3rd Attempt: GOP/Trump Repeal & Replace ACA and Trump lie about pre-exist coverage

CBO wasn't dead wrong. The health care bill that was implemented was not the one they scored - it was changed dramatically by the Supreme Court decision as well as changes to the bill in later years. They never scored the bill that was ultimately implemented.

But beyond that, if you don't believe the CBO's numbers, who's do you believe? Some random politicians that have no background or expertise in health care?

 

The CBO does the best the numbers they have. They are making an informed guess just like everyone one else. They can't predict the future. CML just doesn't care. Its why 65+ year olds hate obamacare. They got their medicare **** everyone else.

 

I actually like Obamacare. The Supreme Court allowed conservative states to hamstring it and make it not work. But, it has generally had a good experience in states that have fully embraced it. I don't want single payer. I want to leverage competitive markets. And, I think the 'chance to prosper' is bs. You have your best chance to prosper when you're shielded from catastrophic health disasters. Besides which, we really need to stop sucking at the teat of employer-provided healthcare. There's no reason employers should be involved at all in my healthcare. It's an artifact of our postwar economic growth and political inaction. Ideally, embracing Obamacare, using legislation to optimize its function instead of forever trying to sabotage it, eventually leads to the exit of corporations from the healthcare function. Employer-based insurance is part of the problem. They can act as strong negotiators for individuals but they mask retail price signals and keep the market from being efficient. And their involvement makes employees beholden to their employers in an inappropriate way. If you want people to be free and if you believe in the power of markets, then you should be a fan of Obamacare.

 

You are not the first, nor will you be the last person, to call out CML on his extreme idiocy and misguidedness.

 

So now both sides have lied about their respective health care overhaul bills.

 

I am not sure why you believe we can have a competitive market with Obamacare. Obamacare has proven we will not have stability in price and coverage. When my insurance company drops my plan and my doctors, i will have to seek a new doctor and restart the whole process again. Insurance companies have way too much leverage. If insurance companies can not pick and choose what they want to cover (which defines insurance in the first place), then they are nothing more than a fragmented version of single payer.

There is a fallacy that everyone deserves equal coverage needs to stop. Everyone needs basic universal healthcare. For those who do not care about their health or do not want to invest, let them stick with universal health care. Then let the insurance companies be insurance companies ... and let people/employers buy supplement healthcare for those who do not want to wait a month for an appointment. And let insurance companies charge their premiums based on peoples lifestyle. If I dont live a destructive lifestyle, I shouldn't pay the same as one who gorges on crap food, smokes, drinks or otherwise neglects their health. If we dont punish those who neglect their health, they will never change. We can compare ourselves to Europe and Asia all we want, but the reality is their populations generally has much more self respect for their overall health.

 

That's a bit of an exaggeration. Not about CML, but about people on Medicare saying, "**** everyone else."

 

I'm fine with mandated private insurance in theory but our implementation of it was incredibly limited and compromised. There are examples of European countries that have taken the route of mandating private insurance (Switzerland being the most notable example) but they implemented it in a far more cohesive and comprehensive manner.

I actually think it would be worth revisiting parts of the 1993 Clinton health care plan. The 1993 plan also mandated health insurance, banned pre-existing conditions, etc.. The 1993 bill also had a similar version of the essential health benefits.

What was different was how the insurance markets were structured. The ACA remarkably didn't do all that much to change how the markets worked in the US. The exchanges only cover a fraction of people since it only targeted the individual market. The existing health care entitlements (Medicare, Medicaid, SCHIP, etc..) didn't really change and employer based coverage didn't really change outside of being effected by the new regulations on insurance coverage.

The Clinton plan on the other hand took the radical step of merging the employer risk pools with the individual markets. Under the Clinton plan, states had to create new health care assoication plans that both employers and individuals bought into. The two markets merged together and created a common risk pool within each state. These were still private plans but everyone was buying into the same set of plans. That means losing your job didn't mean losing your plan. COBRA was effectively ended under the plan since everyone shared the same plans. Even Medicaid was planned to be scrapped in favor of moving Medicaid participants onto association plans. Medicaid patients were fully subsidized while individuals above the Medicaid threshold got partial subsidies in the same way as the ACA exchange plans.

