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Old 10-06-2019, 03:46 PM
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Obamacare


Five year on from its introduction, is it fair to say that this was a scandalous disaster?
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Old 10-06-2019, 03:49 PM
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Nope.
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Old 10-06-2019, 03:51 PM
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It worked exactly as intended, americans still do not have universal healthcare.
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Old 10-06-2019, 03:52 PM
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No.
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Old 10-06-2019, 03:53 PM
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ACA insured millions of uninsured diabetics.

The only disaster is the piecemeal destruction of the Act by the coward in the White House.

Reported for forum change.
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Old 10-06-2019, 03:53 PM
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It worked exactly as intended, americans still do not have universal healthcare.
Thanks to the GOP.
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Old 10-06-2019, 03:56 PM
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No.
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Old 10-06-2019, 04:00 PM
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Well, it's not the screaming success Trumpcare would be, if that existed, that's for sure. But on the other hand, Trump's wall is gorgeous. What's that? He hasn't done that either? Shit fire.

Last edited by bobot; 10-06-2019 at 04:01 PM.
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Old 10-06-2019, 04:01 PM
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I was under the impression that the ACA was at least on a par with the Sestak Job Offer, Fast and Furious and the Bergdahl Swap.

Last edited by CHealy7; 10-06-2019 at 04:02 PM.
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Old 10-06-2019, 04:07 PM
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Originally Posted by CHealy7 View Post
I was under the impression that the ACA was at least on a par with the Sestak Job Offer, Fast and Furious and the Bergdahl Swap.
A historic change in the massively complex US health insurance system — a change that, despite being shrunk and shackled from the get-go (and later moreso) by the Republicans, still helped millions of Americans get insurance, plus helping millions more through pre-existing conditions, 20-something children living with parents, and more...

...you’re comparing this to a scattered handful of minor policies or decisions that one might reasonably quibble with, but few level-headed folks would say are so serious or consequential as to be called “scandals”?

ETA: You forgot the “tan suit.” And the “Marine holding the umbrella.” Now, THOSE were scandalous!

Last edited by JKellyMap; 10-06-2019 at 04:08 PM.
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Old 10-06-2019, 04:09 PM
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No.
So not rattled heh.

Yup, and the dems are doing the same thing again this time 'round. Kamala and Booker loves that big pharma $. Go see.
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Old 10-06-2019, 04:11 PM
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ETA: You forgot the “tan suit.” And the “Marine holding the umbrella.” Now, THOSE were scandalous!
Lest we forget, Michelle was photographed with bare...arms.
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Old 10-06-2019, 04:11 PM
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A historic change in the massively complex US health insurance system — a change that, despite being shrunk and shackled from the get-go (and later moreso) by the Republicans, still helped millions of Americans get insurance, plus helping millions more through pre-existing conditions, 20-something children living with parents, and more...

...you’re comparing this to a scattered handful of minor policies or decisions that one might reasonably quibble with, but few level-headed folks would say are so serious or consequential as to be called “scandals”?

ETA: You forgot the “tan suit.” And the “Marine holding the umbrella.” Now, THOSE were scandalous!
Health"care" in america is an utterly bipartisan scandal.

Ranking 37th — Measuring the Performance of the U.S. Health Care System
https://www.nejm.org/doi/full/10.1056/NEJMp0910064

World Health Organization’s Ranking of the World’s Health Systems
Some people fancy all health care debates to be a case of Canadian Health Care vs. American. Not so. According to the World Health Organization’s ranking of the world’s health systems, neither Canada nor the USA ranks in the top 25.

Improving the Canadian Healthcare System does not mean we must emulate the American system, but it may mean that perhaps we can learn from countries that rank better than both Canada and the USA at keeping their citizens healthy.
http://thepatientfactor.com/canadian...ealth-systems/

U.S. Health Care Ranked Worst in the Developed World
The U.S. health care system has been subject to heated debate over the past decade, but one thing that has remained consistent is the level of performance, which has been ranked as the worst among industrialized nations for the fifth time, according to the 2014 Commonwealth Fund survey 2014. The U.K. ranked best with Switzerland following a close second.
The Commonwealth Fund report compares the U.S. with 10 other nations: France, Australia, Germany, Canada, Sweden, New Zealand, Norway, the Netherlands, Switzerland and the U.K. were all judged to be superior based on various factors. These include quality of care, access to doctors and equity throughout the country. Results of the study rely on data from the Organisation for Economic Co-operation and Development, the World Health Organization and interviews from physicians and patients.
http://time.com/2888403/u-s-health-c...veloped-world/

