SCOTUS Upholds Affordable Care Act!
Comments
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Pip57
You are absolutely right of course about the Canadian system. Everyone is treated the same. Sometimes a bit of a problem for those whose diseases have very unique individualized characteristics. A national system paid for by all taxpayers must necessarily pursue treatments that benefit the greatest number for the least cost. How could it be otherwise? -
I think the people who worry about the advisory board (I am one of them) fear that it will make decisions regarding treatment that will benefit the largest number of patients at the lowest cost That worries me. If at 70 my cancer returns and it can be treated by a hugely expensivef drug I do think there will be policies in place that will limit my access to expensive treatments. Insurance companies will of course love such limitations. No more patients contesting their decisions. Hopefully I am totally wrong.
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From PatMom'sthe link above: The IPAB cannot make recommendations that affect coverage or quality. It seems that that provision prevents your scenario, riverhorse?
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...and I believe the IPAB deals with Medicare, NOT insurance companies, so that your insurance company alone decides what they cover.
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riverhorse -- a national healthcare system is only as good as the people for whom it exists want it to be. If people vote in congressmen/women who campaign on a "won't raise your taxes" agenda all down the line, then obviously the advisory board could end up doing just as you suggest. On the other hand, if the other side campaigns on a "we'll do all we can to ensure that the healthcare you ALL receive is the healthcare you want (even if it means a slight tax raise across the board)" then your worries would be unfounded. Someone very wise once said that people get the government they deserve.
Of course, if you'd rather have your insurance company make those life or death decisions for you, that's up to you! I personally like the ability to vote anyone out of office who tries to change my healthcare.
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pip, love your post!
Governments exist for the people (at least within democratic systems). Their role is to promote the welfare and security of their people. In democracies, it's the people who get to decide who runs the government and who the representatives are who sit in the government.
Insurance companies exist to deliver profit to their shareholders. Company executives and boards of directors get to decide who runs the company, who the employees are and how they are incented.
So who do I want to have make the decisions on what healthcare treatments choices are available to me? A government who's responsibility it is to improve the overall health, well-being and longevity of it's citizens? Or a corporation that is focused on the bottom line?There's nothing wrong with profit - I believe in capitalism and free market enterprise - but I don't want the person deciding on my healthcare choices to be somebody who is incented to minimize costs and maximize profit.
riverhorse, you make the following point, in which you were picking up on something I said: "The new system creates unlimited access to a product (health care) for which there is unlimited demand -- certainly anyone with BC doesn't want limits placed on access to treatment due to cost. I can't see how this is sustainable without the government putting some sort of system in place to rationalize use of resources." Your interpretation of what I said is correct until it comes to the conclusion. My conclusion is not that these extra costs will lead to rationing but that these extra costs will lead to increases in the cost of insurance. So I think the celebrating is premature by those who think that the ACA will result in stable or lower insurance premiums (and yet significant increases in coverage). I understand that there may be more people paying into the system but I think that will be pennies compared to the huge extra costs incurred by the insurance companies who are now legally required to provide significantly more coverage to every customer. I see insurance premiums rising and I see insurance companies going out of business. In the end, if more and more healthcare eventually gets turned over the government, then because the profit will be removed from those transactions, the government should be able to deliver more and better coverage for less money. That's the advantage of the single-payer not-for-profit system. That's not to say that cost control won't still be required - with all the aging baby boomers starting to strain the system, of course that will be necessary - but a single-payer not-for-profit system is able to deliver a lot more for less.
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"So who do I want to have make the decisions on what healthcare treatments choices are available to me? A government who's responsibility it is to improve the overall health, well-being and longevity of it's citizens? Or a corporation that is focused on the bottom line?".
The corporation that insures me has paid every single cent of my treatment thus far. Why would I think that would change? I have had everything I and my docs have wanted or needed exactly when we wanted or needed it. The US gov't cannot provide that same coverage to my mother who is a senior citizen and therefore on Medicare. She has to buy supplemental insurance, from the same corporation that covers me, so that a serious illness won't wipe out her savings and her home.
I will stick with the bottom line focused corporation. -
Mardibra, you and I are among the most fortunate. We have insurance from our employers(former in my case) that has covered everything and challenged nothing our Doctors have offered us. Of course they can stop insuring us anytime they want. That's always a bit unnerving to think of so I don't. I hope new regulations don't allow them to do that.
My husband is on Medicare with a backup of our employer insurance as secondary. He too has not had to sacrifice anything whether it's heart operations or a recent knee replacement. Surprisingly when he needed a cochlear implant to hear he had to wait until he was old enough for Medicare to cover it. Private insurance didn't.
My son continues to be covered at 23 as a disabled adult child. Medicare and private insurance.
