Obamacare

[srstevo44]

So what does everyone think about Obamacare being upheld by the Supreme Court in relation to barebacking? Will the fact that everyone will have to have insurance, and that insurance companies cannot exclude people for pre-existing conditions (like HIV) make it easier to get over the fear of HIV or other STDs? Especially would like to hear from those in countries with socialized health.

[Hotload84]

One would think the Affordable Care Act ("Obamacare") will make it easier to get insurance, particularly where pre-existing conditions are at issue. I understand, moreover, the insurance companies cannot charge higher prices for policies issued to such individuals - so I should think it will be a boon to our community generally, and specifically may reduce the fear-factor related to post-seroconversion medical costs.

[mikealec]

I love the US and Americans, but you guys are nuts if you don't improve access to healthcare, which I get totally free

[drscorpio]

We're getting there, mikealec. I think after people get used to the ACA and see that it benefits them, it will be easier to take the next step towards universal coverage.

[Hotload84]

I love the US and Americans, but you guys are nuts if you don't improve access to healthcare, which I get totally free

We struggle with collectivism and individualism, Mikealec. Moreover, reaching a consensus is all the more troublesome when it entails money (as in the healthcare debate) or the loss of perceived status (as in the same-sex marriage argument). Sometimes we get it right, sometimes we fuck-up. Moreover, because the way we tally votes is skewed by political boundaries, the majority does not always get its way. Finally, add into the mix the challenge of the court system, where the multiple levels of courts at the state and federal levels, each interpreting the laws with the strengths and weaknesses of the individual (not to mention the roll of money and/or profile in determining outcome), it's no surprise American can reach decisions that are, perhaps, counter-intuitive, if not counter-productive.

[bobbie]

I love the US and Americans, but you guys are nuts if you don't improve access to healthcare, which I get totally free

Nothing in life is totally free! Somebody has to pay for it!

[mike_thieriot]

Nothing in life is totally free! Somebody has to pay for it!

Everyone has to pay for it in the end, but overall (and this may sound counter-intuitive), since single-payer systems are far more efficient than the US system, the average person will actually pay much less than if they were only paying for themselves (in terms of total expenditures - be it out of pocket, through insurance premiums, or through taxes). This is leaving aside the fact that with insurance, you're not just paying for yourself either. Private insurance is a risk pool, the same as public healthcare. The difference is that the overhead of public healthcare is much lower (the US's total administrative overhead on health care spending is around 30%, whereas Canada's is about 3%).

[ronetbus]

The individual mandate part of the affordable healthcare act was put in place to appease the insurance companies. In one debate I heard someone say it was to keep health insurance companies from going bankrupt. Health insurance comapines are a huge part of the problem here in the US, so I say let them go under. Conservatives claim Obama's law will put the government in between you and yuour doctor, which is exactly where the insurance companies sit right now, so what's the difference?

[evilqueerpig]

For those on the fence about barebacking, it might change some minds, but hardcore barebackers will be doing what we've always done.

[Hotload84]

The individual mandate part of the affordable healthcare act was put in place to appease the insurance companies. In one debate I heard someone say it was to keep health insurance companies from going bankrupt. Health insurance comapines are a huge part of the problem here in the US, so I say let them go under. Conservatives claim Obama's law will put the government in between you and your doctor, which is exactly where the insurance companies sit right now, so what's the difference?

There is certainly a degree of visceral pleasure, Subtenor, in the thought of the healthcare insurance companies disappearing from the face of the earth, but it's hard to imagine we would ever have the collective courage to accept the chaos that would immediately follow such a collapse. I agree with Mike_thierlot - a single payer arrangement is a much more sensible arrangement, but how to get there? Crash-and-burn or incrementally? I'd choose the later, and trust the future to continuously tweak the arrangement with the hope we would eventually adopt a better system.

[Guest Boxir55]

I don't really like Obama but he has done the right thing here, as has your supreme court.

[DarkroomTaker]

I love the US and Americans, but you guys are nuts if you don't improve access to healthcare, which I get totally free

Sorry i disagree, I have to pay a massive portion of my salary each month Nat insurance etc, then pay for my prescriptions and pay tax!. Nothing is for free. + if That ass Cameron gets his way and more people are being allowed into the country, the NHS will collapse, then we will become like other countries.

[rubio2001]

Half of my family is in the US and the other half are in Canada so I see both worlds. Based on my experience only I've found that there are many, many more guys who are comfortable barebacking in Canada. I'm not sure if their healthcare system is part of their decision to bareback but I imagine knowing that they will have insurance in place if they get HIV probably allows some Canadians the ease of mind they need to go ahead and do it.

However, I find it hard to believe there are many guys in the US who play safe only because of their fears of the US healthcare system.

As for Obamacare I believe this is a great 1st step that will most likely turn into a single payer type system down the road - albeit 20+ years down the road. Decades ago Republicans fought US Social Security and Medicare/Medicaid using the same arguments that they used against Obamacare. I'm hopeful once people get used to the new system they'll not be able to comprehend going back to the old way. It's more important to elect Obama in 2012 than ever before.

[mike_thieriot]

Sorry i disagree, I have to pay a massive portion of my salary each month Nat insurance etc, then pay for my prescriptions and pay tax!. Nothing is for free. + if That ass Cameron gets his way and more people are being allowed into the country, the NHS will collapse, then we will become like other countries.

I always hear this "nothing is for free" argument, but it really doesn't hold water. The reality is that the American system is so royally fucked up that Americans would actually end up paying around HALF of what they do now for health care (all told, including taxes, premiums, and out-of-pocket costs) if they switched to single-payer. This is based on the fact that Canadians, who have a single-payer system (unlike the Brits who have a system where all of the doctors and such are employees of the government, in Canada they are private and simply bill the government). I do think that single-payer, as it is implemented in Canada, is actually better than a completely government-run system such as the NHS in Britain. The Canadian system does need some improvement, for example it needs to cover drugs for everyone, not just seniors and welfare recipients. However, since we already pay half of what the Americans do, we have lots of room to pump more money into the system to get better results, if we so choose.

Also, I'm not positive (forgive the pun haha), but I don't think HIV meds are covered here either, unless you can demonstrate that you absolutely cannot afford them. Though, at $2500+ a month, that should apply to most people out there. But if you end up admitted to hospital and they give you drugs there, those are always covered.

Edited June 30, 2012 by mike_thieriot

[BttmReady]

Obamacare, most likely, will be history within a year.