So did we really repeal and replace
- Thread starter sammyk
- Start date
No and no. It's a half baked bill that isn't near what it will look like in the end. This is just to take some heat off of the party and President. What was presented yesterday will hurt the poor and the sick and give tax breaks to the rich. And without the mandate Trumpcare will be unsustainable.
Obamacare wasn't sustainable either so nothing gained with this. In all honesty as bad as it may sound the Federal Government should've never got involved with health care. Obamacare was a terrible idea & now the country is paying for it.
The U.S. spends far more of its GDP on healthcare than any other developed country and its health outcomes are mediocre at best. In recent years the cost curve has been bent to some degree and there has been some improvement in relation to some outcomes--partly as a result of the ACA. The notion that American healthcare is superior to that of healthcare elsewhere is a notion dear to the hearts of some, but it has no basis in fact. (Of course some people get excellent care, but a great many don't.)
If you don't think the federal govenment has an important role in healthcare, I hope you are prepared to say goodbye to medicare or, if you are a veteran, to the healthcare services offered through the VA.
Should have let it alone with one change. Let companies go outside of their home state to purchase the insurance and you would see prices fall. Competition. Pretty simple!!
And remain the only country in the world where you can lose your house if you get sick.
I just watched a GOP leader say about someone in chemo therapy for cancer who may lose her coverage, that she could go to the ER. Pretty sure they don't administer chemo there.
The Affordable Care Act allowed people to buy policies in other states: https://www.washingtonpost.com/opin...a6ed597e4ca_story.html?utm_term=.d5c15cef0b75
Nope. They are not allowed by federal law (ACA law) to go outside the state lines. Now if the company has sites in different states, that's a different story. But my company which is located only in Penna. is not allowed across state lines.
Companies Tulla, companies. The majority of people with healthcare coverage in this country get it through work.
Two thoughts. The Reps have voted to pull the ACA 70+ times and have had 7 years to put their plan together and it's not ready?
Also, why are they ramming it through before the CBO? The ACA was debated for 9 months and the Reps cried that wasn't long enough.
Also, why are they ramming it through before the CBO? The ACA was debated for 9 months and the Reps cried that wasn't long enough.
Because the Congressional Budget Office is even less effective than you. And they are putting it through quickly because they need to get Obama's mess out of the way before taxes are cut. Obamacare was rightly debated for a long time because everyone (except you) knew that it was horrible legislation, which has been proven to be true. Don't worry, your paycut is coming later this year!
"Why are they ramming it through........."!!?? What about Pelosi on the last go round. "Let's pass it so we can see what's in it!" What's past is prologue!!
Third Party 2018!!!!
All three of those people are going to be pissed off. Seriously, reluctant, 64 years old and making $25,000, did you think about that before you posted? Of course not.
Tax breaks to the rich? What did you say when Obamacare went in and the so-called rich had to pay a huge tax for Medicare? Nothing because you were ignorant about it. I paid $15,000 in Medicare tax last year. That subsidized your healthcare. You're on your own now!
Tulla, you seriously had the #$*$*)% to use a Catherine Rampell article. I would hope that you would know better than to expect legitimate reporting from her. It's almost comical, actually! At the beginning of the article, she states that it's a "dirty little secret" that Obamacare gives Americans this freedom. It doesn't. That statement implies that Americans are free to choose. They aren't. Obamacare allows states to form pacts with each other.
However, later in the article, which you apparently didn't read past the "dirty little secret" part, Rampell clearly states that "but, to date, none has materialized. Let's do some basic thinking; Obamacare has been with us for about eight years, yet no states have been able to join together to form one of these pacts. What does that tell you?
What a total BS article. Now, after reading this article, how can one come away thinking that the author and the newspaper that is behind her, made any effort to provide a fair investigation of the situation?
The VA? Tulla, I don't think you want to mention those two letters, not after Obama's debacle in managing it or mismanaging it, more accurately. Again, another disaster that should have been front-page news.
How much do you know about the healthcare provided by the VA? I would say that on the whole it does a pretty good job. Whether you are measuring health outcomes, efficiency, or patient satisfaction, their scores are pretty good.
And about selling health insurance across state lines, the ACA didn't prohibit it. That was the point Rampell made that I thought was relevant to the above discussion. Remove national standards and selling insurance across state lines really will turn out to be a race to the bottom. Now, of course, Trump and Co. are beginning to understand that healthcare is complicated. Trump wants to trash the CBO. Who else is going to offer a non-partisan assessment of the cost of the bill now in the house? Why would you want to make such a massive change without costing it properly--unless you were worried what the costing would reveal?
Do you support the bill Ryan is calling the "last chance" to fix healthcare? I think the ACA is quite flawed but is better than what is being proposed, which is incoherent, and it would appear that many Republicans in the House and Senate have the same view.
It took something like 9 months for the ACA. And now all of the sudden the CBO doesn't know what they are doing. When it came to rating the ACA the Reps said it was the Bible.
In the last 24 hours I've hear Reps say we may need to decide between a new iPhone and healthcare. I heard another say a woman going through chemo who may lose her insurance under Trump should go to the ER.
Keep in mind all these guys have free healthcare for life.
In the last 24 hours I've hear Reps say we may need to decide between a new iPhone and healthcare. I heard another say a woman going through chemo who may lose her insurance under Trump should go to the ER.
Keep in mind all these guys have free healthcare for life.
How much do you know about it? Perhaps it would be a good idea to give me some examples, not individual cases, but actual patient satisfaction scores. Maybe all of the stories of poor or delayed care and mismanagement by Obama were just untrue.
