Obamacare

[mike_thieriot]

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

I sure hope not. Besides, Romney's odds of winning are pretty slim. He's like the antithesis of everything that is Republican.

[srstevo44]

I'm glad at the input into this forum. Thanks for all the discussion. Currently I'm in a biomedical sciences PhD program with the goal of being a cancer researcher someday. As part of the medical field I see a huge imbalance between research, healthcare, insurance, patients, healthcare providers etc.... The system is so crazy that the individual goals/needs of all of those listed doesn't match up with the others in an efficient manner. For instance medical research and actual implementation of those efforts must pass a huge gap in authority/bureaucracy before even getting to the long process of FDA trials/and approval. Although I fear that forcing people to have insurance and penalizing them if they do not is a blow to civil rights, for healthcare it might be a good move overall. It may also boost funding for biomedical research which I believe (biased I must admit) is a good thing. Similarly, it will increase the need for healthcare providers, but that does come with it's own shortcomings. In response to the Supreme Court decision, the president of my medical school made statements to the local news that we would need to boost admissions by 30% to meet the new demand for doctors/nurses etc....so this could mean that less qualified people will now be getting into medical school. Obamacare could also cause doctors salaries to decline (however I feel they are overpaid), but it could also lower their malpractice insurance premiums if healthcare is to become a more national expense. There certainly are parts of the bill that, in my opinion, make for better policy, they include: not excluding people for pre-existing conditions or dropping them when they become severely ill, allowing children to stay on parent's policies until 26, and curbing insurance premium spikes. Overall I hope this bill helps to create a better balance in the system. I truly believe that a healthcare system that balances research, patient services, healthcare employment, and public education will benefit society immensely.

[srstevo44]

I sure hope not. Besides, Romney's odds of winning are pretty slim. He's like the antithesis of everything that is Republican.

I actually thing Republicans have a chance to sweep both houses of Congress and the Presidency this year. Radical laws like Obamacare can really segregate the nation. Look what happened in 2010 with the Republicans taking the majority in the House mainly in response to Obamacare and big bail out policies. Moreover, radical anything can cause may people to air on the side of caution and make them vote for the party that would return things to the previous status quo. Obama and democrats will really need to push other platform issues to continue to build faith in their party and ideals. The Tea Party can really ride on the large portion of the country staunchly opposed Obamacare and other more socialist policies. As far as Romney goes, he used to be more moderate (which I liked), however he is only chance of winning now is to appeal to the strict conservatives (which even Republicans that were never real conservatives now are hardcore conservatives because they are so against the bail out and obamacare). He is doing a good job of faking it at least because he is determined to repeal Obamacare.

[spacemunkee3]

No country has the perfect health care system. Healthcare is human. It's going to be flawed just like all the people who participate in it, which is everyone, eventually. Waste and abuse is going to be common. Currently health care in America is profit driven. If you have lots of money and/or the best insurance, you get superior care. If not, you suffer, or worse, you die. The AFA is only a first step, designed to neuter just one dominating faction of the US health care cluster-fuck: Big Insurance (companies who are just as greedy and power-hungry as Big Oil). The "US Health Care System" is a myth. What we have is a conundrum of here-and-there regulations combined with Big Insurance dominating the US health care landscape with competing contracts with regional health care providers and doctors. Currently tens-of-thousands of US citizens (yes, full citizens) die every year due to preventable illnesses from lack of affordable access to health care. We have a system where uninsured Americans are charged full-price for services they could never afford, simply because they are not insured (remember those contracts... the "allowed amount" on your EOB). Americans pay more for health care than any other industrialized country and our custom of expensive, employer-based health plans make American products that much more expensive in the global marketplace. The AFA is the first comprehensive health care reform we've had in the US since Ronald Reagan legislated DRGs and CPT coding in the 1980s, effectively giving county-owned hospitals the authority to become their own little corporations. As for Barebacking and the AFA.... LOL... I don't know. What I do know is that back in 2004/2005, when President Bush attached renewal of the Ryan White Care Act (funding for HIV/AIDS meds and treatment for the poor and uninsured) to the Iraq War spending bill, the political debate in Congress delayed states getting funding, and people on HAART waiting lists died needlessly, not because they had reached the end of HAART regime possibilities, but simply because the money wasn't there to even put them on HAART to begin with. I applaud President Obama for actually "caring"... Obamacare, and I regret that Big Insurance spent billions of dollars flaming misinformation and fear about the Act and divisive partisan politics. Before you go assuming what's in the AFA, or believing chain email fear-mongering, I challenge people to read what's in it. It's not perfect and doesn't address all the issues (controlling costs), but it has the backing of the American Academy of Pediatrics, the American Medical Association, the American Association of Retired Persons, and every single HIV/AIDS treatment and prevention program in the United States... that says a lot.

