SCOTUS Upholds Affordable Care Act!

Mardi, the only reason you have affordable insurance is because your employer pays the bulk of the cost.



A lot of employers can no longer afford to do that.



Do you know what the true cost of your insurance is annually?

OK, so presumably your real insurance cost is a lot more than 1200 bucks a year, correct?

My apologies, I sort of came in at the middle of things.



The thing is that most small businesses cannot afford to buy that kind of insurance for their employees. Many big businesses are also having problems, and they are increasingly shifting the cost to the employees or trying to get out of it, like walmart signing its employees up for medicaid.



Then there is the whole problem of people who are self-employed, like I was when I lived in the US.



In other words, it is not realistic fr everyone to get a job with bennies like yours or else make do with charity [not saying you are arguing this, but it is an argument I have seen made plenty of times]. Meanwhile the number of people stuck in the middle, where they have a HHI around the median, i.e. 50K a year, making them too "rich" for medicaid, but way too poor to shell out 12-15K a year for private insurance, has become too large to be workable for the system.

Alexandria, I completely agree. Nor is if efficient, either in terms of cost or in terms of getting everyone covered.



As far as I am concerned, there should be an insurance mandate, with subsidies for those who need them, and insurance should be purchased at the state level, through a buying cooperative, to which everyone belongs and thus the "group" consists of everyone in that state. That way you could retain some state control and ability to tailor to local cnditions, and also keep private insurance in the loop.



But that is just me. I am guessing my solution is close to what Romney did in MA.

PatMom,

Please provide links that support your statement that the Federal Government is restricting the number of hospitals being built.  I tried to find it but couldn't.  I did find this Fact Check which said:

Claim: Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!

False. It's already illegal, with certain exceptions, for doctors to refer Medicare patients to hospitals, labs, medical imaging facilities or other such medical businesses in which they hold a financial interest. Page 317 would modify an exception to that "self-referral prohibition" for rural providers, and says doctors can't increase their stake in an exempt hospital after the bill becomes law.

Claim: Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.

False. Expansion is forbidden only for rural, doctor-owned hospitals that have been given a waiver from the general prohibition on self-referral. It does not apply to hospitals in general. The bill provides for exceptions to even this limited expansion ban (page 321).

Claim: Page 321: Hospital expansion hinges on "community" input: in other words, yet another payoff for ACORN.

False. Page 321 says rural, doctor-owned hospitals that are exempt from the Medicaid self-referral prohibition can ask to be allowed to expand under rules that must allow "input" from "persons or entities in the community." Under that language, anybody in the community could offer their opinion, but nobody - not ACORN or anybody else - would be paid for it." 

This link corrects much more misinformation and misstatements of fact.  It is worth reading because it actually refers to the page of the ACA so the reader can verify the wording of the bill herself.

http://www.factcheck.org/2009/08/twenty-six-lies-about-hr-3200/

Patmom, I don't think anyone on this thread stated that a majority of Americans are without insurance, but 25 percent is a pretty big number of people to just write off.

          And there are many of Americans who have insurance but cannot leave terrible jobs to try business on their own or take another job because of insurance issues.  There are many, like me, who have insurance but are terrified at the slightest bump that we'll lose insurance and, absent the ACA, be unable to buy a private plan because of preexisting conditions.

             So, if the government pays off the student debt of doctors to practice in underserved areas - say at $200,000 per doc, where is that money coming from?  Is that not tax money?  And who is setting up those sliding scale clinics?   The government?  With what money?  Tax money?  Aren't we right back to the idea of government provided healthcare which you seem to be against?If you think charities will just step in, well, have they up to now?  What is the guarantee that there will be charity clinics in areas without doctors now?

           BTW, the assessment i've heard on medical availability is that there are plenty of specialists, but not so many family doctors, and it's a self-selection because specialists make more money. Fewer medical students chose family practice.  So, it's the market, not the government, causing any shortages.  

Being a newbie to a thread like this, I need some clarificaiton on what constitutes "bashing?"  For example, do any of these comments qualify?

CA has been run by Democrats for decades.  Very poorly I might add.  

Your taxes might go up anyway when the Bush tax cuts expire, hopefully. 

Just kind of sick of reading about some of the half-truths, misinformation and personal agendas stated on this thread. (In a post responding to me.)

Accuracy is important. 

I never said that the FEDERAL government is restricting the number of hospitals being built, but it seems to be quite prevalent among state governments. 

 http://www.patriotledger.com/lifestyle/health_and_beauty/x1444026822/South-Shore-Hospital-expansion-gets-state-approval

http://www.dukehealth.org/health_library/news/duke_raleigh_hospital_seeks_approval_for_new_operating_rooms_as_part_of_continued_expansion

http://www.highbeam.com/doc/1G1-120302718.html

I haven't said that giving more people access to care is a bad idea.  I have challenged those who think that adding more patients to an already burdened system is going to magically make the system less burdened.  The key is to expand access to care, and adding more people to the insurance rolls won't accomplish that the way that significantly expanding the number of providers would. 

Medical professionals are not slaves who can be forced to work without compensation, and many of the pieces of the ACA will encourage some (many) to leave the profession with a net result of fewer providers not more providers.

Alexandria5, I guess you didn't notice lassie11's reply to mardibra's quote  "That is not true. Most US citizens are inured and insured well"

with the very dramatic , but inaccurate statement:

"If only that were true, there would be no need for any of this. But it's not true and real people, lots of them, real American citizens, are suffering for a lack of or inadequate health care."

If you are inaccurate in reading this thread, its content and comments, is it possible your understanding of what the ACA will do might be less than accurate too?

Pat, the link from Duke says nothing about the local government limiting beds. Of course you need to apply for a permit, but that doesn't mean that the government is out to make hospital beds scarce.

The Patriot Ledger also talks about a building application being approved. I am puzzled as to how approving hospital building permits is evidence of government limiting hospital beds..

Governor Perry is refusing Medicaid Expansion money from the Feds and refuses to set up Exchanges.  Says it will put his state in economic ruin.  In my mind, if I lived in Texas and were self-employed, I might not like this decision. I might decide to move to a neighboring state that offered a group plan I could join, espeically if I had a pre-existing condition and could not get health insurance on my own.  Smart move?

Anybody else think that those governors who are opting out of setting up exchanges for their states would not do a good job of it anyway so maybe it's for the best that they keep their paws and claws out of it?  Their residents will then be able to go to the federal exchange which will be a larger group and probably a better deal anyway.

I sure wouldn't want somebody whose main political goal was killing the system being the one in charge of the exchange available to me. 

One would think that such a serious decision as rejecting insurance exchanges or rejecting Medicaid expansion would be put to the people of the state for a vote.  Evidently some governors rather act on their own.

From the link  "Duke Raleigh Hospital today filed a Certificate of Need (CON) application with the state of North Carolina"

They filed the CON application because the state of North Carolina needs to approve any hospital expansion in the state.  A couple of Duke's neighboring hospitals, UNC and Rex have been battling back and forth for years because they both want to expand and the state will only approve one expansion, so the area is left with fewer resources because the state hasn't picked which hospital gets to build.

This is not about a local building permit that makes sure that things like structures and plumbing and electrical systems are built to code, this is a state approval to allow them to even start the process of seeking those local permits.