HOW BAD IS U.S. HEALTH CARE? AMONG HIGH-INCOME NATIONS, IT’S THE WORST, STUDY SAYS
As Republicans struggle to agree on a replacement for the Affordable Care Act, the Commonwealth Fund has rated the U.S. health care system as the worst among the 11 developed nations it analyzed as part of an evaluation conducted every three years. The think tank also rated the U.S. health care system as the worst-performing of the nations analyzed when the last evaluation was released in 2014.
https://www.newsweek.com/united-stat...d-worst-637114

How does the quality of the U.S. healthcare system compare to other countries?
Bench-marking U.S. quality measures against those of similarly large and wealthy countries is one way to assess how successful the U.S. has been at improving care for its population, and to learn from systems that often produce better outcomes. The OECD has compiled data on dozens of outcomes and process measures. Across a number of these measures, the U.S. lags behind similarly wealthy OECD countries (those that are similarly large and wealthy based on GDP and GDP per capita).In some cases, such as the rates of all-cause mortality, premature death, death amenable to healthcare, and disease burden, the U.S. is also not improving as quickly as other countries, which means the gap is growing.
https://www.healthsystemtracker.org/...es/#item-start
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Old 10-06-2019, 04:12 PM
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Lest we forget, Michelle was photographed with bare...arms.
A black woman can sure get under some folk's skin.
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Old 10-06-2019, 04:20 PM
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Just some friendly advice, comrade: I wouldn’t go around these parts showing off that you’re so focused on “rattling” other posters. It could be taken the wrong way.

The charitable interpretation of your posts is this: You sound like you want to revive Occupy Wall Street (and related movements), which helped to focus attention on the inequalities built into the system, and how most Democratic leaders were not going to do much, if anything, to fundamentally change the system, so we shouldn’t put too much faith in either major US party. Fine. I actually agree, basically.

But right now we need to strip one of the major parties of its power, as soon as possible, for many reasons (shorter and longer term) — and your focus on the inequities of the system itself is just a distraction (unless you want to start a thread on that, as I suggested).

How do YOU connect these two themes? Maybe you think that the fall of Trump should be accompanied by a rise — not of the Democrats (not even as just a “temporary caretaker until we’ve gotten back to normalcy”) — but rather the rise of some THIRD option, that would fundamentally change the system?

We’d all love to see the plan!

Last edited by JKellyMap; 10-06-2019 at 04:20 PM.
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Old 10-06-2019, 04:36 PM
Fentoine Lum is offline
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Thanks to the GOP.
Then can't you just vote Democratic? Why can't your party git-r-done?
  #17  
Old 10-06-2019, 04:39 PM
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Originally Posted by JKellyMap View Post
Just some friendly advice, comrade: I wouldn’t go around these parts showing off that you’re so focused on “rattling” other posters. It could be taken the wrong way.

The charitable interpretation of your posts is this: You sound like you want to revive Occupy Wall Street (and related movements), which helped to focus attention on the inequalities built into the system, and how most Democratic leaders were not going to do much, if anything, to fundamentally change the system, so we shouldn’t put too much faith in either major US party. Fine. I actually agree, basically.

But right now we need to strip one of the major parties of its power, as soon as possible, for many reasons (shorter and longer term) — and your focus on the inequities of the system itself is just a distraction (unless you want to start a thread on that, as I suggested).

How do YOU connect these two themes? Maybe you think that the fall of Trump should be accompanied by a rise — not of the Democrats (not even as just a “temporary caretaker until we’ve gotten back to normalcy”) — but rather the rise of some THIRD option, that would fundamentally change the system?

We’d all love to see the plan!
Avoiding objective reality again to label again? Run-n-tell on me.

Health"care" in america is an utterly bipartisan scandal.

Ranking 37th — Measuring the Performance of the U.S. Health Care System
https://www.nejm.org/doi/full/10.1056/NEJMp0910064

World Health Organization’s Ranking of the World’s Health Systems
Some people fancy all health care debates to be a case of Canadian Health Care vs. American. Not so. According to the World Health Organization’s ranking of the world’s health systems, neither Canada nor the USA ranks in the top 25.

