Affordable Health Care Law under review by SCOTUS

[chancellor]

Now I just have to figure out what part of that post to put in my tag line.

[Sour Masher]

Indeed. You'd think they'd be a bit more cautious with their ludicrous characterizations - you can really run into trouble making idiotic generalizations about large groups of people like that.

I have to admit, though, it does give me pause... Even though the vast majority of people who oppose universal health care are clearly greedy sociopaths who would like to see the lazy poor ground into mulch to fertilize the perfectly manicured grounds of their estates so that their show ponies might prance more proudly, every once in awhile I'll hear one of the more educated and less eeeeeevil among them say something that sounds almost fair and sensible, like...

They have doubts about the government's ability to effectively and efficiently manage such a complex system, and would like to see it play out at the state level first; or,

They have concerns that the reduction and/or removal of competitive practices, profit motives, and private innovation will drive higher costs and damage the quality of the delivery of service; or,

They fear that the health care industry will become bogged down in the swamp of government corruption, cronyism, and back room special interest sleaze; or,

They have apprehension about things like:

- Lessened patient flexibility and choice.
- Free/ subsidized care leading to higher consumption of services and exploding costs that will outstrip the hoped-for cost reduction associated with better preventative care.
- Government mandates impeding doctor flexibility, leading to poorer quality of overall patient care.
- The removal of personal behavioral incentives to take responsibility for one's own health.
- Reduced incentives to pursue medical research, development, and investment.
- The government passing additional restrictions and tax increases on smoking and fast food, leading to an erosion of personal freedoms.
- Health care services, drugs, equipment, etc. may become subject to rationing by the government, leading to unintended consequences like unacceptable waits for treatment.
- Once a government benefit is taken as a right by the public, it becomes virtually impossible to undo it or rein it in later if the costs should spiral out of control.

Assuming you believe that respectful acknowledgement of reasonable concerns like those might better advance us to a place of understanding and compromise, how would you appeal to those folks to join your side in the universal health care cause?

This is a good post, and well taken. I wish everyone who opposed universal healthcare outlined their reasons like you have in a clear and straightforward manner (although I disagree with several of them, but I'll refrain from getting into that in this post), and had the same spirit of legitimate dialectic, desire for change for the better, and openness to opposing ideas, if only they were measured and well-tested. If all of our politicians had that, we might be able to get somewhere, as both sides of this and many debates have merit, if only those who disagree would simply agree on trying to do the very best for all people, rather than make decisions for purely partisan reasons or to maintain power.

But they don't, and what we are left with, in this case, is a horrible plan that will hurt millions of Americans. It seems painfully clear to me that this bill is NOT the answer to the shortcomings the ACA had--and for all those shortcomings, it tried to help millions, and did. This bill, from everything I've read, seems clearly and substantially worse for millions of Americans, including those least likely to be able to afford decent health insurance or care. It seems barbarically cruel to leave untold masses of people to suffer, and, in many cases, to die an early death. Despite the points you make, and despite the inadequacies of what this bill seeks to replace, surely we can agree that removing millions from being insured, and making it financially impossible for millions more to afford insurance over the long haul, is not the best answer?

I can't help but go back to my old standby on such debates--the main reason for disagreement on universal healthcare is affordability, correct? If that is the case, how can we, as a country of voters, justify wasting 100s of billions of dollars on never-used, outdated military hardware that simply feeds the pockets of the military industrial complex when our health care situation is such a debacle, as so many Americans in this land of prosperity go without adequate health care?

I'm not suggesting that a democratic party plan (is there even one unified democratic party to forge such a plan?) would be perfect or would not be improved by vigorous debate and refinement. I'm arguing that more coverage for more people, ensuring more treatment for those in need, even in a wasteful, imperfect form, is better than throwing money away on needless defense contracts that do nothing to actually protect our country. And yet the same people opposing more health care coverage support more military spending, without being equally critical of the massive government waste and inefficiencies that obscenely overspends in some areas, while allowing our intelligence and counter-intelligence fall behind other agencies that are much more streamlined and focused on 21st century warfare.

Picking up on your fast food restrictions concern (I am tempted to link to everyone who used to make the same arguments about compulsory education and seat belts, but I'll refrain), if the ACA was the legislative equivalent of fast food, at least it was food. At least folks could survive on it. Cutting billions in healthcare just to spend more on useless military hardware, and another Trump campaign promise is to actually raise defense spending by over $50 billion a year, is like foregoing the fast food not for apples and grapes to feed our children, but for toys that we will never take out of the packages, while our children starve.

