Obamacare / Affordable Care Act : classic or dud?

the weak execution of the ACA allowed the Republican Congress (and Republican leadership in general) to fuck with it

This is true. But your suggestion would require that the Democrats designed the ACA in order to purposely lose control of the House and Senate in the next election. Yeah. Right. Very cunning of them, I'm sure.

im having a real hard time imagining they ever wanted single payer. more like furthering the entrenched industry deathgrip.

the Obama Adminstration (whose goal was a single payer system)

in the same way that his goal *wink wink* was also shutting down gitmo

i hope the republicans throw 13,000,000 lazy bum americans off health care to cut taxes on the hardworking and virtuous wealthy. #mrga

BARBARA EHRENREICH: WHY I’M GIVING UP ON PREVENTATIVE CARE

The piece itself belies the headline a bit.

But still.

I have been more intimate with the current medical system than I ever would have chosen and I agreed with the major thrust of that piece. Health and illness are extremely personal, science is extremely impersonal, and capitalism is extremely greedy and uncaring, and physicians are pushed around chaotically by all these influences, so medical practice is caught in a maelstrom of irreconcilable conflict. This doesn't conduce to the reinforcement of reasonable and caring medical practice.

TEN BUCKS HUH

The beauty of this system is that the mega-rich and their servants feel unashamed about rubbing your nose in their shit. Like they're doing you a favor. And sadly, too many people love it and ask for more. https://t.co/iDtEizfziB

— Dennis Perrin (@DennisThePerrin) December 10, 2019

Still amazed by how many people know jack shit about this law. See stuff like "Trump didn't get rid of Obamacare but at least he made it so ppl aren't forced to buy Obamacare, they can now buy thru private insurers". Just change the name of this country to Dunning-Krugerstan already.

and of course Trump obv doesn't understand it at all

Still amazed by how many people know jack shit about this law.

That's because, other than the expansion of Medicaid, they made it too damned complicated so as to preserve as much of the for-profit aspects of the system as possible. The whole web-based Marketplace idea that maintains 50 different state-of-residence variations, multiple tiers of coverage, alongside individualized subsidies recalculated annually, was always a shambles waiting to happen, even before the Republicans started undercutting its funding.

I just qualified for Medicare and was enrolled automatically in the two main parts A & B, which is pretty sweet, but compared to comprehensive universal health care such as UK's NHS, Medicare has gaps in coverage and a bunch of sidecar programs - like part D, various commercially sold supplementary plans and Medicare Advantage - that can be quite confusing, too.

The US Congress is so in the thrall of the capitalist health care system they are incapable of legislating a straightforward, comprehensive system that just ensures that people get health care.

I agree that it resulted in an even more convoluted system (most of my work time is devoted to correcting "discrepancies" between govt records and insurance Co records), but the 3 core provisions of the law are simple enough to understand. At this point there's no excuse to think that "obamacare didn't allow ppl to buy thru private insurers" or other stuff you here conservatives regurgitate.

it does seem like a good portion of people have literally no clue what medicaid expansion means, like literally i think their brain shuts off at "medicaid" and they just stop thinking at that point, assuming that there is absolutely no hope that they would understand. because otherwise you'd think there'd be riots over states choosing to let more of their own people die rather than accept federal money that was already put aside for them to expand medicaid.

riots over states choosing to let more of their own people die rather than accept federal money

At the risk of being trenchant, I think you are underestimating how warped people's thinking becomes when it comes to money. in terms of powerfully modifying behavior, money is on a par with addictive drugs.

I wonder how many people's lives a law has to save before some people would be fine with paying more taxes because of it. 5 million? 10 million? What if a lot of them are children? 2 million sick kids' lives = what, 20 million normal adults?
It just disgusts me to see people moaning about having to pay more post ACA when that money is literally going to save lives.

tried to sign up for same ACA plan i had last year in December; thought i did

failed to notice "Premier" dangling from plan name as NY State phoneguy walked me thru process

new member card shows deductible $3000 higher than 2019

pray i can get this changed

(that added cost is more than a month's takehome pay)

Health insurance in this country, on balance, can die in a fire

I get that insurance co's are seen as unnecessary middlemen who live to deny claims & I'm for single payer, but hospital and pharma companies LOVE having them around as whipping boy. Insurance companies have to have their premiums approved by govt, and legally must pay out 85 cents of every dollar they receive to members' claims. Meanwhile hospitals can charge $60 for an aspirin and pharma can charge whatever they want for life-sustaining medications. Insurers respond to prices set by those 2 groups.

Don't forget the massive doctor salaries propped up by absurd protectionist policies

But yeah

and that the Catholic church keeps buying up hospitals and clinics in the US to add to their portfolio.

xpost Drs often get their own absurdly high insurance to pay.

Lol first time I've seen the Catholic church blamed for insane healthcare costs in the USA

I mean Catholic hospitals are a menace to society regardless

they are the largest owner of private healthcare in the US and have been heavily involved in m&a in the last decade. In some rural areas they are the only game in town and can deny you for care based on whatever their faith says. I mean this is a crude summary but there has been a lot written about this.

Fair enough, thanks for clarifying

they own a lot of hospitals all over the world but at least in the US their work is not "charitable". They are as capitalist as everyone else.

Yeah the mindset that health care should lean more towards charity than profiteering has gone out the window in last few decades. Everyone from aspiring doctors to religious orgs like Catholic "charities" view it as ticket to $$$$$$. There are obv many great, caring docs that got into the profession to help ppl, but there are also a shit ton of ppl who picked it because doctor=$$$$. Anecdote alert: my sister is office mgr for OBGYN grp, and out of 20 OBGYN docs only 1 or 2 strike her as truly caring about their patients. The rest are in it for the cash.

When I was younger I ran across a couple of OBGYNs that would not prescribe birth control. It didn't even occur to me to ask before my appt because I was like "HOW IS THIS A THING???"

one of those shockingly old thing I learned today is about how Mother Theresa was kind of terrible and likely has all her hoarded billions still stored in the Vatican.

a family member worked at a USA catholic hospital where anyone who couldn’t pay had their costs paid for by the church. menace to your neoliberal society!

back to obamacare, but I used it for 2 years? and I chose a empire blue cross plan because my gyno of 10 years accepted it. When I went to make an appt I learned they didn't accept the obamacare version of blue cross. No one in the office knew why. I called their billing and they were just like "it was too difficult" to deal with.

insurance is a fuckin scam

'tis

abolishing it (the mersh version) wd improve our moral fiber

it should be illegal to get a bill months later for services that have already been rendered because insurance whimsically chooses to later deny something.

I changed the problem described earlier by selecting the plan I originally wanted, effective Feb 1. However nothing I spend this month (and there's plenty) will count toward the new deductible. So I suspect I will lose about a grand instead of three (unless I get a goddamn benefits job by mid-year). I'd do the math but it's too depressing.

can avoid those charges by getting stuff pre-approved

it could be something as dumb as your doc office coding something the wrong way causing claim to be denied, but see it's really fun to just blame insurance co's for everything wrong with our fucked up system

example of backasswards way we do things:
I'm advised to have colonoscopies every few years due to Crohn's. If I do, it's coded as "preventative" and isn't covered by insurance. So one might choose to forego regular screenings. Then, things that can be addressed at early stages progress, and now I'm needing to get admitted to a hospital, which will most likely order a colonoscopy anyway except now it's coded as "diagnostic" and is covered by insurance. But obv now the ins co has to pay out $$$ for my hospitalization, in addition to the diagnostic colonoscopy! And I'm in poorer health. Lose-lose situation.