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Old 11-14-2013, 10:54 AM   #1
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Default FIXING OBAMACARE

This just in: Pres. Obama to allow canceled insurance plans to be renewed for one year.

Should be interesting to see how health coverage in America will\may evolve over time now. What will it look like in 2years? 5 years? 10 years? 25 years?
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Old 11-14-2013, 01:37 PM   #2
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Everybody here knows my own ideas on that. I just think universal, single payer is inevitable. I don't even bother with the political argument over it anymore. I think it's just inescapably practical. Eventually, we will have no other option. I guess some people thought the ACA was some kind of sneaky stepping stone to that, but I never agreed with that take. I think the ACA was a last ditch effort by the insurance companies to avoid it. After all, ACA delivers everybody to the doorstep of the insurance companies. How anybody can think that's a stepping stone to single payer is beyond me, except maybe by the circuitous route that it will fail and then single payer will be inevitable. Me? I think it's inevitable either way. People on the single payer side of the equation are just waiting for common sense to lead everybody else to that same conclusion.
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Old 11-14-2013, 01:42 PM   #3
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Everybody here knows my own ideas on that. I just think universal, single payer is inevitable. I don't even bother with the political argument over it anymore. I think it's just inescapably practical. Eventually, we will have no other option. I guess some people thought the ACA was some kind of sneaky stepping stone to that, but I never agreed with that take. I think the ACA was a last ditch effort by the insurance companies to avoid it. After all, ACA delivers everybody to the doorstep of the insurance companies. How anybody can think that's a stepping stone to single payer is beyond me, except maybe by the circuitous route that it will fail and then single payer will be inevitable. Me? I think it's inevitable either way. People on the single payer side of the equation are just waiting for common sense to lead everybody else to that same conclusion.
Refreshing to see a real true believer. Roh watchin' this whole thing unfold. Still dreamin' of the day he can create that account on ProctologyAppointment.GOV
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Old 11-14-2013, 01:47 PM   #4
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Ro the Swiss have had a system just like the PPACA in place for the last 20 years and Massachusetts for the last 10. The PPACA will work too if given a chance. If the republicans manage to burn it to the ground then we can look forward to going back to spiraling premiums, denial of coverage for pre-existing conditions, cancellations when we get sick, etc.

Anybody here who thinks the republican party gives a rat's ass about HC reform is living in dreamland. They just want to deny the dems a political victory, drag us back to the mess we had before, and go back to ignoring the problem.

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Old 11-14-2013, 01:49 PM   #5
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Refreshing to see a real true believer. Roh watchin' this whole thing unfold. Still dreamin' of the day he can create that account on ProctologyAppointment.GOV
Fun facts to know and share:
http://sickothemovie.com/checkup/

One example:
"The U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds." "World Health Organization Assesses The World's Health Systems," Press Release, WHO/44, June 21, 2000.
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Old 11-14-2013, 01:54 PM   #6
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Repeal

That is how you fix it.
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Old 11-14-2013, 02:03 PM   #7
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Ro the Swiss have had a system just like the PPACA in place for the last 20 years and Massachusetts for the last 10. The PPACA will work too if given a chance. If the republicans manage to burn it to the ground then we can look forward to going back to spiraling premiums, denial of coverage for pre-existing conditions, cancellations when we get sick, etc.

Anybody here who thinks the republican party gives a rat's ass about HC reform is living in dreamland. They just want to deny the dems a political victory, drag us back to the mess we had before, and go back to ignoring the problem.
I suppose then you get into the ethical debate. I think, in a modern industrial society, health care should be a right. What's the best way to do it? Everybody agrees that you need to spread the risk as broadly as possible. In ACA, the mandate is supposed to accomplish that. So, if you're going to accept that premise, why have two payers? You pay to the insurance company, who takes some profit, then you pay the provider, who also takes some profit? Why?
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Old 11-14-2013, 02:09 PM   #8
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I suppose then you get into the ethical debate. I think, in a modern industrial society, health care should be a right. What's the best way to do it? Everybody agrees that you need to spread the risk as broadly as possible. In ACA, the mandate is supposed to accomplish that. So, if you're going to accept that premise, why have two payers? You pay to the insurance company, who takes some profit, then you pay the provider, who also takes some profit? Why?
And under a single-payer system you pay government bureaucrats instead. And you can't take your money anywhere else so they have no incentive to provide quality service.