[spacemunkee3]

I don't think so. RomneyCare (that Mitt passed in MA) is exactly the same as ObamaCare, and Romney's denial of that is going to backlash. True, this will radicalize the GOP Tea Party base, but they were already radicalized and anti-Obama. The key deciders will be Independent voters in swing states, and if there's one thing that turns off Independent voters more than any health care mandate, it's radical extremists. And let's understand a fundamental point: Obamacare is nowhere near any kind of "socialist" ideology. It's just the opposite. It actually enhances and subsidizes corporate participation in health care, but makes those corporate entities more responsible to the patients and insureds that they cover. True, most Americans are opposed to the individual mandate contained in the AFA, but only because they have been misinformed with inflammatory rhetoric about how it will work. The majority of Americans fully support the more important and bigger parts of Obamacare: ending pre-existing condition clauses, kids covered until age 26 if in college, and Medicaid expansion for the working poor.... all of which Romney opposed, until just two days ago.

[bobbie]

I hear what you're saying. But many Canadians come to the USA for all types of elective surguries because they can't get them in a timely manner in Canada.

Also I never hear of many people going to Canada for any speacial surgeries...but, many people from other contries come to the USA for critical medical help...so we must

be doing SOMETHING right

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.

[spacemunkee3]

Bobbie: there are some really top-notch and fantastic hospitals and doctors here in the United States. I might add to your statements that the United States is home to some of the very best schools of medicine and we are a very innovative leader in high-tech health care, pharma, medical R&D and medical machines. And there are some really generous hospitals, organizations, doctors and corporations who give away millions-of-dollars of free health care every year to people who couldn't afford it otherwise.

BUT, the Canadians coming here to have elective procedures example is NOT an example of what we're doing right, but what American health care does wrong. Canada operates on a need-based, priority basis where non-life-threatening/non-acute/elective ailments are rationed secondary to more serious, life-threatening ailments. This does not mean that Canadians who have been deemed "elective" will never get care, but they will be placed on a waiting list. Now, IF certain Canadians have enough money, they can come to the United States and pay a doctor or hospital to treat them sooner at their convenience. Because here in the United States, health care is not a human right for all citizens, like in Canada. Health care in the USA is like any other product (car, house, boat) to be sold to any buyer, at whatever price the seller thinks is reasonable.The sad thing is that whereas Canada rations health care based on need, America rations health care based on the patient's ability to pay. So, in your example, there will always be a poor working American who is under-insured or uninsured, with the same ailment as the Canadian patient, and he/she will NEVER be eligible to have their elective suffering relieved, until they can pay for it.

And also true, Americans enjoy some very advanced critical care expertise and high-tech life saving techniques, but they come with a very high price. We live in the only nation, where a patient can be severely injured, die, and be brought back to life and even have severed limbs replaced, only to lose their home, vehicles and any monetary savings... becoming homeless on the street... just to pay for that critical care. But plenty of rich foreigners come here to take advantage of our advanced health care system and even pay in advance.

I've personally witnessed wealthy Middle Easterners rent (via sizable donation to the hospital) entire hospital floors for the care for one foreign person with a critical diagnosis. But what about all the Americans that had ailments, even serious conditions, that probably needed those hospital beds, you may ask? Tough. This is America. Money talks and bullshit walks.... even in health care.

We can do better.

[HungLatinDom]

I don¡t understand why people are irate about higher taxes, but paying 12K a year in health insurance, plus copays is just part of life. Seriously? Next time a Teabagger complains about hig taxes in Europe, he should add his college loans and insurance expenses to his federal taxes, and let's see how worse Europeans are doing.

[HungLatinDom]

Bobbie:

Citation please. I hear that claim all the time, but I have never seen the numbers behind it.

[mike_thieriot]

Bobbie:

Citation please. I hear that claim all the time, but I have never seen the numbers behind it.

It's actually surprisingly few. I wouldn't trust anything an American believes about another country, particularly Canada. Most of them still believe we live in Igloos... And wait times are not THAT long here. The problem is that it varies wildly based on what city/municipality you live in. For example, I grew up in a small town in Ontario where the health system was just horrendous. You'd wait ten hours in the hospital unless you were in serious condition. But that's because there were a shortage of doctors, which makes sense because, after spending a decade or more enjoying the exciting world of the big city while in medical school, who would want to relocate to the middle of bumfuck nowhere? You couldn't possibly pay me enough to practice in a small, rural town if I was a doctor. By contrast, since I moved to a city of about 500,000 just outside of Toronto, I have never waited more than half an hour for anything.

[calrockxxx]

Here's an anecdote:

I have pretty good health care (I'm in MA so coverage is mandated) but I spent a day in an ER last week because my insurance wouldn't pay for the refills on two meds Ive been taking for the past five years. I had to go to the hospital to get my condition stabilized, and at the end of the day they sent me home with any extra meds. They just gave me more prescriptions that the insurance company refused to cover.

So it turns out the insurance company just willy-nilly 'updated' their drug formulary and told me I now have to pay about $1500 for a month's supply. And these aren't even HIV drugs!

I haven't looked at the Obamacare legislation in any detail, but I hope it contains some requirements for insurance to cover all prescriptions. It's ridiculous to let people who can't afford their meds go without them unless they're being hospitalized. Talk about a waste of money!