Should Obama care be repealed?

[luv2]

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

[taivin]

All I know is when it comes to health coverage many people think it should be free. I am one of those whose premiums doubled. It's been a disaster. I'm so glad that all the other people are getting free health insurance while I pay for it. Not happy. I was fine with paying $320 a month. That's the thing, a lot of people scream when they have to pay over $50 a month for coverage. I'm on a family plan. Obamacare was good for some but more of a disaster for those us who have to pay for their care. It's hitting the middle class hard. That's essentially what it is...take from the rich to give to the poor. The thing is; I'm not rich.

I voted for Trump

[shakes320]

The tort reform argument is patently false. Tort cases amount to about 2% of overall health care costs, whether settled out of court or take to trial.

[shakes320]

Thank you for this. "Don't have sex" is an inadequate, close minded, simplistic, solution to a complex problem. As HCPs, I'm sure we can do better.

[kbrn2002, ADN, RN]

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.

That is exactly the problem with people utilizing the ER as their primary source of health care. To many of them it is free.

People are seen in an ER regardless of ability of pay, and many of them do pay nothing for care received. For the hospital's financials the lucky situations are when the people utilizing an ER instead of seeing a physician in an office are covered through state provided insurance. At least then they receive some payment for services provided.

I work with a few CNA's that have state insurance for low income families either free or at a greatly reduced rate and I am appalled at the level of coverage they receive. As in it's crazy good insurance! They can see any provider for anything at either zero or very low cost. It covers all physicians, even specialists. It covers chiropractic, dental including orthodontics, vision, psych care, alcohol and drug addiction treatment and even holistic providers and faith based providers. Pharmaceuticals have either zero co-pay or at most a dollar or two no matter what med is prescribed.

Of course depending on what state you're in the provided insurance varies widely in what is covered and what is not but I am more than a little disgusted that the insurance for low income families where I live covers way more than what my insurance that I pay quite a bit for does. With my insurance I have a co-pay and am expected to pay the balance of the bill until my deductible has been met. Plus I am totally responsible for medical bills not covered under the policy.

I am not against providing health care for low income families but I sure wouldn't mind seeing some changes bringing their insurance coverage more in line with what most policies cover. It doesn't seem at all fair to me that people who pay nothing for insurance receive way more comprehensive coverage than people who pay a lot for their insurance.

Sorry for the rant. I didn't start to reply with the intention of going on and on about state provided insurance. Obviously it bothers me even more than I was aware that low income families receive way better medical benefits than I do.

[pat8585]

You know what would be great? Let ALL americans have the SAME health insurance plan that all the US senators and Congress people have.

I would be wiling to switch !

[chare]

You know what would be great? Let ALL americans have the SAME health insurance plan that all the US senators and Congress people have.

I would be wiling to switch !

You are aware the members of Congress purchase their Healthcare via the exchange, aren't you?

[pmabraham, BSN, RN]

And while HSA's are great, it's not possible to make them the sole way that we pay for healthcare. Even if we required that everyone save up $1 million dollars in their HSA, that would still need to be a deductible based plan with coverage beyond that million dollars.

Take a look at how much the U.S. government put into Obamacare during the 1st few years of its existence especially the 1st two years. That money could have funded $1 to $3 million per U.S. citizen for HSA's. Then have insurance ONLY for catastrophic events.

[chare]

Take a look at how much the U.S. government put into Obamacare during the 1st few years of its existence especially the 1st two years. That money could have funded $1 to $3 million per U.S. citizen for HSA's. Then have insurance ONLY for catastrophic events.

The US population for 2010 was ~309 million. Are you suggesting that the government subsidized Obamacare for 300 to 900 trillion dollars?

[AliNajaCat]

Obviously it bothers me even more than I was aware that low income families receive way better medical benefits than I do.

I don't know why you believe that, because it's not true. In the case of the gentleman I know best, he pays $80/month for his insurance via the state health connector (exchange). It was $40/month last year, but his income went up a little so he crossed over into the next higher income bracket for subsidy. That's out of a net income of less than $1000/month (I see his checks). So, that's about 8% of his income goes to insurance premium. What percentage is yours? If you earn $50,000/year, 8% is about $4000 per year, or about $333/month. We just had somebody here whining that hers was $260.

He has a $50 copay if he goes to an ER (which he had to do due to injury and a medical error in prescription for BP leading to syncope while driving the truck, twice last month). That's another $100, another 10% of his monthly income for that month. If you have a $100 copay, what percentage of your monthly income is that?

When he sees his MD, that's a $15 copay. Probably same as yours, but again, a higher %age of his income.

So... tell me how this is "way better benefits" than yours. You want to swap with him?

[Zooey72]

Neither the Republicans nor the Democrats are going to be able to make healthcare affordable because neither of them understand why it is expensive (or choose to ignore). To start with, health insurance is not healthcare. There is a finite amount of resources and adding more people without expanding the resources brings down the overall care of everyone. So the trick is to expand the amount of resources available, part of which means more doctors, nurses, CNAs etc. What is difficult about that is that normally if you have a shortage in a field all you have to do is raise the amount of money paid and more people will flock to that field. It is difficult to become a doctor or a nurse, and saying 'lets raise their pay by 10%' is not going to get more people to go through the hard things it takes to become a doctor/nurse (could work with CNAs though, they don't get paid nearly as much or have to go nearly as much school). So culturally if you want to bring the cost of healthcare down you need to have more younger people want to commit themselves to very difficult schooling after high school. That can be a hard sell, esp. since more people coming into the field will depress wages.