Explain what point Rampell was making. Seemed to me that she was trying to debunk the fact that it couldn't operate across state lines, only to admit later that no states had formed pacts despite having had eight years to do so. Tulla, I think you are a smart guy, but you avail yourself of very limited news sources and have your mind made up regardless of the outcome. You appear to judge the so-called intent of programs rather than the results.
Of course Trump wants to trash the CBO. They're incompetent. Their scoring is narrowly focused and wrong. Like so much of Washington, it's establishment BS. And Trump is here to break that establishment. People who benefit from it or those who can't think out of the box, or just those who fear the "what if", aren't going to be comfortable with this concept. So, I get where you are coming from. But you will need to buckle up for the ride; it's going to be pretty uncomfortable.
I don't know enough about the bill Ryan is proposing. I don't trust him much more than even a guy like Chuck Schumer. Unless you understand the entire bill, we should probably just let things play out.
Healthcare is something I do know a lot about. Overall, the VA does a good job. Of course, in certain specialty areas they are going to have a hard time competing with the richest hospitals and healthcare systems that are much more reseach-intensive and can offer high -profile clininian-researchers elaborate labs and other supports, etc. The VA also has a problem that it is an easy target for many politicians who want to be seen as champions of Vets, which entails decrying what the VA provides in terms of health services. For instance, in the last few years far more effective drugs for Hep C have become available. The huge Vietnam generation is on the one that is learning that many in the group have Hep C, which can be really serious. That group makes up an especially large part of the VA client base. Now the problem with the new drugs, the most well-known of which are produced by Gilead, is that they are hugely expensive--sometimes around $1,000 per pill. Fortunately, the VA can do what Medicare can't --negotiate prices--but the price is still huge. The VA would like to treat everyone with Hep C regardless of fibrosis stage, but that would mean the whole VA drug budget would go up in smoke. So they set up a triage system--the patients with the most advanced disease get treated first. Guess what? Lots of congressman yelled and screamed that the VA was failing vets, yet most of those who complained were voting against proposals to increase the VA's healthcare budget, increases needed to pay for the Hep C treatments.
I've looked at the satisfaction surveys for the VA hospitals. Some think they show quite high rates of satisfaction; some think not all the most important things are being measured. This is a problem rooted in the U.S. Healthsystem. Hospitals use different measures, blow their horns about the results they like, "our docs are tops," and bury the results they don't. I'm more focused on community-based healthcare, homecare, etc. and here the VA does quite well. A week ago I went to a meeting in D.C. (not sponsored by a govt body but by doctors' organizations and private foundations) where we looked at a number of local programs across the country. One of the best was the VA Greater Los Angeles Healthcare System. The preenter, Dr. Lisa Rubinstein, had tons of data about their outcomes and about what the system's patients thought about their care.
I could list lots of other examples, but the point I would want to make is that the U.S. has by far the most expensive healthcare system--of course it's not a system--in the world and we get mediocre (at best) results. There's no doubt that the U.S. offers outstanding services and care in some high-end areas and there are some quite good pieces in the system--I like Kaiser Permanente--but the system is too oriented toward benefiting insurance companies, drug companies, and physicians and physician groups. (Solving the problem of new docs coming out of residency programs with half a million dollars or more in debt would help.) The ACA went part-way to addressing the underlying problems--with some really valuable structural and cultural changes resulting, as Dr. Don Berwick recently said, i.e more progress in the last 3-5 years than in the many previous decades--but what Trump/Ryan are proposing will only move us backwards. There's a reason the AHA, the AMA and dozens of other healthcare organizations and professional associations are opposing it.
Good insight, Tulla. Much appreciated. I do need to give more consideration to the degree of difficulty that is involved when managing the VA. Good points on Gilead and the Solvaldi drug, although it does need to be stated that Solvaldi is a cure, not a drug that patients need to take for life. Still, congressmen are phonies when they complain about the very things that they are limiting.
There is always going to be someone or some constituency that is going to be unhappy with how healthcare is administered. No doubt that healthcare is the most expensive in the US, but I'd disagree with our statement about us getting mediocre results. Regarding the cost, Trump is possibly the guy to negotiate drug costs lower and convince drug companies to provide lower pricing in the USA, while charging higher prices overseas. The difference between Solvaldi in the US and India was vast. How could Trump do this? Basic threats for one, and offer potential fast approval times for new drugs in exchange for lower pricing. The key to faster approval times is to continue to have relatively safe drugs on the market.
Did you back off on the concept of crossing of state lines? No mention of it in your most recent post. It's clearly not individuals who can elect to do this. I think Rampell gets a check from the Democratic Party, in addition to the Washington Post. That is bias that is hard to duplicate.
"Everyone will be covered and the cost will go down." -- Trump
24 million will lose coverage under Trumpcare -- CBO (which according to the Reps was accurate when looking at the ACA, but somehow now is not to be trusted).
24 million will lose coverage under Trumpcare -- CBO (which according to the Reps was accurate when looking at the ACA, but somehow now is not to be trusted).
Well at least the rich will get a tax break so not all is bad. But check this out. If you are older and poorer you get the shaft baby at least all of those old people who voted for Donny will have a nice red hat to wear
http://kff.org/interactive/tax-cred...-act-vs-replacement-proposal-interactive-map/
http://kff.org/interactive/tax-cred...-act-vs-replacement-proposal-interactive-map/
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Also good news is I've watch a few town halls with Trump voters in Kentucky and West Virginia and they seem to already have Trump and the GOP on a short leash. Buyers remorse has kicked in.
Go back and check; I've always said that the CBO was incompetent. Heck, it's a bureaucratic Washington organization!