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ACA, do we want it gone?

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  • Hatton
    replied
    My problem with the ACA is that it really does not help the middle class.  The truly poor can get medicaid.  The next rung of people get an ACA subsidy then the next rung is hosed.  If you look at the premiums and deductibles even I a relatively healthy near-retiree cringe at the cost.  The entire health care system is out of control.  Actually look at some EOBs.

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  • IntensiveCareBear
    replied
    I try not to fuss over things which I have no control. ACA and anything else they come up with is just tilting to socialized medicine. It is not "if" but when.

    ...We all know it's "your body, your responsibility" at the end of the day. The answer was, and is, better health and nutritional education.

    Health care costs too much because people expect too much. Many expect too much because their insurance costs so much. For others, it is entitlement or boredom or weakness or who knows what that drives them to seek excess care or workups. Everyone wants the million dollar workup, and nobody wants to pay for it. Most cannot pay, yet still feel entitled.

    Docs and hospitals clearly don't help since they are driven for profits... more diagnoses and more meds and tests means more income. Consider how you treat patients at a charity or mission clinic versus how you treat them in the hospital office... night and day difference. Docs want the million dollar workup since their private practice or hospital RVU bean counters are promising them more gold pieces for doing it.

    If the patients are educated and self pay, they are logical and frugal. If the docs and hospitals are ethical and not in so much debt and not so afraid of malpractice... they don't over-diagnose and over-test so badly. But that is just not reality. It hasn't been for awhile.

    The moral of the story is take care of your body, learn how to have it run optimally, and spend your health care money (shouldn't need to spend much!) like it is really your own money. "Health is the first wealth." There are ways to live free in an unfree world. I'm just glad the tax penalty for not carrying health insurance is gone; that was a crock. GL

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  • burritos
    replied




    I don’t. It allowed a lot more people to get insurance, it covers pre existing conditions and covered mental health. A lot of my patients have benefited from it.
    Click to expand...


    Is it insurance? I think it's more like groupon for medical care.

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  • spiritrider
    replied




    As a 62 year old retired physician, hx of breast cancer, it is terrifying that the administration wants to get rid of pre-existing condition coverage.
    Click to expand...


    The problem isn't with covering pre-existing conditions. It is the vast numbers of people who are gaming the system by not getting coverage until they need it, including coverage for pre-existing conditions. The mandate never had any practical effect on this.

    The way pre-existing conditions were treated before ACA (except for some states) was criminal. The two biggest problems were the ability for insurers drastically raise rates or deny renewal.

    A middle ground could exist where individual would have to pay more for new coverage with pre-existing conditions (maybe 2X), but renewal was guaranteed. This would provide more incentive for people obtain coverage before they absolutely needed it and if they don't their loss. To my knowledge they have not proposed getting rid of coverage for pre-existing conditions, just the current free-for-all coverage.

    The ACA was a delusion that everybody would obtain coverage and have the young people subsidize the old. The bottom line is understanding how insurance works. For any insurance system to be workable it has to have sound actuarial basis and a sufficient pool of healthy people paying for a smaller number of intermittent unhealthy people.

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  • Lordosis
    replied




    “Would the 3.8% tax on cap gains go too?”

    I laughed out loud at that one.
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    Just like fat cells once created they never go away.

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  • Tim
    replied
    @Bmac,
    “How can we consider ourselves a great and humane country if we don’t care for all our citizens?”

    With all due respect, quoting you out of context is not fair. That is the most blatant argument for pure unadulterated socialism I have ever seen. Equal results are the foundation of your logic. I apologize, it’s one solution. I simply disagree with the solution of wealth redistribution to be “great and humane”.

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  • G
    replied
    "Would the 3.8% tax on cap gains go too?"

    I laughed out loud at that one.

    Leave a comment:


  • Lordosis
    replied
    Would the 3.8% tax on cap gains go too?

    Leave a comment:


  • Bmac
    replied
    Everyone should have healthcare. Therefore everyone needs to pay in. Healthy as well as unhealthy. There should be a mandate. Pre-existing conditions must be covered. How can we consider ourselves a great and humane country if we don’t care for all our citizens?  I think it is horrible that ACA has been gutted. Not perfect, by a long stretch, but at least a step in the right direction. Certainly many have benefited from the ACA.

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  • MSooner
    replied
    I do think it is funny that Christian Health Sharing ministries have thrived because of the ACA, but if it is repealed I hope all the friends/family I have using it get their a** back on an insurance plan ASAP. I don't think my generation (in college when ACA was passed) quite realizes what "no coverage for pre-existing conditions" really means.

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  • Tim
    replied
    If preexisting conditions were pulled out of ACA, would the other requirements remain? Most would support a government subsidy for that need. Then the fog starts rolling in. Whatever we call it, not everyone will get the “best care money can buy”.

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  • Emilyjane
    replied
    As a 62 year old retired physician, hx of breast cancer, it is terrifying that the administration wants to get rid of pre-existing condition coverage.

    Leave a comment:


  • wideopenspaces
    replied
    I don't. It allowed a lot more people to get insurance, it covers pre existing conditions and covered mental health. A lot of my patients have benefited from it.

    Leave a comment:


  • Tim
    replied
    Never. Requiring specific coverage (most significantly preexisting) and subsidizing payments (while making it more expensive for others) has never been done.
    It was an attempt to redistribute the costs as well as the minimum coverage. Bottom third benefited, middle third unknowingly had higher costs that hurt, and the top third could afford it.
    The sad part, politics rather than economics were and are the focal point.

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  • spiritrider
    replied
    I do not agree with much of what was in the ACA, but I have gladly massively benefited from it as have my girls.

    Even though I have a lot of philosophical problems with it, it would be a massive mistake for it to go away without a replacement.

    We can debate what that replacement might look like, but I'm guessing we would have as much trouble coming to a consensus as the politicians do. We all come from our own set of life experiences and biases.

    Leave a comment:

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