[senorsheep]

With all due respect, Sour Masher, I have no interest in discussing health care policy differences with someone who frames the issue as one of mass murder. If that's how you see it, then our perceptions of the health care landscape do not intersect, and we're just too far apart to have a productive conversation. Take care.

[Sour Masher]

With all due respect, Sour Masher, I have no interest in discussing health care policy differences with someone who frames the issue as one of mass murder. If that's how you see it, then our perceptions of the health care landscape do not intersect, and we're just too far apart to have a productive conversation. Take care.

Please reframe the issue for me, so I might understand your perspective more. The decision to remove health care options for many people who need it to live, without providing them with alternatives, puts them at greater risk of dying, doesn't it?

[senorsheep]

Please reframe the issue for me, so I might understand your perspective more. The decision to remove health care options for many people who need it to live, without providing them with alternatives, puts them at greater risk of dying, doesn't it?

If ACA disappeared overnight tonight, people would have the same alternatives they had before it became law less than a decade ago. They wouldn't start crawling out into the streets and dying en masse before our eyes. So, no, absent statistical proof, I reject your premise.

I recognize that those pre-ACA alternatives were often not effective and sensible, and Democrats were right to say that we needed better alternatives for people facing situations like catastrophic health events and pre-existing conditions. I would have been completely on board with pursuing solutions focused specifically on those issues, and would have been happy to pay more to cover them, provided we could have arrived at solutions that were fair, effective, affordable, and limited in scope. I think enough other independents and moderates, plus even a decent number of Republican voters, would have come on board, too, under those conditions.

I think it was a mistake to attempt to address those situations under the umbrella of an untested partisan federal health care overhaul. I would have preferred to see the universal model tested and perfected in California and other like-minded state laboratories, and then presented to the nation as a proven option after the kinks were smoothed out.

But we didn't. It was rammed down the country's throat on a partisan vote as soon as it was politically expedient, fomenting resistance and resentment, and now the replacement will be rammed down the country's throat in the same fashion, fomenting more resistance and resentment. It's hard to see a good path forward from here.

[Sour Masher]

If ACA disappeared overnight tonight, people would have the same alternatives they had before it became law less than a decade ago. They wouldn't start crawling out into the streets and dying en masse before our eyes. So, no, absent statistical proof, I reject your premise.

I think that is an overstatement of what I said. No need to reject that premise, as it wasn't mine. Everything else you said is accurate, and I agree the mistakes of the past are playing out again. My premise is that they are playing out for the worse this time than with the ACA, which itself was partisan, flawed, and a missed opportunity. This is even more of that, but it will also leave millions uninsured that had coverage under the ACA, and many of those people will suffer, and some will likely die preventable deaths because our politicians have once again failed to do what they should be doing--crafting laws that serve the people in the best way possible instead of playing political games with people's lives and well-being.

Related to my frustration at the health care debate, as I've stated, is the massive resources spent on defense, and the worry we put into terrorism and illegal immigrant crime, when cancer, diabetes, heart conditions, and the like are all much bigger threats for many more people in this country. If we could just agree on that undeniable fact, we could hammer out the details, make concessions as needed on concerns over personal freedom, government waste and mismanagement, and the like, and in the end, put forth something a lot better than what is being put forth now.

[senorsheep]

I think that is an overstatement of what I said. No need to reject that premise, as it wasn't mine. Everything else you said is accurate, and I agree the mistakes of the past are playing out again. My premise is that they are playing out for the worse this time than with the ACA, which itself was partisan, flawed, and a missed opportunity. This is even more of that, but it will also leave millions uninsured that had coverage under the ACA, and many of those people will suffer, and some will likely die preventable deaths because our politicians have once again failed to do what they should be doing--crafting laws that serve the people in the best way possible instead of playing political games with people's lives and well-being.

Related to my frustration at the health care debate, as I've stated, is the massive resources spent on defense, and the worry we put into terrorism and illegal immigrant crime, when cancer, diabetes, heart conditions, and the like are all much bigger threats for many more people in this country. If we could just agree on that undeniable fact, we could hammer out the details, make concessions as needed on concerns over personal freedom, government waste and mismanagement, and the like, and in the end, put forth something a lot better than what is being put forth now.

I don't think it's accurate or helpful for Democrats to say that Republicans are killing people, or are OK with people dying. If you all think that advances your cause, knock yourselves out. It certainly does nothing to win me over.

I don't like our massive defense spending, either. That's one reason I voted for Obama in 2008; I had hoped that he'd be willing and able to take that on. I was disheartened that the Dems were able to band together to push ACA through, but couldn't or wouldn't make a noticeable dent in the military budget.

