Obamacare? what are your thoughts

SycamoreGuy · Apr 26, 2014

Oregon just dropped their state exchange. What other state will follow suit?

toomuchbaloney · Apr 26, 2014

Oregon just dropped their state exchange. What other state will follow suit?

Obama administration prepares to take over Oregon's broken health insurance exchange - The Washington Post

Behind the scenes, the officials say, federal and Oregon officials already have agreed that closing down the state marketplace is the best path to rescue what has been the country’s only one to fail so spectacularly that no resident has been able to sign up for coverage online since it opened early last fall.

Some of the state-run marketplaces have prospered, including California’s, Connecticut’s and Kentucky’s. But others have been failures, placing a political stain on Democratic statehouses that were among the most enthusiastic in embracing the federal health-care law. In addition to the three states that are currently the focal point of administration officials, exchanges have faltered in a few other places, including Hawaii and Minnesota.

Probably the next to follow will be one of the remaining states with an exchange that is struggling.

Not_A_Hat_Person, RN · Apr 26, 2014

Twenty six other states, all of which opted out of the ACA, use the federal exchange.

Delicate Flower · Apr 27, 2014

Of course shopping around doesn't work now. That's not how the system is set up. It is set up to cater to insurance companies and Medicaid/Medicare plans, not individuals with a limited amount of money looking for a good deal.

It costs providers a lot to deal with insurance companies too, and of course there is all the profit that insurance companies make. If we are talking about cutting costs without cutting care, I think that is what needs to be looked at. There is so much freaking waste in this industry where everbody is crying about high costs. It doesn't make sense to look at one and not the other.

Covering preventive care to save cost certainly has merit, but there are much cheaper ways to do at least some of that in my opinion. Blood pressure, cholesterol, and blood sugar check clinics to be a start. I like the idea of cash-only primary care. There is a practice like that here in NC. Access Healthcare You pay an annual membership fee of $459, which includes a physical and annual screening labwork/tests, and then if you need to be seen in the office for illness it is only $20.

I think the reason the high deductible bothers me so much is there is a high premium to go along with it, and most plans also have pretty hefty coinsurance. I feel like if I want catatrophic/high deductible insurance, then I want to be able to use my monthly cash reserves- which I would have thanks to a relatively low premium - to take care of my health how I see fit, and then if something really bad happens, I pay the high deductible and get the care I need.

I can hear Muno in my head chastising me that I am basically saying I only want to pay for my own healthcare, not anyone else's, and the system can't work like that. Maybe not. But can the system work with middle class workers paying for everyone else's healthcare but their own? (an exaggeration and generalization, but you get the point). I think if we as a country decide that we want to take care of everyone's basic health needs, as a society, we should all have to pay for it. a.k.a Taxes. Progressive taxes. And for goodness's sake, cut the connection between employment and health insurance.

sMoLsNurse · Apr 27, 2014

I go to work everyday in order to provide for myself and my family. I went to college and received two bachelor's degrees in order to this, and I paid for all of it. I'm furthering my education in pursuit of a master's degree, not for grins and giggles, but to better provide for my family, and I'm also paying for this. We also work in order to have health insurance, money to save for retirement, an employer sponsored retirement plan, and a host of other benefits. As a conservative, if you want it I believe you should have to work for it too.

Did you receive pell grants for your college education? Many people would consider that to be a "government handout" as well...

DoGoodThenGo · Apr 27, 2014

It's another tax on the middle class. The Obamacare was a conservative right-wing agenda.

Democrats for decades going back to the great "Liberal Lion" Ted Kennedy have been fighting for a universal healthcare scheme in the USA. The Clintons came close but got beaten back by various vested interests and others who thought that would be the end of such "nonsense". Then came the little upstart AA political wunderkid/superstar, Obama.

Not only did the African American Obama manage kick the all but then assumed coronation of Mrs. Clinton and return of that family to the WH, but he stole much of her thunder on social issues.

Unlike the Clintons who hemmed and hawed about a return battle to "Clintoncare" or whatever it was called , Obama stuck to his guns and despite what emerged not being all that the Democrats/liberals would have wanted (universal healthcare), it was close enough to the mark to make them happy.

