Should Obama care be repealed?

[luv2]

[h=1]another poll question?[/h]

[MrNurse(x2), ADN]

For those nurses that are covered by an employer plan, be aware that in the next few years the ACA mandated ALL new employees, every job, every state, to be on an ACA plan. Employer plans were going to be killed off by attrition. That meant that great plan you get through your employer would be 5-10 times what gets withheld from your check. I really did read the plan. Most of the worst had yet to be implemented.

[llg, PhD, RN]

Many of us (including the Obama Administration) ... have been saying all along that the original legislation has needed to be tweaked. Unfortunately, the previous Congesses would not agree to that -- they wanted an "all or nothing" approach to fixing it and would not allow many adjustments to be. The "repeal or nothing approach" meant that many known problems could not be addressed.

Also, the success of the program depended on cooperation from the state governments. My understanding is that where the states cooperated, thing have gone better. In states that refused to cooperate, it has gone worse. Thus, overall, there have been mixed results.

I leave it to you to speculate as to why the Republican Congresses and some "red states" would not allow Obamacare to be improved while Obama was still in office.

[Extra Pickles]

Repealing without replacing?

GOP senators outline first Obamacare replacement plan

[Daisy4RN]

I think that the Healthcare system before the ACA needed some work. I think the majority of problems could have been fixed without repealing the previous system and implementing the ACA before even reading it (as some politicians admitted). At the very least they should have tried. Now that we have the ACA we see it is not working either, more people affected negatively than those helped. What ever you want to call it (repealed, replaced etc) it needs to be fixed. There are many options but whatever they do I hope somebody reads it first this time!

[NursieNurse14]

Social Security is not a hand out. We pay into social security and we get it back it is not welfare.

[MunoRN, RN]

For those nurses that are covered by an employer plan, be aware that in the next few years the ACA mandated ALL new employees, every job, every state, to be on an ACA plan. Employer plans were going to be killed off by attrition. That meant that great plan you get through your employer would be 5-10 times what gets withheld from your check. I really did read the plan. Most of the worst had yet to be implemented.

No such requirement exists in the ACA, employers are not being required to place new employees in a marketplace plan, they're not even allowed to if they wanted to. Small businesses can choose to utilize the SHOP marketplace plans (Small Business Health Option Program) which is somewhat similar to the individual ACA market plans, and as a small business owner this is a huge improvement over what was available to me in the past.

And ACA plans are not "5-10 times" that of employer provided plans, which averaged $14k a year for a family plan even before the ACA, an ACA marketplace plan with similar coverage and deductibles averages just over $12k.

The ACA is far from my first choice for how to reform healthcare coverage, but just repealing it wouldn't help anything, according to the CBO it would raise premiums up to 25% above what they already are in the ACA marketplace, and there would be an immediate increase in number of uninsured of 18 million, rising to closer to 30 million in a short period after repeal.

[MunoRN, RN]

We probably have widely varying reasons why we don't like the ACA, but at least people generally agree we could do better, so what would you all change?

[TriciaJ, RN]

One of the biggest drivers of healthcare cost is liability coverage. When is someone going to address the issue of tort reform?

[Tenebrae, BSN, RN]

I voted no, however I've said all along the affordable healthcare act doesn't go nearly far enough.

The system in my country is far from perfect, however at least I can be secure in the knowledge that should I end up with an injury that inhibits me from working, or an illness or terminal illness I wont face bankruptcy or leaving my family a legacy of debt

[AvaRose]

All I know is Trump has already started to repeal the ACA and when it is gone I will be back to having no insurance as my currently affordable plan through my employer will jump from $75 a paycheck to at least $400 a paycheck. Then again I'll be working for now anyway as Trump has also vowed to basically eliminate Social Security (not sure he'll succeed but it would only take a few executive orders for him to try to drain the SS funds probably to pay for his "wall" since Mexico sure as heck won't pay). 20 years of payroll deductions gone...

[sallyrnrrt, ADN, RN]

I challenge any of the above posters to describe one person they know well who has worked hard all his or her life and whose health has deteriorated over the last fifteen years since they saw a physician for lack of health insurance. I challenge them to describe an elderly person they know personally who would be on the streets or dead without the "handout" that is Social Security. I challenge them to describe what their life was like when they themselves had, say, a soft-tissue infection that went untreated for months because they couldn't afford self-pay without health insurance. I challenge you to describe the daily life of an accident victim whose money is gone and who sits right now in a darkened room in a third-rate SNF rotting away.

I assure you that I know all of those people personally, and have been among them myself. The first guy earned less than $24,000 last year; he is among the working poor but the health plan I got him into has subsidized ("handout?") premiums which have allowed him to have both medical and dental care for the first time in more than fifteen years. This, in turn, has not "bankrupted" him, but made it possible to keep working.

If you don't know these people or see them regularly in your work, you have no business whatsoever shooting off your mouth about what a "disaster" the Affordable Care Act is and how it hasn't done anything of substance. What was it supposed to do? What has it done? Dropped the uninsured rate to its lowest level EVER in this country. Dropped the childhood uninsured rate to less than 2%. Made it possible for millions and millions of people to be immunized, have cancer screens, get routine dental care, have reliable contraception, get medications for chronic conditions like diabetes, COPD, MS, CP, and others. And why do you think the insurance companies aren't screaming to make the ACA go away? Because they're making money, too.

OK, you want to wave a wand and make that all go away? Maybe it's easy for you to say that....because you don't know anybody for whom it has been life-saving. I do. Look around you, see those people you ignore on the streets or in your ERs or your children's school cafeteria. And tell them it's all gone. And you-- will you help them then?

I actually see see the multitude of patient situations you propose every week in my clinic....

[AliNajaCat]

One of the biggest drivers of healthcare cost is liability coverage. When is someone going to address the issue of tort reform?

This is actually not true. The biggest drivers of healthcare costs are related to the lack of regulation and negotiation for costs as paid by a national health service for all citizens. Costs for Medicare are more regulated, e.g., a hospitalization cannot be billed for more than a specific amount for a Medicare patient, and the patient cannot be balanced billed. For medical devices and drugs, prices are pretty much whatever the market will bear. The same total hip replacement manufactured in the US and sold world-wide will cost you thousands of dollars here....and $56 in Belgium, where they're all bought by the national health service. This has nothing to do with liability (although this is a frequent distractor by people who don't want to see profits decreased).