To me employee risk pools are one of the sillier things we deal with. My last company self-funded its health insurance program and they flat out admitted that something like 5-10 people in a 500+ person company were consuming 40% of health care spending. Larger state based risk pools would distribute that cost far more effectively.

The Clinton plan wasn't perfect either but to me its a major step above the ACA. In fact at the time, the biggest argument against the Clinton plan was that association plans would create "networks" of coverage. Funny enough, private insurance companies did that anyway so the biggest argument was a fairly silly one.

 

I actually have a dear friend in the ICU right now in a hospital in Austin. I've been her car ride to doc appointments since she has a number of health complications mostly stemming from having Primary Immunodeficiency. Her liver and pancreas do not produce the enzymes our bodies make to digest and absorb nutrients in food. She has take over 40 pills a day just to maintain. She's a Respiratory Therapist that was top of her class when she's healthy enough to work. She doesn't smoke or any hard drugs. If she ever did smoke and needed an organ transplant she'd be denied almost immediately because of it. So she can't do anything recreational that may prove harmful to her.

All that said she didn't do anything harmful to her body to get her condition. It was the unfortunate luck of the draw with simply being born with it. A pre-existing condition. I understand there's some people on this very board that would probably be okay with her losing her insurance and going to "free" clinics that don't exist and then citing Darwin's natural selection so the U.S. can do budgetary cuts at the expense of millions of Americans lost lives, but that's bullshit IMO. I get that life isn't fair and it certainly hasn't been fair to her despite her making the best of her situation, but she's a real person. Not a statistic and she's not a freeloader that's abused her body to the point where it's begun to shut down. She's an honest citizen and a taxpayer. She's one of the sweetest, most positive people I personally know. And you got rich old men potentially deciding the fate of her health care for the sake of more money to a small number of people and just get to something passed for news headlines. That's ****ed up and it isn't right.

 

An excellent post, LB. My best wishes for your friend and I hope she beats this. Sounds like beating it might be impossible at this time, but research keeps coming up with new ways to treat disease. I have an inherited genetic condition from my late father that's far easier to keep under control. My body doesn't want to process fats (lipids) due to this condition. Without meds, my cholesterol is over 600, and my triglycerides over 1200. Anyone familiar with typical lipid numbers might be astonished that they are that high, or would be.

I'm still around because they invented statins like Lipitor. They give me excellent lipid numbers and, unlike Dad, who lived before statins were discovered, I'm thin, if anything. My father lived until his early 60's (he was told by the Mayo Clinic that he wouldn't make 40) because as an university professor back in the day, he had superb Blue Cross/Blue Shield insurance. There was a yearly limit on the deductible, which he maxed out every year, and he could see any doctor he wished. Ended up getting Dr. Denton Cooley, Michael DeBakey's (famous heart surgeon) longtime protege, until they had a falling out. Dad took every drug being researched that might help his condition, and before they were available to the general public.

Why can't everyone have insurance like that? We're supposed to be a great country, and in numerous ways, we are, but in today's world, unless you are wealthy, or very, very lucky, that kind of insurance really isn't an option. It gave my father an extra 25 years, and we treasure every one of them.

 

Im genuinely not trying to lump pre-existing conditions with those who neglect their health. There are plenty of pre-existing conditions that happen at birth, much less occur throughout ones life. Im not a heartless person who feels they should not get coverage unless they can pay for it out of pocket. I just believe the 'insurance' route is not the way to take care of them ... universal health care is. If we are going to burden society with these costs, lets do it through the government, not through private companies who contentiously disrupt the market when their profit margins slip a penny below their internal threshold.

 

If we extend this reasoning to its logical end, most of your wealth should be confiscated to fund the health care of others.

There is no right to a scarce resource.

 

No, that is not the logical end.

 

So did they confiscate most of people's wealth to fund for health care in other developed nations? Are their healthcare more expensive than the ones in the US?

 

Most of my wealth has not been confiscated to fund the health care for others. Its gone up in the past 2-3 years, but it had been going up before Obamacare as well.

 

@Commodore, much of our wealth has already been confiscated to fund the enrichment of health industry stockholders. Why is that okay?