The Terrifying Stakes Of Repealing Obamacare Without A Clear Replacement

[Ghostpanther]

Shockingly there are many things from 1999 that we'll never get back.



This graph proves that the current administration has failed!

No, it doesn't work that way. Unfortunately the world changes and we have to create new systems to improve from where we are now moving forward. Comparing to 1991 and saying "Look at how much we are failing!" is meaningless.

The healthcare landscape has changed. It is more expensive and the number of people trying to access it is astronomically higher than it was before. The number of people without insurance accessing hospital services is also astronomically higher. The amount of lost revenue from providing services to people who never pay the bill is astronomically higher.



The graph proves that in spite of the inertia of the current economic subsystem pushing toward fewer insured, more sickness, less access, the ACA was able to help move it in the other direction. How that is anything but success is beyond comprehension.

How people can forget the deductibles have also gone waaay up is also hard to comprehend. Having coverage is not the same has having good and affordable coverage. My insurance plan for example, while at a lower increase rate recently in price, still is raising faster than the rate of inflation and if you count in the higher deductibles I have to pay, not sure it is slowed. :P

[drakensoul]

Well a black muslim, communist, weak, dictator,anti-colonial gay guy pushed for the change

Me: "How this success could be viewed as un-success is beyond my comprehension"
You: "Well a black gay guy did it!! So it's bad!"

Reality: A positive thing has happened. Regardless of whether or not you dislike the man who pushed for it, he did something for good.

Tell me, what large, sweeping improvements in quality of life for the American people have you created?

[Ghostpanther]

How the hell is what you are proposing less of crushing government imposed burden than simply requiring people to buy insurance? Oh right, because it doesn't affect YOU in any way, and fuck all those doctors amirite?

If they are overcharging and getting rich off the suffering of people, then yeah, fuck them. But I am not convinced the doctors are the biggest concern. The hospitals and the drug companies for sure, share a large part of the blame.

[ati87]

Two things:
Add a public option by having Medicare compete with private insurers.

Have government directly negotiate prescription prices. (as other countries do to drive down these ridiculous drug costs)

Realistically even if some republicans wanted the entire party is ruled by the active crazy-asylum patients. Less big changes then public option was even among democrats a hard selling point.

[drakensoul]

How people can forget the deductibles have also gone waaay up is also hard to comprehend. Having coverage is not the same has having good and affordable coverage. My insurance plan for example, while at a lower increase rate recently in price, still is raising faster than the rate of inflation and if you count in the higher deductibles I have to pay, not sure it is slowed. :P

You mean people actually have to pay for the coverage? Is that the part you're having difficulty getting over?

In an average night of admitting 20 patients to the hospital, 10 of them are uninsured. They rack up an, on average, $30,000 hospital bill. That's $30,000 x10, or $300,000 that the hospital will never see. Every night, just from the people that I admit. How do you think they make that money up?

They charge the next person 80% more. Every time. They mark their prices up.

So now you have an insurance system which changes that to 4 being uninsured. That means $180,000 of the previously un-paid $300,000 is now going to be paid by insurance.

Of course the premiums go up, that's how the bill gets paid.

The benefit is that if the bill is paid now, hospitals won't have to jack their prices up 50, 60, 80% in the future to continue to account for the 50% of people they get zero money from. So yes, you'll pay a higher premium now. And the benefit is that everyone will benefit as a people, and your hospital bill won't be 80% more expensive (to pay for the 50% uninsured, no income) if you ever do end up being admitted.

Over time this will lower the cost of healthcare because the need for massive markups decreases since the number of people not paying goes down.

The burden is shifted to paying for services as they are rendered instead of basically putting them on credit and charging the next person who comes along 22% interest to make up for the guy who didn't pay his bill before.

And yet you think that's a failure in the system. No, my friend, that's how we start to fix it.

[Ghostpanther]

You mean people actually have to pay for the coverage? Is that the part you're having difficulty getting over?

In an average night of admitting 20 patients to the hospital, 10 of them are uninsured. They rack up an, on average, $30,000 hospital bill. That's $30,000 x10, or $300,000 that the hospital will never see. Every night, just from the people that I admit.

So now you have an insurance system which changes that to 4 being uninsured. That means $180,000 of the previously un-paid $300,000 is now going to be paid by insurance.

Of course the premiums go up, that's how the bill gets paid.