All the PPACA does is privatize the function of paying out from a pool of the insured to those who need it. And because it's being done by companies who are concerned about keeping customers they will look for ways to provide the best service at the lowest cost. I'd rather have that than a government bureaucracy controlling payments, as long as the insurance companies are properly regulated to prevent them from screwing their customers, which they are under the PPACA.
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Old 11-14-2013, 02:10 PM   #9
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Ro the Swiss have had a system just like the PPACA in place for the last 20 years and Massachusetts for the last 10. The PPACA will work too if given a chance. If the republicans manage to burn it to the ground then we can look forward to going back to spiraling premiums, denial of coverage for pre-existing conditions, cancellations when we get sick, etc.

Anybody here who thinks the republican party gives a rat's ass about HC reform is living in dreamland. They just want to deny the dems a political victory, drag us back to the mess we had before, and go back to ignoring the problem.
There's virtually no employer-provided insurance in the Swiss model. The PPACA encourages it (or often mandates it). To say it moves us to the Swiss model when it maintains our biggest distinction from the Swiss model is pure wishful thinking.
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Old 11-14-2013, 02:15 PM   #10
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There's virtually no employer-provided insurance in the Swiss model. The PPACA encourages it (or often mandates it). To say it moves us to the Swiss model when it maintains our biggest distinction from the Swiss model is pure wishful thinking.
Didn't say they are exactly the same. But they are similar enough to suggest that the PPACA will work if properly implemented.

I offer no guarantees. All I'm saying is give it a chance.
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Old 11-14-2013, 02:41 PM   #11
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Didn't say they are exactly the same. But they are similar enough to suggest that the PPACA will work if properly implemented.

I offer no guarantees. All I'm saying is give it a chance.
Again, there's no logic behind thinking it will work, because it does nothing to address the American system's real flaw.

Too many consumers are removed from the real cost of their healthcare. On one level, because of overinsurance. And that is multiplied by the fact that many (probably most) consumers don't even pay (much) out of pocket for the insurance itself.

Americans need to know and care more about what health services and insurance really cost them. The ACA does what most past reforms have done... it tries to further mask the true cost.

So it won't work. It can't work.
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Old 11-14-2013, 02:46 PM   #12
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Again, there's no logic behind thinking it will work, because it does nothing to address the American system's real flaw.

Too many consumers are removed from the real cost of their healthcare. On one level, because of overinsurance. And that is multiplied by the fact that many (probably most) consumers don't even pay (much) out of pocket for the insurance itself.

Americans need to know and care more about what health services and insurance really cost them. The ACA does what most past reforms have done... it tries to further mask the true cost.

So it won't work. It can't work.
Real-world evidence says you're wrong. I'll take that over your theories.
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Old 11-14-2013, 02:55 PM   #13
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Again, there's no logic behind thinking it will work, because it does nothing to address the American system's real flaw.

Too many consumers are removed from the real cost of their healthcare. On one level, because of overinsurance. And that is multiplied by the fact that many (probably most) consumers don't even pay (much) out of pocket for the insurance itself.

Americans need to know and care more about what health services and insurance really cost them. The ACA does what most past reforms have done... it tries to further mask the true cost.

So it won't work. It can't work.
Explain why American healthcare costs double that of other industrial democracies and is generally less effective?

And what would bring down costs by 50% to bring it into line with those 'unsustainable' healthcare systems?
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Old 11-14-2013, 03:10 PM   #14
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they can't do this it will blow up the whole system. If they don't cancel those policies those 15 million people don't pay into the system. If they don't get the young people they don't either. All it takes now to completely blow Obamacare out of the water is a delay of the fines for not having insurance.