Improving the Canadian Healthcare System does not mean we must emulate the American system, but it may mean that perhaps we can learn from countries that rank better than both Canada and the USA at keeping their citizens healthy.
http://thepatientfactor.com/canadian...ealth-systems/

U.S. Health Care Ranked Worst in the Developed World
The U.S. health care system has been subject to heated debate over the past decade, but one thing that has remained consistent is the level of performance, which has been ranked as the worst among industrialized nations for the fifth time, according to the 2014 Commonwealth Fund survey 2014. The U.K. ranked best with Switzerland following a close second.
The Commonwealth Fund report compares the U.S. with 10 other nations: France, Australia, Germany, Canada, Sweden, New Zealand, Norway, the Netherlands, Switzerland and the U.K. were all judged to be superior based on various factors. These include quality of care, access to doctors and equity throughout the country. Results of the study rely on data from the Organisation for Economic Co-operation and Development, the World Health Organization and interviews from physicians and patients.
http://time.com/2888403/u-s-health-c...veloped-world/

HOW BAD IS U.S. HEALTH CARE? AMONG HIGH-INCOME NATIONS, IT’S THE WORST, STUDY SAYS
As Republicans struggle to agree on a replacement for the Affordable Care Act, the Commonwealth Fund has rated the U.S. health care system as the worst among the 11 developed nations it analyzed as part of an evaluation conducted every three years. The think tank also rated the U.S. health care system as the worst-performing of the nations analyzed when the last evaluation was released in 2014.
https://www.newsweek.com/united-stat...d-worst-637114

How does the quality of the U.S. healthcare system compare to other countries?
Bench-marking U.S. quality measures against those of similarly large and wealthy countries is one way to assess how successful the U.S. has been at improving care for its population, and to learn from systems that often produce better outcomes. The OECD has compiled data on dozens of outcomes and process measures. Across a number of these measures, the U.S. lags behind similarly wealthy OECD countries (those that are similarly large and wealthy based on GDP and GDP per capita).In some cases, such as the rates of all-cause mortality, premature death, death amenable to healthcare, and disease burden, the U.S. is also not improving as quickly as other countries, which means the gap is growing.
https://www.healthsystemtracker.org/...es/#item-start
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Old 10-06-2019, 05:07 PM
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Originally Posted by CHealy7 View Post
Five year on from its introduction, is it fair to say that this was a scandalous disaster?
Depends.

It was a tepid half measure promoted by (for lack of a nicer word) cowardly democrats who were terrified to make anyone angry. They watered it down so republicans, fox news, pharma, the insurance industry, hospitals and the AMA wouldn't be mad at them. All they accomplished was the rich and republicans were mad at them anyway, but now their base was too demoralized to bother to vote for them in 2010.

But it did help about 20 million people gain insurance. yeah for some of them, its shit insurance. Is someone spending 9% of their gross, pre tax income on a plan with a $5000 deductible, no out of network coverage and tons of exclusions and exceptions really a 'winner'? Not really.

It would be cheaper and easier to auto-enroll the uninsured into medicaid or medicare than to give them subsidies to buy private insurance. But that pisses off the medical industry (private insurance can't compete with medicaid or medicare, and these programs offer lower reimbursements so less money for pharma, hospitals and doctors).

The only true path to health reform is ballot initiatives on the state level. Even in states where democrats control 60-80% of state legislature seats and the governorship, democrats refuse to push for UHC. Even UHC based on places like switzerland which isn't single payer.
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Old 10-06-2019, 06:48 PM
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I would agree, but when VT attempted it, they discovered it would be a fiscal disaster and abandoned the effort. Excess profit is just too baked into the system to succeed piecemeal. But I see no obvious solution. Canadian medicare was put in before medical care got so expensive and has adjusted gradually. It was tried first in one province (Sask.) and was wildly successful.
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Old 10-06-2019, 06:58 PM
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Avoiding objective reality again to label again? Run-n-tell on me.
Not sure why you felt the need to post this twice. Do not spam the boards posting the same thing multiple times.

[/moderating]
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Old 10-06-2019, 08:02 PM
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Five year on from its introduction, is it fair to say that this was a scandalous disaster?
No, it has not been a scandalous disaster. First,it was introduced 9 years ago, not 5. Second, the exchanges have provided a chance for millions to become insured, and they have not had a death spiral/collapse. See the link for the uninsured rate movement since the exchanges fully activated. This represents people buying subsidized private insurance or medicaid. These were people who originally couldn't afford or were too sick to get coverage. There were about 25 million of them, so for them, this has been a lifeline.

https://www.healthsystemtracker.org/...rcent-insured/

But there are two problems:

1) Design: As it was originally written, it was too weak. The subsidies weren't strong enough, and the mandate was too weak. Like any big bill, there were unintended holes in the law that needed to be fixed. For it to do what was intended, there need to be improvements (big improvements). The Supreme Court ruling that made the Medicaid expansion optional for the states was a big blow, too, for millions.

