has been posted here before, and it was just posted in this thread,  Suffice to say, in order of their asking, No and No - not in any significant way, at this time.

If you stopped to think this through, you might realize that covering people with pre-existing conditions cost the insurers money.  Remember these are new customers for the insurers.  So costs of each service can go down, but insurers are now covering more people, and they are more expensive.  It's math.

And yes, they are also milking their rent seeking positions.

The math would also suggest that more people seeking services drives up demand, and price, since the number of doctors is remaining relatively stagnant.

And in addition to my earlier point, more customers gives the insurers a better bargaining position to lower the amount they pay out, which causes the healthcare provider to inflate the price further.

[Ser Scot A Ellison]

BR,

This link shows the rate of inflation for the US for 2015 to be .5%:

http://www.usinflationcalculator.com/inflation/current-inflation-rates/

According to this Forbes article the rate of increase in medical costs for 2015 is 2.8% significantly higher than the rate of inflation generally:

http://www.forbes.com/sites/mikepatton/2015/06/29/u-s-health-care-costs-rise-faster-than-inflation/

 

[Fez]

According to this Forbes article the rate of increase in medical costs for 2015 is 2.8% significantly higher than the rate of inflation generally:

http://www.forbes.com/sites/mikepatton/2015/06/29/u-s-health-care-costs-rise-faster-than-inflation/

That's either an out lie or someone deeply misreading something.

No one has any clue how much health care costs increased in 2015 yet. There's a year long lag while the data is collected and analyzed. The data for 2014 was only just released earlier this month, back on December 2.

[Fez]

On another note, there's finally starting to be some fire showing up behind all the smoke around rumors about Rubio.

When Marco Rubio was majority whip of the Florida House of Representatives, he used his official position to urge state regulators to grant a real estate license to his brother-in-law, a convicted cocaine trafficker who had been released from prison 20 months earlier, according to records obtained by The Washington Post.

In July 2002, Rubio sent a letter on his official statehouse stationery to the Florida Division of Real Estate, recommending Orlando Cicilia “for licensure without reservation.” The letter, obtained by The Washington Post under the Florida Public Records Act, offers a glimpse of Rubio using his growing political power to assist his troubled brother-in-law and provides new insight into how the young lawmaker intertwined his personal and political lives.

Rubio did not disclose in the letter that Cicilia was married to his sister, Barbara, or that the former cocaine dealer was living at the time in the same West Miami home as Rubio’s parents. He wrote that he had known Cicilia “for over 25 years,” without elaborating.

[TrackerNeil]

It also ended up being implemented by the 2012 Republican candidate for the Presidency. Who was also calling for something like it at the national level.

To this day I sometimes still shake my head at the notion that in 2012 the Republicans nominated the Father of the Massachusetts Mandate.

[Mr. Chatywin et al.]

It also ended up being implemented by the 2012 Republican candidate for the Presidency. Who was also calling for something like it at the national level.

20 years ago and sooner then that too prominent Republicans were pushing this idea, among others. Once the Democrats proposed it, it became the worst thing ever. This should come as no surprise of course, since GOP leadership literally got together before Obama was even inaugurated and planned to oppose everything he did in order to try to make him a 1-term president. To ignore the extremely partisan dimensions of opposition to Obamacare is just silly.

I agree.

And my point was that if we had more statesmen and stateswomen and less worthless politicians then there could have been a bipartisan approach to the passing and updating of the ACA.