Even though I am a free market guy, I'm not a knee-jerk "no universal health care" guy. I do care about the health and well-being of my fellow citizens, and am willing to make concessions to a collectivist solution I find fair, effective, affordable, and as limited in scope as possible. I'd just like to see us tread a bit more cautiously - together - into something this big, rather than careening wildly back and forth from election to election.

My initial post was just me expressing my annoyance with the usual partisan demonization rhumba. It's garbage, and does nothing to help anyone.

[GwynnInTheHall]

Indeed. You'd think they'd be a bit more cautious with their ludicrous characterizations - you can really run into trouble making idiotic generalizations about large groups of people like that.

I have to admit, though, it does give me pause... Even though the vast majority of people who oppose universal health care are clearly greedy sociopaths who would like to see the lazy poor ground into mulch to fertilize the perfectly manicured grounds of their estates so that their show ponies might prance more proudly, every once in awhile I'll hear one of the more educated and less eeeeeevil among them say something that sounds almost fair and sensible, like...

They have doubts about the government's ability to effectively and efficiently manage such a complex system, and would like to see it play out at the state level first; or,

They have concerns that the reduction and/or removal of competitive practices, profit motives, and private innovation will drive higher costs and damage the quality of the delivery of service; or,

They fear that the health care industry will become bogged down in the swamp of government corruption, cronyism, and back room special interest sleaze; or,

They have apprehension about things like:

- Lessened patient flexibility and choice.
- Free/ subsidized care leading to higher consumption of services and exploding costs that will outstrip the hoped-for cost reduction associated with better preventative care.
- Government mandates impeding doctor flexibility, leading to poorer quality of overall patient care.
- The removal of personal behavioral incentives to take responsibility for one's own health.
- Reduced incentives to pursue medical research, development, and investment.
- The government passing additional restrictions and tax increases on smoking and fast food, leading to an erosion of personal freedoms.
- Health care services, drugs, equipment, etc. may become subject to rationing by the government, leading to unintended consequences like unacceptable waits for treatment.
- Once a government benefit is taken as a right by the public, it becomes virtually impossible to undo it or rein it in later if the costs should spiral out of control.

Assuming you believe that respectful acknowledgement of reasonable concerns like those might better advance us to a place of understanding and compromise, how would you appeal to those folks to join your side in the universal health care cause?

I get it Sheep, but why in the world will they accept the SAME inefficiency in our national Defense budget and allow them to "figure it out" while wasting billions and they won't when it comes to taking care of the health of their populace and people WERE dying prior to Obamacare so yeah, those who got coverage face a more serious challenge of NOT dying than before the repeal so much for generalizations.


BTW I did not speak in absolutes on purpose so I never said EVERY Trump supporter.


I'll say it now, if they spend wastefully on defense and you do NOTHING to stop it, shut the f*ck up about wasteful spending when it comes to healthcare.

Again, not pointing fingers because I don;t know what you do, but there are plenty of Trump supporters who fit the bill.

[OaklandA's]

If ACA disappeared overnight tonight, people would have the same alternatives they had before it became law less than a decade ago. They wouldn't start crawling out into the streets and dying en masse before our eyes. So, no, absent statistical proof, I reject your premise.

Over 20 million people have gained medical insurance through ACA. If it was repealed tomorrow, obviously those 20 million people would lose their coverage. Research has shown that the uninsured have about a 40% higher death rate than those insured, and that dropping 20 Million people would lead to approximately 10,000-20,000 extra deaths per year.

I think it was a mistake to attempt to address those situations under the umbrella of an untested partisan federal health care overhaul.

This "untested, partisan" plan had actually been tested successfully in the state of Massachusetts by a Republican governor.

[Hornsby]

Indeed. You'd think they'd be a bit more cautious with their ludicrous characterizations - you can really run into trouble making idiotic generalizations about large groups of people like that.

I have to admit, though, it does give me pause... Even though the vast majority of people who oppose universal health care are clearly greedy sociopaths who would like to see the lazy poor ground into mulch to fertilize the perfectly manicured grounds of their estates so that their show ponies might prance more proudly, every once in awhile I'll hear one of the more educated and less eeeeeevil among them say something that sounds almost fair and sensible, like...