2) To make improvements as mentioned in #1, it requires our congress to do a markup bill. But that won't happen. It has been the subject of withering attacks from Republicans for a full decade, and they will never change on that point. Back then, I had figured they would eventually give in and try to be constructive to improve the law. I was wrong. They'll never accept it, but they also don't want to do anything to improve the situation either. The current president has done a number of things to try to destroy the exchanges. He's cut off CSR payments. He's stopped outreach funding. He's stopped funding navigators. He's trying to put work requirements on Medicaid recipients. He's zeroed out the mandate penalty to make it a mandate in name-only. Many states don't want to run their own exchange and try outreach, especially red states...which also won't accept the Medicaid expansion, even though it's a very good deal with the federal matching funding. Republicans are dug in against the ACA at the federal and state levels.

Given #2 above, the only way anything changes for the better currently is on a state-by-state basis. I live in a red state that wants to do absolutely nothing to help people. There are blue states that are starting to take matters into their own hands.

If Democrats ever get both houses of congress and the white house again (like 2009), they will likely to some version of Medicare for All. The politics has shifted, IMO, because of #2. The Republicans aren't going to be constructive. So, I think Dems are saying "F it, we'll just go M4A".....

The main problem is politics. The ACA has worked well, but needs to be fixed. However, politics won't allow it....
  #22  
Old 10-06-2019, 08:06 PM
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Obamacare worked well but didn't go far enough.
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Old 10-06-2019, 08:25 PM
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I will be happy to introduce you to at least a dozen people whom I know personally, none of whom would have any health insurance at all were it not for the Affordable Care Act.
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Old 10-06-2019, 08:33 PM
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Old 10-06-2019, 09:12 PM
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I was under the impression that the ACA was at least on a par with the Sestak Job Offer, Fast and Furious and the Bergdahl Swap.
In some sense you are correct in that these things are similar in at least one way. The "scandalous" parts of each are made up bullshit.
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Old 10-06-2019, 10:31 PM
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Five year on from its introduction, is it fair to say that this was a scandalous disaster?
Tell us why it was a scandalous disaster, pray tell. In your own words, please, not quotes from Fox or Trump.
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Old 10-06-2019, 11:26 PM
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I will be happy to introduce you to at least a dozen people whom I know personally, none of whom would have any health insurance at all were it not for the Affordable Care Act.
Not to one up you, but I know people who would be *dead* without the ACA. They had or developed conditions that insurance companies have spent years trying to avoid paying the bills for. Nobody was going to perform their treatment without health insurance.

ACA could have been a ton better, but it was better than nothing at all.
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Old 10-06-2019, 11:32 PM
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Not "scandalous," but it's far from "affordable." Plenty of people are still paying sky-high, crippling insurance premiums for unsatisfactory coverage. We are decades overdue for single-payer.

It was a huge blunder of the D's to not implement single-payer in 2009.
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Old 10-07-2019, 12:09 AM
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Yes plenty of people have care who would not have had before while substantially reducing the budget deficit from what it otherwise would have been. A pretty reasonable 2017 assessment of what it has and has not done - in the face of multiple attempts to kneecap it - here.

20 million covered who would not have otherwise been with added financial security, decreased inequality, and a decreased Federal deficit. Too soon to grade its impact on overall health but the focus is now better. Still though expensive and confusing.

Overall a very significant success despite GOP attempts to make it fail, and definite room to accomplish much more.
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Old 10-07-2019, 12:28 AM
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Well, the death panels still haven't kicked in yet, so we're going to have to wait and see how those turn out before we decide whether Obamacare failed.
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Old 10-07-2019, 07:18 AM
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Depends.

But it did help about 20 million people gain insurance. yeah for some of them, its shit insurance. Is someone spending 9% of their gross, pre tax income on a plan with a $5000 deductible, no out of network coverage and tons of exclusions and exceptions really a 'winner'? Not really.
I agree with a lot of what you say. But a fair % (not sure the exact number) who gained coverage via the ACA did with with Medicaid expansion, which has no co-pays/deductibles and usually little to no premiums. Just a point of info.
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Old 10-07-2019, 08:07 AM
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It was a huge blunder of the D's to not implement single-payer in 2009.
You've forgotten how tight the margin was in passing the ACA. Even that watered down half measure was within an inch of getting derailed by right-leaning dems, single payer in 2009 was flat out impossible. If Obama had spent his political capital tilting at that windmill, we'd have neither.

