Should Obama care be repealed?

[luv2]

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

[DeeAngel]

At 63 it's actually other people are subsidizing your costs, not the other way around. The per-person healthcare costs of those 60-65 are many times that of someone in their 20's, but thanks to the ACA insurers can't make your premiums 6 or 7 times that of someone in their 20's, even though that's what would be required to keep 20 somethings from subsidizing your insurance, instead they are capped at 3 times that of a 21 year old policyholder.

You seem to be comparing your pre-ACA individual market plan to what's available now, which is an apples and oranges comparison. In the pre-ACA individual market, plans rarely covered major costs, so you were basically paying less for something with almost no actuarial value.

You've been paying to SS and Medicare, which doesn't kick in at only 63, I think maybe you should have calculated your costs a bit more before retiring at 63. Bronze plans are required to cover generic meds with just a copay prior to the deductible being met, so you might consider generics.

I take generic Wellbutrin and Ventolin but there is no generic Symbicort and that is a $300.00 inhaler. All the other inhalers that are equivalent from other manufacturers (all brand name only) are very close in price. I guess I'm going to have to look into getting the inhalers from Canada. I'm just so sick of this BS.

[DaphneMH]

While Obamacare may have a few kinks, the truth is that universal healthcare would not EVEN be a point of dissention if it were not first initiated by Democrats. The replace part is an acknowledgement that there would be an angry populace if the rug was pulled. The powers that be just don't want Obama's name attached to it. It's a "progressive" concept for a reason.

[HopefullNurse17]

While Obamacare may have a few kinks, the truth is that universal healthcare would not EVEN be a point of dissention if it were not first initiated by Democrats. The replace part is an acknowledgement that there would be an angry populace if the rug was pulled. The powers that be just don't want Obama's name attached to it. It's a "progressive" concept for a reason.

I said this earlier in the thread but I honestly think that was the true intention of the ACA. It has been obvious for some time that there is something incredibly wrong with our healthcare system, a lot of countries do it better and for a lot less money. The answer seems to lie in Universal coverage whether that be a total universal system or some combination of public and private like some countries have. Our system was way too entrenched to change overnight, the Democrats saw this as a necessary first step. I'm sure they were hopeful that Hillary would get elected, they would get the Senate and they could start on some tweaks to go further towards Universal coverage and cost-saving, too bad that plan fell out the window.

[Jolie, BSN]

Bronze plans are required to cover generic meds with just a copay prior to the deductible being met, so you might consider generics.

Source please? Effective date please?

[smartnurse1982]

Trump's plan to purchase insurance across state lines seems like it might work.

[elkpark]

Trump's plan to purchase insurance across state lines seems like it might work.

Might work how? (And it's a Republican idea that's been around for a long time, not just "Trump's" idea.) It's important to understand what that means. It's always been possible to "purchase insurance across state lines." Over the years, I've been covered by many insurance companies that were not based in my home state. The big insurance companies have been offering policies all over the US for many years. What the Republicans are talking about is eliminating the ability (the right) of individual states to establish and regulate standards for insurance offered in the state to the state's residents, as states have always done, to protect the rights and wellbeing of the state's residents, and allow insurance companies to offer whatever kind of cheap, useless insurance policies they want. A lot of people who know a lot more about this than me have argued for years that this proposal would produce a "race to the bottom" among insurance companies. Once again, for a party that seems to carry on a lot about "state's rights" and the evils of "federal government power grabs," they are always might quick to throw states under the bus when it comes to accommodating the desires of their well-heeled corporate friends. One of the GOP's big complaints about the ACA is that it takes away states' right to make choices about healthcare coverage for their own citizens, that make sense for the individual states, by dictating what has to be covered by insurance policies, but the GOP wants to do exactly the same thing, just in the opposite direction -- remove the right of states to establish standards within their own boundaries, for their own citizens.

[Cowboyardee]

Trump's plan to purchase insurance across state lines seems like it might work.

What does 'work' mean in this context? What major problem does it solve?

The problems with the American insurance system have been pretty well understood for a good while now:

- Insurers, middlemen, and claims investigators take a big cut of healthcare spending and contribute nothing directly to medical care. (Of course, other systems have their own bureaucrats, but still...)