Obama is on the ropes and this is going to kill midterms for the conservative dems.
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Old 11-14-2013, 03:10 PM   #15
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Explain why American healthcare costs double that of other industrial democracies and is generally less effective?

And what would bring down costs by 50% to bring it into line with those 'unsustainable' healthcare systems?
I thought USA had better cure and survival rates for cancer then the EU did?
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Old 11-14-2013, 03:16 PM   #16
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Real-world evidence says you're wrong. I'll take that over your theories.
There is no comparable evidence from an employer-based coverage system of relevant size. Because we're the only one.

The 'evidence' generally given consists of the fruits of either greater market freedom, or greater price controls (rationing)
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Old 11-14-2013, 03:17 PM   #17
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an apology should be enough, right?

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Old 11-14-2013, 03:20 PM   #18
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There is no comparable evidence from an employer-based coverage system of relevant size. Because we're the only one.

The 'evidence' generally given consists of the fruits of either greater market freedom, or greater price controls (rationing)
As far as I can tell the employer-based coverage is not essential to the PPACA. I'm pretty sure that part can be removed and the system would work just fine.

Once again, real world evidence: Switzerland, Massachusetts. They have largely the same systems as the PPACA and they work. Real-world evidence trumps theory any day. And if we need to reform the PPACA to more closely match those systems in order for it to function better then so be it. There's no reason to think we can't.

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Old 11-14-2013, 03:36 PM   #19
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As far as I can tell the employer-based coverage is not essential to the PPACA. I'm pretty sure that part can be removed and the system would work just fine.

Once again, real world evidence: Switzerland, Massachusetts. They have largely the same systems as the PPACA and they work. Real-world evidence trumps theory any day. And if we need to reform the PPACA to more closely match those systems in order for it to function better then so be it. There's no reason to think we can't.
So your evidence consists of comparing a country where 80% of coverage is employer or government based to one where virtually none of it is?

Should we disband Medicare/aid? Let's get on this Swiss Model.
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Old 11-14-2013, 03:53 PM   #20
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I thought USA had better cure and survival rates for cancer then the EU did?
Generally I believe that is true. It's a variable and one that gets distorted by diet, age, smoking etc.

Do we really have the world’s best cancer care?
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Survival rates also reflect normal distribution. There are over 200 types of cancers; most are treated similarly among industrialized nations. If we review survival rates from all cancers throughout the industrialized world, different countries lead in different cancers. Survival rates from head and neck cancers are higher in Canada than in the US. Germany has the highest survival rate in esophageal cancer; Austria in stomach cancers; Belgium in pancreatic cancer; etc.

There is the additional question of statistical versus clinical significance. Our five year survival rate for breast cancer is 83.9%, the highest in the world. The survival rate in Canada is 82.5%. Is this difference clinically significant?

Mortality rate, in contrast, reflects the number of people dying of a disease annually. This statistic eliminates the early diagnosis confusion, though over-diagnosis remains.

An intriguing study recently compared mortality rates from all treatable cancers among the US, the UK, France, and Germany. US mortality rates are better compared to our peers. Perhaps Americans do receive better treatment.

Here’s the catch. When mortality rates are restricted only to patients under 65, the US loses its lead – we are right in the middle. Only when we compare mortality rates among patients over 65 do we excel among our peers. Why? Possibly because Medicare gives older Americans the health care access they lacked when younger.
http://www.kevinmd.com/blog/2012/12/...ncer-care.html

From the Lancet study. It varies in the US, Sate to Sate, black vs white.
Study Of 31 Countries Finds Wide Variations In Cancer Survival Rates
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In the international comparison, the researchers saw the highest survival rates for breast and prostate cancer in the USA. They also noted Japan as having the highest survival for colon and rectal cancers in men and France as having the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers, while Algeria clearly claimed the lowest survival for all cancers in both men and women.
http://www.medicalnewstoday.com/articles/115086.php

But cancer isn't the only indicator of healthcare success.

