Obamacare....? Just heard how terrible it is from some Americans - Politics Forum.org | PoFo

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#14728789
I haven't been back to America in a few years... the healthcare in America has always been the WORST !
( unless you are very poor or older, then you can get some assistance)

But the premiums are going up and the services are coming down ?

Ex president Bill Clinton said it is a mess !

.. that, with his wife running for the Presidency and closely linked to Obama...

So it sounds pretty true to me .

What is your feedback or knowledge of how it is actually working?
#14728791
Obamacare is in an ultimately losing battle with actuarial science. The idea of a health system based on mandated private insurance was adapted from ideas proposed by Republican think tanks. Democratic strategists reasoned that the GOP couldn't oppose an idea they originally came up with.

Big mistake.

You simply cannot reason with those who have based their entire political existence on never saying yes. It is a waste of energy. There is no compromise they will accept.

Democrats should repeal and replace ACA with a genuine single payer system. The best way is to extend Medicare coverage to everyone.
#14728806
quetzalcoatl wrote: Democrats should repeal and replace ACA with a genuine single payer system. The best way is to extend Medicare coverage to everyone.

Agreed! I don't get the calls for "we want choice!" "we want freedom to choose!". I don't think I'm alone in feeling overwhelmed, confused, and manipulated when I pore over 6 different insurance companies' plans, offering numerous different plans each, with different deductibles, copays, lifetime limits, annual out-of-pocket maximums, exclusions, and premiums. When I need medical care I just want to go get it. But spend a couple of hours every year making choices and you risk making a mistake in assumptions on how much care you will need in the coming year. Just give me the damned coverage!

Single-payer is a good intro to national healthcare and that is the beginning. We also need to look at the schemes for compensation, drug company incentives for prescribing drugs, fee-for-service, etc. Increased compensation for each service provided is a conflict of interest!
#14728814
It sucks.

But it's still better than it was. That is to say, it's too expensive for the shit I have, but if I get hit by a truck at least my parents won't lose their home.

Part of the reason it sucks is that I'm paying a company that doesn't want to just cover things, but make as lavish a profit as possible. So there's every incentive for the company to make it as convoluted and difficult to use as possible. Including the fact I'm paying for their lawyer to make sure I can't use the rest of the service I'm paying for.

Make this single-payer and be done with this nightmare. First step there is a government option.
#14728856
I never understood Obama's reasoning on this. Dr Lee pointed out Nixon's plan was similar, maybe Obama knew about it and thought it was the easiest way to get the jobdone, buuuuuut:

On the campaign primaries, Hillary and John Edwards argued hard for a single payer system. Obama seemed unclear on how his proposal differed, except people wouldn't be "forced" to participate. I was never clear on his level of undetstanding on the nuances onvolvef
#14728891
It was simply the art of compromise. It was what could be done. The health care industry is right at 17% of our GDP. An astonishing number especially compared to the UK where they have much better coverage, much better outcomes and come in at about 8% of GDP. But with that much money involved there was no way to overcome the political bribes. (I refuse to call them anything but what they are.)

Of course it is far better than we had before. There are a few losers but vastly better coverage for most people and access to millions of people who not only did not have coverage but could not get it. Women and young people particularly benefited from it.

The republicans whine like wimps about it but of course their beloved George Bush passed the most expensive medical program since Medicare without allocating one cent in revenue to pay for it. Another reason this life-long republican is disgusted with them.

The PPACA (which some call Obamacare) is a great leap forward. It is a necessary step toward a single-payer system. Quetz is correct that the best way to fix our healthcare system is to delete two words in one law. The words are "over 65".

To the OP's point though. Obamacare is definitely NOT "terrible" for any Americans. Service is NOT "coming down". Some prices are up but that is not a great indicator.

Sort primer in US health care. Very short:

The insurance companies in the US have off-loaded the most expensive patients to the government already through Medicare. Virtually everyone over 65 (the most expensive folks) are primarily covered by the government. People with disabilities are frequently covered by Medicaid; a government program. Before the PPACA those with pre-existing conditions such as high blood pressure or diabetes were simply told to get lost. When they were insurable they were charges absurd premiums. My brothers wife was charged $1500.00 a month for insurance despite the fact that she did not frequently see a doctor. Obamacare fixed that. Ask my brother how he feels about Obamacare.

So essentially the insurance companies cherry-picked the best customers and left the rest to the government to police up.

There are many more and even more absurd quirks in our health care system but I will spare you the two-hour rant. Suffice it to say that people in GB have far more choice with their government plan than do Americans with their private plan. How could that be? It is like this. The CEO of a large insurance company does not care one rat's ass what you think about quality. It is just a cypher for him. But every member of parliament right up to the prime minister (and maybe even her dear old Majesty) cares a great deal what a British subject thinks about quality of care. And they are running the show in the NHS. So maybe they don't get to choose their doctor from a smorgasbord of practitioners but they do know that every practitioners "boss" is paying attention.

So what would it mean if the US could cap costs at, say 10% of GDP on a single payer government plan? (10% rather than 8 because we are sort of spread out.) It would mean a stimulus of about $900 billion dollars a year. Universal coverage. Far better outcomes. Greater longevity. On and on.

At the end of the day, if the US did not allow big business to bribe elected officials, we would have come to the same conclusion that every other developed nation has already come to. That in the end the only health care system that makes any sense at all is a single-payer system.

ON EDIT:

Let me make one more point. People who are on Medicare have enormous choice when it comes to selecting a physician, not requiring unnecessary referrals and simplified billing. It is true that those with supplemental policies have slightly less choice as they still have to deal with insurance companies but compared to the average employer provided plan, far more choices. If the government took over the whole shooting match and ran it like medicare without the need for supplemental plans virtually every American could have far more choice for far less money.
#14728903
According Washington Post is the Swiss-system better and cheaper, then Obamacare, because the US-system is too restricted, no competition
.

Even if you factor out the cost we are barely in the middle of the OCED pack for outcomes. If you factor in what we spend (more than double what the UK spends and 3/4 what Switzerland spends per person covered) we are being screwed like a cheap.....well getting a bad deal.

The reason is not that there is too little competition. We are just being screwed. A anti-viral drug that sells to South Africa for $900.00 per course of treatment sells in the US for $78,000.00. Same factory, same drug.......

Some would say that we are financing much of the research from which the entire world benefits and that is true. But even foreign drug manufacturers are cashing in on the US market. Drugs that are made overseas are sold in the US for anywhere from 10-200 times what they cost in their country of manufacture. It is a crime and it is the fault of the republicans in congress who refuse to allow Medicare to negotiate the cost of drugs. They are completely sold out. It is criminal. The lawmakers who voted for this law are traitors to their nation. Nothing less.
#14728961
Some very informative posts !

In GB you pay for the NHS from the very first money you earn, and you continue to pay for it throughout your life.. but what a bargain !

It is wonderful , but now increasingly over stretched, due to many immigrants coming into the country... and people coming in from outside the UK having medical procedures, theoretically the country Medical tourists came from should re pay the NHS for their services however it never seems to work out that way.

If you have a National Insurance Number, you can go into any Surgery and get medical care.

In America, Medicare is the only government agency that I know of that functions well, or at least effectively, but things might have changed?

Expanding Medicare to all ages, single payer seems to makes the most sense.
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