The benefit is that if the bill is paid now, hospitals won't have to jack their prices up 50, 60, 80% in the future to continue to account for the 50% of people they get zero money from. So yes, you'll pay a higher premium now. And the benefit is that everyone will benefit as a people, and your hospital bill won't be 80% more expensive (to pay for the 50% uninsured, no income) if you ever do end up being admitted.

Over time this will lower the cost of healthcare because the need for massive markups decreases since the number of people not paying goes down.

I do not have a issue with paying for my coverage per say. Have for many years. But even from your points, it is clear the system we have now is not working well and the health care costs keep increasing each year faster than the rate of inflation. This is a trend which cannot continue. Other countries cost of health care for each citizen is much lower than the US is.

[drakensoul]

I do not have a issue with paying for my coverage. Have for many years. But even from your points, it is clear the system we have now is not working well and the health care costs keep increasing each year faster than the rate of inflation. This is a trend which cannot continue. Other countries cost of health care for each citizen is much lower than the US is.

I think you're missing the point that one of the reason prices are increasing rapidly is because of the number of uninsured people who do not pay. Of course the hospitals jack their prices up 900% when over half of the people who walk through and get expensive care don't pay for it.

Two things have to happen to fix it: Access has to be universal (so that you don't have large swaths of the population getting essentially free care and then transferring their bill to the next guy), and honestly we need a single payer system so the other aspect of price fixing and gouging doesn't work.

These are huge changes that will take time. There is no magic one-button fix. To think that implementing the ACA was going to, overnight, completely fix the healthcare system is ludicrous.

But the ACA is a large first step at fixing one of the huge problems. It's unfortunate people don't realize that.

[Macaquerie]

I do not have a issue with paying for my coverage per say. Have for many years. But even from your points, it is clear the system we have now is not working well and the health care costs keep increasing each year faster than the rate of inflation. This is a trend which cannot continue. Other countries cost of health care for each citizen is much lower than the US is.

Do you know why that is? I'll give you a hint - it sounds like what you'd call a couple gay guys going out to dinner.

[Gorsameth]

I agree with that. The mandate part of Obamacare is one of the things they need to leave out of any replacement. But health insurance is like any other type of insurance. Having it can make a difference of being saved from financial ruin.

Allowing signups with pre-existing conditions requires a mandate or only sick people will get insurance and no system can handle that.

If your not allowing pre-existing conditions then your stripping millions who are in need of the ability to get insurance.

[I Push Buttons]

Two things:
Add a public option by having Medicare compete with private insurers.

Have government directly negotiate prescription prices. (as other countries do to drive down these ridiculous drug costs)

That would do little overall.

I mentioned this in that thread about deregulating the healthcare industry, but ridiculous drug prices are a pretty small aspect of the overall huge healthcare costs in the US.

$324 billion was spent on drugs in 2015. 80% of it was already generic. You could take that remaining 20% that encompasses expensive name brand drugs and lower their costs significantly, make them free even, it would be largely irrelevant.

It would lower healthcare spending from $3,200,000,000,000 to a whopping $3,140,000,000,000.

[paralleluniverse]

I disagree. I still think it can be done without a mandate. Having a stronger economy and at the same time, putting in controls on health care costs can make it more affordable The health care industry right now is taking the people in the US to the cleaners. Limit what they can charge based on the rate of inflation. They are in the business of health care, which is not a industry they should be allowed to take advantage of people in need of thier coverage. It has been done before with energy prices.

Wow, clueless GOP thinking.

Without a mandate, only the sick will buy in, while the healthy wait until they're sick to buy. That means the cost of covering those who buy insurance will be through the roof because it's not offset by the premiums of healthy people. This is a price death spiral because the high price drives out the healthy even more, which makes the risk pool even sicker, which increases the price further. If you then put in price controls, then insurers will go out of business as their costs go through the roof.

Price controls for energy was an economic disaster and caused massive inflation.

Contrary the the lies that Trump tells you, it cannot work without a mandate.

And btw, ACA already controls the % of premiums that must go to covering healthcare costs, which varies from 60% of bronze plans to 90% for platinum plans. It's already regulated.

[Ghostpanther]

I think you're missing the point that one of the reason prices are increasing rapidly is because of the number of uninsured people who do not pay. Of course the hospitals jack their prices up 900% when over half of the people who walk through and get expensive care don't pay for it.

Two things have to happen to fix it: Access has to be universal (so that you don't have large swaths of the population getting essentially free care and then transferring their bill to the next guy), and honestly we need a single payer system so the other aspect of price fixing and gouging doesn't work.

These are huge changes that will take time. There is no magic one-button fix. To think that implementing the ACA was going to, overnight, completely fix the healthcare system is ludicrous.