According t Bloomberg, the US is ranked 46th, just ahead of Serbia, but just below Iran.
http://www.bloomberg.com/visual-data...care-countries

Last edited by DenverBrit; 11-14-2013 at 03:55 PM..
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Old 11-14-2013, 04:00 PM   #21
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I think we can argue what country has best care till we are blue in the face but it matter little. The USA has such loose immigration policies for law skill labor you wonder if we compare to the Swiss etc who for the most part have very strict immigration laws. If everyone was a college grad, going to work, then we wouldn't have this problem. It's all the poor people without coverage.
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Old 11-14-2013, 04:01 PM   #22
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And under a single-payer system you pay government bureaucrats instead. And you can't take your money anywhere else so they have no incentive to provide quality service.

All the PPACA does is privatize the function of paying out from a pool of the insured to those who need it. And because it's being done by companies who are concerned about keeping customers they will look for ways to provide the best service at the lowest cost. I'd rather have that than a government bureaucracy controlling payments, as long as the insurance companies are properly regulated to prevent them from screwing their customers, which they are under the PPACA.
But the government administrator doesn't take a profit. I've worked in a hospital for years, so I see Medicare and Medicaid work on the ground every day. I don't buy any of the hysteria about the government boogie man running health care. It works good enough.

There is no such thing as a perfect health care system. People die. People also get very sick, or old, and still hang on for a long time. It's a fact of life. For the best for the most, I still go with single payer. It's still the best solution for the big flaw in the ACA concept: There are millions of people living below the poverty line who are not going to be able to afford it and will still come to the ERs.
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Old 11-14-2013, 04:02 PM   #23
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And under a single-payer system you pay government bureaucrats instead. And you can't take your money anywhere else so they have no incentive to provide quality service.

All the PPACA does is privatize the function of paying out from a pool of the insured to those who need it. And because it's being done by companies who are concerned about keeping customers they will look for ways to provide the best service at the lowest cost. I'd rather have that than a government bureaucracy controlling payments, as long as the insurance companies are properly regulated to prevent them from screwing their customers, which they are under the PPACA.
But the government administrator doesn't take a profit. I've worked in a hospital for years, so I see Medicare and Medicaid work on the ground every day. I don't buy any of the hysteria about the government boogie man running health care. It works good enough.

There is no such thing as a perfect health care system. People die. People also get very sick, or old, and still hang on for a long time. It's a fact of life. For the best for the most, I still go with single payer. It's still the best solution for the big flaw in the ACA concept: There are millions of people living below the poverty line who are not going to be able to afford it and will still come to the ERs. Not only that, it will significantly lower the cost of drugs with volume buying.
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Old 11-14-2013, 04:10 PM   #24
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Everybody here knows my own ideas on that. I just think universal, single payer is inevitable.
Will never happen. The pendulum will swing back in the other direction before such a thing could ever become a reality, and there's no political will in DC to fight for such a thing. Who is going to do it? Where are they going to get their support? How will it get past the House? Or even the Senate?

This is fantasy. There is no political roadmap in existence right now for this to be a reality.
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Old 11-14-2013, 04:11 PM   #25
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So your evidence consists of comparing a country where 80% of coverage is employer or government based to one where virtually none of it is?

Should we disband Medicare/aid? Let's get on this Swiss Model.
The Swiss model does offer government subsidies.

Quote:
The government subsidizes health care for the poor on a graduated basis, with the goal of preventing individuals from spending more than 10 percent of their income on insurance.
http://www.forbes.com/sites/theapoth...h-care-system/

And once again, employer-based insurance doesn't appear to be an essential part of the PPACA. If we need to abandon that requirement it can be done and the evidence suggests that the PPACA will function just fine without it.

So yes, if need be the PPACA can be more closely modeled after Swisscare through reform.
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