Persons need to make up their minds to two things, the two major social changes of the Obama administration healthcare and gay marriage are *NOT* going anywhere once he leaves office. Nothing is going to be repealed, cancelled, or whatever. I don't care if Bugs Bunny and Daffy Duck are the next POTUS and VPOTUS, that is just the way things are so people best stop thinking about such things and move on.

Going forward the questions are going to be how to make "Obamacare" work without bankrupting the federal and state governments. There is also still more, much more to do in terms of not only assuring access to care but the quality of that care along with ensuring both patients and whoever is paying receives value for money.

What should happen and perhaps will in future is the federal government becoming far more aggressive in dealing with costs. This could mean everything from removing the laws preventing Medicare from establishing a formulary and negotiating pharmacy prices, to a host of other direct controls.

imintrouble, BSN, RN · Apr 28, 2014

To be blunt, I'm not saying that. I am, however, saying don't tax me so they may live.

I respect and value a person who says what they believe. There is no way to misinterpret the above statement. I like that too. The only way we can have an intelligent conversation about anything, is if both sides are allowed to voice their opinion. No matter how repugnant it is to the other side.

The question that arises from the above post, is one that's been churning for centuries.

The prodigal son comes to mind.

Should the person who works hard, makes tough choices, and does all the right things, have to pay for the person who squanders their potential?

toomuchbaloney · Apr 28, 2014

I respect and value a person who says what they believe. There is no way to misinterpret the above statement. I like that too. The only way we can have an intelligent conversation about anything, is if both sides are allowed to voice their opinion. No matter how repugnant it is to the other side.
The question that arises from the above post, is one that's been churning for centuries.
The prodigal son comes to mind.
Should the person who works hard, makes tough choices, and does all the right things, have to pay for the person who squanders their potential?

Not everyone who is poor has squandered their potential. The majority of the working poor would prefer to pay their own way and would work hard to accomplish that if given the opportunity. Our wealthy country should be in the business of investing in the people, the largest asset of the republic.

SycamoreGuy · Apr 28, 2014

Not everyone who is poor has squandered their potential. The majority of the working poor would prefer to pay their own way and would work hard to accomplish that if given the opportunity. Our wealthy country should be in the business of investing in the people, the largest asset of the republic.

Investing in people sounds great, if only it were that simple.

toomuchbaloney · Apr 28, 2014

Investing in people sounds great, if only it were that simple.

Nothing is a simple as we might prefer.

Investing in the citizens of the USA is not that difficult, however. Providing unemployment assistance and extending those benefits during a recession is an example of investing in the people. Some just prefer to categorize those efforts in less than flattering language. All of that money will be spent immediately in communities and businesses around the country. It is an investment that keeps people afloat until the jobs market catches up to the needs of the populace. It is difficult for me to understand how Congress can essentially do nothing concrete to create jobs and then abandon the unemployed American worker.

Similarly, providing low cost educational support for the working classes is an investment in the people. Subsidizing child care for working moms, another investment. SNAP benefits are an investment in the health of our citizens who are "food insecure".

MunoRN, RN · Apr 28, 2014

I respect and value a person who says what they believe. There is no way to misinterpret the above statement. I like that too. The only way we can have an intelligent conversation about anything, is if both sides are allowed to voice their opinion. No matter how repugnant it is to the other side.
The question that arises from the above post, is one that's been churning for centuries.
The prodigal son comes to mind.
Should the person who works hard, makes tough choices, and does all the right things, have to pay for the person who squanders their potential?

I think the statement you're referring to pretty well captures the contradictory views I think we'd all like to believe were possible to exist simultaneously.

I don't think anyone argues that ideally everyone would get the care they need, particularly life-saving care, and yet it wouldn't cost the system anything. In reality however that simply isn't possible, so while the statement is clear, it's not rational.

imintrouble, BSN, RN · Apr 28, 2014

Maybe I just don't see the big picture. I see the same drunks, addicts, and young adults with chronic illnesses, week after week after week. Changing nothing, and getting free health care via Medicaid.

I stand behind people who buy steak and crab legs with their LINK cards. It's a tired old story, I get tired of repeating it, just as much as some of you get tired of hearing it.

Maybe if I saw more of the working poor where I live, I'd be more on board with what some of you believe. But I don't. Very few of those who receive the services available, want to lose those services by getting a job. Or changing their jobs. Or advancing their education to attain a better job.

That's what I see where I live.