They have doubts about the government's ability to effectively and efficiently manage such a complex system, and would like to see it play out at the state level first; or,

They have concerns that the reduction and/or removal of competitive practices, profit motives, and private innovation will drive higher costs and damage the quality of the delivery of service; or,

They fear that the health care industry will become bogged down in the swamp of government corruption, cronyism, and back room special interest sleaze; or,

They have apprehension about things like:

- Lessened patient flexibility and choice.
- Free/ subsidized care leading to higher consumption of services and exploding costs that will outstrip the hoped-for cost reduction associated with better preventative care.
- Government mandates impeding doctor flexibility, leading to poorer quality of overall patient care.
- The removal of personal behavioral incentives to take responsibility for one's own health.
- Reduced incentives to pursue medical research, development, and investment.
- The government passing additional restrictions and tax increases on smoking and fast food, leading to an erosion of personal freedoms.
- Health care services, drugs, equipment, etc. may become subject to rationing by the government, leading to unintended consequences like unacceptable waits for treatment.
- Once a government benefit is taken as a right by the public, it becomes virtually impossible to undo it or rein it in later if the costs should spiral out of control.

Assuming you believe that respectful acknowledgement of reasonable concerns like those might better advance us to a place of understanding and compromise, how would you appeal to those folks to join your side in the universal health care cause?

I think that your thoughts are very well reasoned and probably quite true, however (isn't there always a "but"?), I'd wager confidently that less than 2% of all the people on the repeal the ACA argument has given much, if any of them actual thought. Just as most people on the left have given consideration to the legitimate concerns that you bring up. It's a much more visceral debate, and not particularly well argued by either side.

I obviously fall in the camp of keeping, and improving, the ACA. While it was flawed, as are ALL programs, government or not, it was a vast step forward for us as a society in the US. It was moving the ball forward towards, perhaps, an eventual goal of single payer. It's also a program that all polls show was, and remains popular with the majority of the people, even those in Red states.

Oakland A's has distilled it down to it's essence...people will die with this plan, plain and simple. You can argue the numbers, but you can't argue that people with medical coverage, even basic medical coverage, have a higher quality of life than those who don't. And no matter what this bill ends up looking like, it's a step backwards for us as a nation. By not taking care of the least well off, the aged and infirm, we fail as a people.

[onejayhawk]

This "untested, partisan" plan had actually been tested successfully in the state of Massachusetts by a Republican governor.

If you are equating Massachusetts with ACA, it's an apple brandy and orange TicTacs comparison. They are not very similar.

J

[baldgriff]

Even though I am a free market guy, I'm not a knee-jerk "no universal health care" guy. I do care about the health and well-being of my fellow citizens, and am willing to make concessions to a collectivist solution I find fair, effective, affordable, and as limited in scope as possible. I'd just like to see us tread a bit more cautiously - together - into something this big, rather than careening wildly back and forth from election to election.

This sums up much of my thinking very well.

In my mind the careening back and forth makes it more and more unlikley that this country will ever actually have a single payer system. Basic coverage should be something that everyone "can afford". The problem is how do you define basic coverage.......

will this basic coverage include dental and eyes? many kids out there in the need of braces or the ability to actually see clearly
Is chiropractic care available? Plenty of individuals that are finding "alternative" methods to pain relief
Is birth control a covered prescription? Like it or not, there are plenty that wont want this covered (I dont understand this view)
Would abortions be covered as basic coverage? Ive said that this genie cant be put back in the bottle, but some would say the government will be paying for more abortions

What about diabetics? Blood testing kits covered? and Insulin pumps?
Cancer - is Chemo a "basic" medical coverage?


Rather than continuously debating the morality of a single payer system, lets discuss and define exactly what people see as "basic" coverage or what actually is affordable. At a high level I think most of us agree that health care can be done better (I agree with that). Im interested to hear from people where they draw the line.

[TranaGreg]

... Im interested to hear from people where they draw the line.

IMO the line will not be set in stone; it will move over time. It's better to go with something - anything - and refine it. Trying to get it perfect will result in, well, nothing.

To answer some of your questions - for us,
general dental and eyes are not covered (obviously emergency services - someone with a broken jaw or a pencil in his eye - would be covered)
chiro is not covered
birth control pills are not covered
abortions are covered
for diabetics blood testing pumps & insulin pumps are covered (with limitations)
generally chemo is covered, altho there have been some situations where it isn't (and these have sometimes been newsworthy as flaws in the system that need to be fixed)

again, it's not perfect but it continues to be refined over time.

edit: dental services are covered for those on social assistance.

[cardboardbox]

birth control pills are not covered
abortions are covered

While I dont think its worth the political fight to ban abortion, I will vote against anyone who says govt should pay for abortions. If there's ONE drug our govt should be giving out for free, its birth control so that the number of abortions drops.

[baldgriff]

Now this is silly -
why would we not cover birth control pills and yet cover abortions? Isnt one of these more preventative than the other (and probably cheaper?)