Last edited by tastysandwiches; 10-07-2019 at 08:07 AM.
  #33  
Old 10-07-2019, 09:20 AM
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I was under the impression that the ACA was at least on a par with the Sestak Job Offer, Fast and Furious and the Bergdahl Swap.
Wow. Wow! We have another forum here where impressions like yours can be addressed frankly.

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It was a huge blunder of the D's to not implement single-payer in 2009.
Remember that Obamacare had Zero (with a Z) Republican votes (despite that it was largely a Republican program! ) In early 2009 the Democrats could not break a filibuster because Moscow Mitch refused to allow Al Franken to be seated. (Ted Kennedy, key advocate of healthcare, passed away just 7 weeks after Franken was finally sworn in.)

Because Every.Single non-Republican Senator was needed to override a Republican filibuster, Joe Lieberman, Senator from the State of Insurancecticut had complete veto power over every provision of the bill. Guess what was most important to him?

Normally, after versions of a bill pass both the Senate and House there is a conference to iron out differences and fix weaknesses. However this was impossible — by the time a conference might be scheduled there were 41 Republican Senators (including Ted Kennedy's replacement), all vowing to vote No no matter what! The only ACA that could possibly be enacted, therefore, was the version the Senate had passed in the earlier autumn.
  #34  
Old 10-07-2019, 09:53 AM
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Bergdahl Swap.
FYI, that's pretty much SOP for the US POW exchanges; we let go a LOT of their guys for a few of ours. It's been that way for a long time- Bergdahl's swap wasn't remarkable or unique at all. (source- a friend of mine is a military history professor and writes books on this kind of thing, and gets interviewed on national news outlets for it)

As for the ACA... I think I'd call it a qualified success if you're looking at it from the Democrat/liberal side. It's not perfect, but it has got a lot of people insurance who wouldn't have otherwise had it, and more importantly, it mandates that a lot of preventative care stuff is at no charge to the patient (https://www.healthcare.gov/coverage/...care-benefits/).

That's a game changer in a lot of ways, if people can get basic preventative care screenings and some treatment at no cost. People don't have to make a choice between their annual physical or OB-Gyn appointments and making ends meet.
  #35  
Old 10-07-2019, 01:20 PM
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Obamacare had two objectives. 1. Expand coverage so fewer people went without insurance 2. Bend the cost curve so that healthcare spending would be cheaper. Both have failed.

The percentage of Americans without health insurance is 13.7% and when Obama was elected it was 14.6%. This is at a time of record low unemployment.

Premiums have been increasing at the same rate they were before Obamacare.

These failures are why Democrat candidates for president are running on Medicare for All, instead of Obamacare.
  #36  
Old 10-07-2019, 01:36 PM
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Obamacare had two objectives. 1. Expand coverage so fewer people went without insurance 2. Bend the cost curve so that healthcare spending would be cheaper. Both have failed.

The percentage of Americans without health insurance is 13.7% and when Obama was elected it was 14.6%. This is at a time of record low unemployment.

Premiums have been increasing at the same rate they were before Obamacare.

These failures are why Democrat candidates for president are running on Medicare for All, instead of Obamacare.
Yeah, because they blew it the first time, if you accept that they ever really wanted to do a better for the people. Just like Don's promises of what he would do with healthcare. Silent on healthcare since his election even though he had both houses for 2 years.

"Running on" and delivering are very different things.
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Old 10-07-2019, 01:54 PM
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Originally Posted by puddleglum View Post
Obamacare had two objectives. 1. Expand coverage so fewer people went without insurance 2. Bend the cost curve so that healthcare spending would be cheaper. Both have failed.

The percentage of Americans without health insurance is 13.7% and when Obama was elected it was 14.6%. This is at a time of record low unemployment.

Premiums have been increasing at the same rate they were before Obamacare.

These failures are why Democrat candidates for president are running on Medicare for All, instead of Obamacare.
Uninsured rates. https://www.google.com/amp/s/www.vox...care-medicaidy

16.1 as the law was signed. 18.0 just before the ACA exchanges opened. Down to 10.9 as Trump was elected.

Back up to 13.7 as GOP attempts to kneecap it got implemented.

Premiums are not all healthcare spending. You know that. https://www.ama-assn.org/about/resea...-care-spending Growth rate of spending has decreased and is at levels last seen in the ‘60s despite our aging population.