But the ACA is a large first step at fixing one of the huge problems. It's unfortunate people don't realize that.

Some good points. But the ACA was overall a failure to address the main issue of health care costs. Price increasing at a much higher rate than is necessary.

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Do you know why that is? I'll give you a hint - it sounds like what you'd call a couple gay guys going out to dinner.

I do not know what the hell you are talking about. Not in the habit of thinking bad about gays. :P

[drakensoul]

Some good points. But the ACA was overall a failure to address the main issue of health care costs. Price increasing at a much higher rate than is necessary.

It's like talking to a wall.

The healthcare costs are in part a reaction to the uninsured rate, and it will take time to fix that. The fact that the ACA went into effect and you didn't see it immediately correct itself doesn't mean anything other than you haven't been patient enough, and haven't let the ACA develop more because you're too hardheadedly set on killing it.

Another problem is people who have zero connection to or understanding of the healthcare system think that they know what it needs and why it isn't working.

Trump doesn't have a clue. He thinks he's going to negotiate prescription drug prices and let people buy insurance across state lines (like, say, United and Blue Cross already do) and that's going to fix it. This is laughable.

[paralleluniverse]

Allowing signups with pre-existing conditions requires a mandate or only sick people will get insurance and no system can handle that.

If your not allowing pre-existing conditions then your stripping millions who are in need of the ability to get insurance.

We tried to explain, but he doesn't get it.

The GOP have duped him into their magical fantasy where the rules of logic don't apply.

[Gorsameth]

Some good points. But the ACA was overall a failure to address the main issue of health care costs. Price increasing at a much higher rate than is necessary.

American costs are (in part) so high because there are many uninsured people.

Insurance works based on cost spreading. X people will get sick, costing Y dollars. So you need W amount of people paying Z to cover Y. The bigger W is the smaller Z can be.
The mandate assures the greatest possible spread by requiring everyone to be insured. Thus leading to the lowest cost.

[Ghostpanther]

Wow, clueless GOP thinking.

Without a mandate, only the sick will buy in, while the healthy wait until they're sick to buy. That means the cost of covering those who buy insurance will be through the roof because it's not offset by the premiums of healthy people. This is a price death spiral because the high price drives out the healthy even more, which makes the risk pool even sicker, which increases the price further. If you then put in price controls, then insurers will go out of business as their costs go through the roof.

Price controls for energy was an economic disaster and caused massive inflation.

Contrary the the lies that Trump tells you, it cannot work without a mandate.

And btw, ACA already controls the % of premiums that must go to covering healthcare costs, which varies from 60% of bronze plans to 90% for platinum plans. It's already regulated.

You know you can make your point better without resorting to petty insults.

I am still against a mandate as such in the ACA and nothing you have said has changed that opinion. There are better ways to do it.

[Gorsameth]

You know you can make your point better without resorting to petty insults.

I am still against a mandate as such in the ACA and nothing you have said has changed that opinion. There are better ways to do it.

"There are better way"

Name a better ways, or any country in the world running a better way.

[Ghostpanther]

American costs are (in part) so high because there are many uninsured people.

Insurance works based on cost spreading. X people will get sick, costing Y dollars. So you need W amount of people paying Z to cover Y. The bigger W is the smaller Z can be.
The mandate assures the greatest possible spread by requiring everyone to be insured. Thus leading to the lowest cost.

So you saying controlling the costs of health care has nothing to do with it? Germany has better coverage which has no bearing on controlling drug costs?

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"There are better way"

Name a better ways, or any country in the world running a better way.

Germany? Like I said, I may be missing something about them, but their system sounds like a good one.

[drakensoul]

There are better ways to do it.

I'm just curious what your expertise is to be able to make that judgment. Do you have any relation to the healthcare field at all?

You've said there are better ways to do it at least 5 times but haven't actually said what any of them are.

What better ways?

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Germany? Like I said, I may be missing something about them, but their system sounds like a good one.

Germany is a country, not a way to improve healthcare.

Germany is vastly different, do you know anything about their system? Or you're just spouting off that it's better with zero clue of what it actually is?

The ACA is a step toward being more like Germany.

[Gorsameth]

So you saying controlling the costs of health care has nothing to do with it? Germany has better coverage which has no bearing on controlling drug costs?

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Germany? Like I said, I may be missing something about them, but their system sounds like a good one.

Health insurance is compulsory for the whole population in Germany.

https://en.wikipedia.org/wiki/Healthcare_in_Germany

Want to try again?