I don't know how this is all going to shake out. I wish others the coverage we are so grateful for. I just hope they improve things, not trash them in a partisan brouhaha. -
Yes, I am fortunate for sure! There are some good things about ACA one of which is eliminating the term "pre existing condition". I live in Massachusetts so I have not had to worry about that for several years. But, I'm not a fan of ACA in its entirety. My previous post was in response to Beesie's post and was intended to draw a comparison between private and gov't healthcare in the US. I am clearly doing better than the existing gov't plan, Medicare, as evidenced by my moms need for supplemental insurance. No need to price private insurance because she doesn't need it. She is fortunate to be able to afford the supplemental insurance and is fortunate to have Medicare. I think ACA is intended to be "Medicare light" for the masses. Many would be very grateful to have it. But, I will stick with the for profit insurance company for as long as its offered to me.
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Oh heck. I don't think anyone is happy with the ACA in it's entirety. I wish we had managed a better plan but given the number of times they've tried to reform health care, and gotten no where? As least this is a start. I have semi decent insurance. They've paid out $65,000 on me from Feb to June. They've turned some things down and I've had to pay more than I feel like I can afford, but I got treatment, and they have really been fairly decent to deal with. The problem is, I'm 51. That means I have to keep working at this job (or find one with equally good beni's) for the next 14 years. If I get laid off? I'm sunk. If Mom needs me to care for her full time, we're sunk. If the cancer should come back and make be sick enough that I can't keep working? Done. I don't have a spouse to fall back on so yeah. I'd like a safety net. And I feel so very sorry for the people who don't have coverage and need to figure out how to come up with their annual salary x2 for a really rather uncomplicated illness.
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I do have problems with idea that because one is lucky, one should ignore those who are not. And luck has a bad habit of changing. Not a Lady, as the song says.
Those who have insurance through their jobs are a layoff away from being uninsured. (COBRA, by the way, is so expensive that many people who are laid off cannot afford it.) Those who have insurance through their spouses are a divorce away, a death away from losing insurance.
I am not thrilled with the ACA, but I'll take what we can get.
And on the insurance company being the one to rely on: insurance companies are highly regulated, but they still are primarily profit driven organizations. The government has inefficiencies and problems, but ultimately, in a democracy, which we're supposed to be, it answers to the people.
As far as costs go: I still maintain that we will go a long way to containing costs when we adopt healthier lifestyles. Tax sugar. Provide incentives for exercise.
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While we are all talking about it here's a little quiz from the Kaiser Foundation about what is really in it ...
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Alexandria, did anyone suggest that those of us with insurance are ignoring those without ? Or do not want a solution? We are acutely aware that at any time our employers can dump us. I remember some 25 years ago when Verizon notified us of the new clause giving them that latitude. That's why we need ACA or whatever improved form it can take.
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I'm not ignoring those who don't have insurance. I want people to have coverage and ACA is a step toward getting them that coverage. It's certainly better than nothing. But my current coverage is, IMO, better than the gov't coverage could ever be so I'm sticking with it. The US government is the most inefficient machine in existence as far as im concerned so I'm not interested in leaving my health in their hands as long as I have a choice. For now, I still have a choice.
And for the record, I ate a candy kiss today so no, Im not a proponent of sugar tax! -
Republicans must not have pre existing conditions or have to worry about their 22 yr old traveling across the country with no insurance. Who are these people? Are they that rich they can take care of all the issues this law is trying to cover for the middle class? Do they have a clue how fast one can loose their insurance? I am baffled by this behavior and I think we should get the citizens of Massachusetts on these talking heads programs and let them tell their story. I have not heard one negative thing about the Romney care in Massachusetts. Actually the state is doing well financially. Go figure.
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Rianne, brainwashing is all that comes to mind.
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I did not mean to offend anyone. I wasn't referring to anyone on this thread. I just meant in general - people who are strongly against the ACA tend to be people who have the luck to have good insurance and seem unaware that they could be without it should luck change. I am in agreement with the vast majority of the posters on this thread that ACA could be better, but it's a start.
The sugar tax was something of a joke - (she said, unwrapping her Trader Joe's chocolate bar) but, honestly, how much of our medical expenses are going to taking care of conditions that might have been prevented by lifestyle change. I don't put bc in that category, but there's diabetes, heart disease, both of which have a clear relation to lifestyle. Increasing exercise, improving diet could go a long way to reducing health care costs. And if we can prevent just some of the multiple cases of type 2 diabetes by getting people to move and cut back on sugar, that would cut our health care costs overall.
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Hey, hey, hey! Easy on Republicans. I'm a republican and a citizen of Massachusetts!
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HI Kaybe, I'm still not sold government run health care or mandates to get health care is against our own best interst. I think riverhorse made an excellent point. I'd much rather battle with an insurance company to pay a bill than a government to approve a treatment. Ugh., seems very scary to me and seems like too much potential control over my life. Right now, we can pay cash (granted if we have it) if an insurance company denies certain treatment. But with government control, its seriously possible to lose the ability to pay cash for a treatment you want under a gov't controlled health care world. I'm sorry, I am not feeling the thrill on this one.!