The other component to this is technology. In the 80's when cell phones first made their appearance only the very rich had them. If you don't have a lot of money you knew that was a 'rich person thing', and knew you could not afford one. Expensive healthcare is no different. I am willing to bet when Steve Jobs was sick he had the best money could buy in terms of healthcare. I also bet he owned several planes, yachts, buildings, etc. People can come to grips with the fact that rich people can have nicer things, but when it comes to their health (or life) they think they should have access to the same kind of care. This is not me being mean, but it just doesn't work that way. 30 years from now everyone will probably have access to the same care Steve Jobs received, but by than maybe they will have a cure for cancer and only the very rich can afford that. This not me being mean or callous, that is just economics. Rich people can afford expensive things first, and before anyone gets upset and says 'they shouldn't get them if everyone can't'. If there is no market for this cutting edge technology when it comes out, than it won't be invented. The reason the phone in your pocket can do the amazing things it can do is because some rich people in the 80's spent an insane amount of money to be able to carry around huge ugly phones that held a 15 minute charge. Smarter people on these boards can point out the same thing in terms of healthcare of what was possible only to the rich 30 years ago and what is now available to everyone today.

You can try the democrats way by splitting up existing resources to more people which lessens care for all. Or you can try the Republican way which is the free market can somehow get more people to want to become doctors and nurses (just rearranging the seats on the Titanic). Neither one expands the resources available, so neither one will work. If you want to fix it get more people to go into the medical prof. And that is a hard sell esp. for doctors who while they may make a lot of $ have to commit a decade or more of their lives to incredibly hard schooling where they get nothing but 100's of thousands of debt when they get out. Ultimately a doctor will make a heck of a lot more than your average person does, but our society does not believe in delayed gratification.

[Cowboyardee]

Neither the Republicans nor the Democrats are going to be able to make healthcare affordable because neither of them understand why it is expensive (or choose to ignore). To start with, health insurance is not healthcare. There is a finite amount of resources and adding more people without expanding the resources brings down the overall care of everyone. So the trick is to expand the amount of resources available, part of which means more doctors, nurses, CNAs etc. What is difficult about that is that normally if you have a shortage in a field all you have to do is raise the amount of money paid and more people will flock to that field. It is difficult to become a doctor or a nurse, and saying 'lets raise their pay by 10%' is not going to get more people to go through the hard things it takes to become a doctor/nurse (could work with CNAs though, they don't get paid nearly as much or have to go nearly as much school). So culturally if you want to bring the cost of healthcare down you need to have more younger people want to commit themselves to very difficult schooling after high school. That can be a hard sell, esp. since more people coming into the field will depress wages.

The other component to this is technology. In the 80's when cell phones first made their appearance only the very rich had them. If you don't have a lot of money you knew that was a 'rich person thing', and knew you could not afford one. Expensive healthcare is no different. I am willing to bet when Steve Jobs was sick he had the best money could buy in terms of healthcare. I also bet he owned several planes, yachts, buildings, etc. People can come to grips with the fact that rich people can have nicer things, but when it comes to their health (or life) they think they should have access to the same kind of care. This is not me being mean, but it just doesn't work that way. 30 years from now everyone will probably have access to the same care Steve Jobs received, but by than maybe they will have a cure for cancer and only the very rich can afford that. This not me being mean or callous, that is just economics. Rich people can afford expensive things first, and before anyone gets upset and says 'they shouldn't get them if everyone can't'. If there is no market for this cutting edge technology when it comes out, than it won't be invented. The reason the phone in your pocket can do the amazing things it can do is because some rich people in the 80's spent an insane amount of money to be able to carry around huge ugly phones that held a 15 minute charge. Smarter people on these boards can point out the same thing in terms of healthcare of what was possible only to the rich 30 years ago and what is now available to everyone today.

You can try the democrats way by splitting up existing resources to more people which lessens care for all. Or you can try the Republican way which is the free market can somehow get more people to want to become doctors and nurses (just rearranging the seats on the Titanic). Neither one expands the resources available, so neither one will work. If you want to fix it get more people to go into the medical prof. And that is a hard sell esp. for doctors who while they may make a lot of $ have to commit a decade or more of their lives to incredibly hard schooling where they get nothing but 100's of thousands of debt when they get out. Ultimately a doctor will make a heck of a lot more than your average person does, but our society does not believe in delayed gratification.

Your explanation of American healthcare might explain some theoretical floor on what healthcare could cost in absence of more providers. However, it has no ability to explain why Americans pay more for healthcare than the citizens of other countries with similar standards of living.

I see no reason to get lost in theoretical supply and demand concerns. What we should be doing is trying to match (or surpass) the efficiency of other proven systems operating in similar circumstances. In healthcare, we as a nation fail by this metric. And no, it's not because of our supply of medical personnel. The US has more nurses per capita than the UK, Canada, Japan, France and many other first world nations. We have more doctors per capita than the UK, Canada, Japan, South Korea among others. And generally worse health outcomes, definitively higher spending, and less efficiency than any of the above.

A couple pages back I laid out the (fairly well known) reasons US healthcare lacks the efficiency of other countries' systems. One (of the many) reasons the healthcare debate keeps going in circles in the US is because there's so little knowledge and perspective among American voters and politicians about what other options are out there and what they offer in comparison to the American system.

[Zooey72]

There is not an easy answer to healthcare, but there is an easy answer to your question. The countries you are speaking of have (almost) no national defense. Their sovereignty is owed to our huge capital expenditure to ensure their safety.

We are getting off the topic of healthcare; but compare apples to apples. Or do you really think any country in Europe would not have been overrun 70 years ago by the Soviets if not for us?