- For insurance to be an economically viable model, insurance companies either need to be able to reject new applicants who have pre-existing conditions OR to have some kind of guarantee that the young and healthy members of the population will not forgo insurance until they are sick. If too many healthy people opt out of insurance, then insurance plan prices rise too high for those who do buy in, which then encourages even more people to opt out of insurance, raising prices even higher. This is the much anticipated insurance 'death spiral' so many articles have been written about.

- Price of most healthcare services is effectively hidden from consumers via insurance plans, offering no downward pressure on prices as you would see in most viable markets.

- The US lacks the central bargaining power that countries with nationalized healthcare have (and have actively outlawed such bargaining power where we might have it, such as with medicare's ability to bargain against drug companies), with the predictable result that we pay vastly more for many medical devices, tests, drugs, etc than the rest of the world does and functionally foot the bill for R&D and corporate profits for many multinational corporations.

- Since the poor are entitled to emergency medical services regardless of their ability to pay, those costs are redistributed to those who do pay for insurance. But since insurance cost is not (by and large) scaled for income, the bill for American healthcare functions essentially as a HUGE non-progressive tax that simply clobbers the middle class. Compare this to other nations which pay for healthcare via taxes, which do scale with income.

These problem have all existed since before the ACA. The ACA did not address all of these problems. It was a compromise in the first place. It did, however, address some of them. Not always well, but it was an attempt. My concern (and the concerns of just about anyone paying attention) is that the Republican plans will fail to address ANY of these systemic problems. I hope I'm wrong. But I fail to see what reducing state regulations with respect to insurance accomplishes in terms of making the American healthcare system more viable.

[Susie2310]

Why not just raise taxes and expand Medicare to everyone?

[Cowboyardee]

Why not just raise taxes and expand Medicare to everyone?

First and foremost because it's politically non-viable. Might change in the future, but the most recent elections moved the balance of power in the opposite direction from any kind of universal payment system. If it was non-viable during Obama's early presidency when the democrats had control of congress, it's not even in the discussion now.

[Susie2310]

First and foremost because it's politically non-viable. Might change in the future, but the most recent elections moved the balance of power in the opposite direction from any kind of universal payment system. If it was non-viable during Obama's early presidency when the democrats had control of congress, it's not even in the discussion now.

Yes, I understand the politics. But my point is this could be done relatively simply if there was the political will.

[Beldar_the_Cenobite, CNA]

The one thing I don't like about it is you can't choose to not have health insurance. I have the VA, so the IRS and anyone else in charge of monitoring those who don't apply for ACA or provide the feds with their own private insurance can look at the direction of my hand that leads them out the door. When I worked low paying jobs, I refused health insurance because I didn't want a lot of money coming out of my paychecks because I couldn't afford to have benefits when I had to survive. I don't know if low-income people have the ability to qualify for section 8 to offset the cost of rent they have to pay so they have some money in their pocket they can use to buy things they need, but I think the ACA law is a little too harsh.

I know I'm giving my two cents while having the VA for health insurance but even if I won the lottery tomorrow, the VA would have been like "You make too much money, you can afford your own health insurance". I'm not sure if the disqualification rule is still in effect where if you make over 80K a year, they disqualify you from health care.

[smartnurse1982]

The one thing I don't like about it is you can't choose to not have health insurance. I have the VA, so the IRS and anyone else in charge of monitoring those who don't apply for ACA or provide the feds with their own private insurance can look at the direction of my hand that leads them out the door. When I worked low paying jobs, I refused health insurance because I didn't want a lot of money coming out of my paychecks because I couldn't afford to have benefits when I had to survive. I don't know if low-income people have the ability to qualify for section 8 to offset the cost of rent they have to pay so they have some money in their pocket they can use to buy things they need, but I think the ACA law is a little too harsh.

I know I'm giving my two cents while having the VA for health insurance but even if I won the lottery tomorrow, the VA would have been like "You make too much money, you can afford your own health insurance". I'm not sure if the disqualification rule is still in effect where if you make over 80K a year, they disqualify you from health care.

If Obamacare did not force people to have health insurance,then who would treat these people if they had an emergency?

The ER?

No,they do not treat people for free.

Someone has to eat the cost even if you didn't want to.

Too many people think the care provided in the ER is free.