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"Right now, we can pay cash (granted if we have it) if an insurance company denies certain treatment."
Actually quite often you can't. If your doctor or hospital has a contract with your insurance company it includes a clause that they are not allowed to charge you for any amounts that the insurance does not cover. My best friend found that out when she wanted a bone density test because of her extensive family history. The insurance would not cover it until she was 65 and the doctor/hospital would not administer the test because they could not legally bill her for it because of their insurance contract. That whole scenerio blew me away.
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We have no complaints about our Medicare coverage either. I think a lot of this angst about the govt running things badly, ignores the complexity of the systems. It is the very complex nature of our society and the govt we vote for that makes some interactions with the govt so difficult.
Actually I've had far more trouble at the state level than the federal. DMV lines anyone? -
Sorry mardibra! You're my pal and I love ya whatever your political affiliation! I'm an Independent and have voted both parties.
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Today I saw a GOP superpac ad calling the ACA mandate "the biggest tax increase in America's history". Then I turned on CNN and saw a multitude of newsclips of politicians saying the same thing.As I understand it, if a person refuses to buy health insurance (given that this person has the financial wherewithal to purchase it), then he is assessed a penalty. Seems only fair that he should be taking responsibility for his own health, instead of depending on the local emergency department!Then I read this in Forbes webmag, which puts the lie to the tax meme:In the opening paragraphs of Chief Justice Roberts’ opinion, he clarifies that the law specifically does not involve a tax. If it did, Roberts clarifies, the Court would have had no choice but to reject the case for lack of jurisdiction as a tax case cannot be brought until someone is actually forced to pay the tax. This is, as we know, not the case.
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But my current coverage is, IMO, better than the gov't coverage could ever be so I'm sticking with it.
Mardibra - I'm baffled by this statement. Maybe you can explain why you wouldn't continue with your "current coverage" under ACA (presumeably private insurance) and what exactly is "gov't coverage" that you could theoretically choose instead?
If you already use Medicaid, Medicare and VA (the only government plans I know of under ACA), then you would probably continue to use those.
i'm wondering if those opposing ACA think there is some sort of single payer system they would be signing up for as opposed to a private health insurance plan?
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Sigh....on an earlier post someone was saying that they would rather have the gov't be responsible for their healthcare and not a for profit corporation. I disagreed. Which is why I said I'm sticking with what I have. ACA won't do a thing for me because I'm already covered.
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Yorkiemom....thank you! Feeling like a red headed stepchild amongst all these dems!
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Lindasa - any gov't forced "penalty" is also known as a tax regardless of what they call it. The only money that goes TO the govt is tax.
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Ok..I haven't caught up with all of the posts, but reading what you wrote it sounded like you might think the "Exchange" were not comprised of private health insurance plans. Thanks for the clarification.
Having said that, I disagree with your assessment of private versus public administered healthcare delivery. People love Medicare and it has a much lower cost of administration than private healthcare plans. Atleast with ACA, private insurers will now be limited to 20% of premiums going to administrative functions and those private companies who have exceeded 20% will be required to issue a refund this August to their premium payers. Medicare admin costs run 2% of expenditures - what happens when you remove the allowance for profit.
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See, I can't get all upset about the "OMG! The government is making me pay a penalty, or buy something I don't want" argument. I pay taxes. Lots of taxes and my money gets spent on all sorts of things I disapprove of, and some things that I do approve of. Some taxes I can take some control of, such as with gas taxes, or cigarette taxes. Others, I pay just because I get a paycheck. I am required to have insurance on my car, even though I might never get in an accident. I am required to have insurance on my house. My tax dollars have been paying for other people's medical care, the elderly, the very poor, and the Native Americans who use IHS. I pay farmers not to grow food. So, why is it some great insurmountable hurdle to say everyone who can afford to, is expected to pay into the system that pays for your health care? Buy insurance please. But if you refuse, you'll be charged a token amount (less than one visit to the ER in most cases) to help keep the hospitals afloat.
Actually, as I think about it we are "forced" to buy all sorts of things, car seats for the kids, helmets if we ride a motorcycle. Airbags and seatbelts, and a ton of antipollution stuff all crammed into every car that's sold.
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HI Whiterabbit. I actually pay cash for a lot of my medical as the coverage is sometimes lower on Insurance and the companies will provide lower cash price as they're paid for. I did this for my PET/CT, which was 3600 Insurance cost and they only paid 50%, Paying cash it only cost me 890.00 for cash. I'm not sure everyone has the same experience as your friend.
At either rate, I'm afraid of lack of control and governement involvement .
KAM- not sure that everyone loves medicate. Thats pretty broad based. I can say for my family, we hated that my Father had to rely on it. They denied much needed treatment for him and it was sad. A tough battle ensued and we lost. My experience is not everyones, but to say people love it, I think is using a broad paintbrush.
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