I call bullshit.
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Old 10-07-2019, 02:17 PM
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Could some of the negative reaction to Obamacare be attributed to the fact that - whatever his personal merits - Obama was an atrocious Chief Executive, passive and disengaged?
  #39  
Old 10-07-2019, 02:22 PM
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Originally Posted by CHealy7 View Post
I was under the impression that the ACA was at least on a par with the Sestak Job Offer, Fast and Furious and the Bergdahl Swap.
Well, whatever you think about the ACA, it's gone much better than infrastructure week.

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Originally Posted by CHealy7 View Post
Could some of the negative reaction to Obamacare be attributed to the fact that - whatever his personal merits - Obama was an atrocious Chief Executive, passive and disengaged?
The words you are looking for are "shifty and uppity." For example, "Yes, there are quite a few people who hate Obamacare for no other reason than a shifty and uppity President got credit for it."

Last edited by Ravenman; 10-07-2019 at 02:23 PM.
  #40  
Old 10-07-2019, 02:22 PM
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Originally Posted by CHealy7 View Post
Could some of the negative reaction to Obamacare be attributed to the fact that - whatever his personal merits - Obama was an atrocious Chief Executive, passive and disengaged?
What do you think about the ACA? C'mon, man, details.

Last edited by bobot; 10-07-2019 at 02:23 PM.
  #41  
Old 10-07-2019, 02:24 PM
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Five year on from its introduction, is it fair to say that this was a scandalous disaster?
Very much so.
  #42  
Old 10-07-2019, 02:34 PM
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Originally Posted by CHealy7 View Post
Could some of the negative reaction to Obamacare be attributed to the fact that - whatever his personal merits - Obama was an atrocious Chief Executive, passive and disengaged?
No more JAQing off. If you wish to make an argument, now is the time to do so. If you ask a question, then also address it yourself.

If a mindless rant is what you want, I can move this to the Pit.

[/moderating]
  #43  
Old 10-07-2019, 02:35 PM
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Obamacare has had, frankly, a stunning level of success.

Let us recall that this is a HUGE piece of legislation. Not just in total size of the text, but that it impacts nearly 20% of the country's GDP. This type of legislation isn't the sort of thing you put down on paper and walk away for the next 8 years.

It needs to be managed, you need to see where things go right and things go wrong and make the necessary changes so it operates smoothly. You don't need to do this because the legislation was faulty, you need to do this because it was written by human beings, not gods.

Obamacare had NONE of that. Soon after it was passed the House turned Republican and that house of Congress actively sought Obamacare's destruction, casting dozens upon dozens of votes to fully or partially dismantle the ACA. Forget about passing legislation to fix anything that went wrong with it.

So, this legislation which absolutely required active management, was continuously attacked and undermined by the legislature, yet it STILL remains, despite its most rabid opponents holding all three parts of government required to eliminate it.

The only thing scandalous about it was the GOP's craven attacks, failure to manage, and failure to repeal and replace.
  #44  
Old 10-07-2019, 02:39 PM
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Originally Posted by CHealy7 View Post
Could some of the negative reaction to Obamacare be attributed to the fact that - whatever his personal merits - Obama was an atrocious Chief Executive, passive and disengaged?

Well there was certainly an effort to cripple his administration and bastardize his name and anything they could attach his name to which began with a meeting in the eve of his inauguration, as we all know and recall. Have you seen what followed him into that office? You know, every time I see images of Obama and Don juxtaposed, I'm reminded that the corrupt dishonest half-stepping pig with a slew of spawn from 3 different babymommas is the fatass greasy white guy.

Last edited by Fentoine Lum; 10-07-2019 at 02:40 PM.
  #45  
Old 10-07-2019, 03:50 PM
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Normally, after versions of a bill pass both the Senate and House there is a conference to iron out differences and fix weaknesses. However this was impossible — by the time a conference might be scheduled there were 41 Republican Senators (including Ted Kennedy's replacement), all vowing to vote No no matter what! The only ACA that could possibly be enacted, therefore, was the version the Senate had passed in the earlier autumn.
Let me be more clear. Since House and Senate voted on the same bill, that version of ACA, at least, was always going to become law. The GOP had the option to entertain amendments to improve the bill; each passable by the majority party or — assuminbg Moscow Mitch chose to play hardball — if there was one (1) Republican Senator willing to vote for the proposed improvement.

`Moscow' Mitch McConnell did not allow this. The intent was to deliberately retain ACA defects, hoping that its flaws would annoy the public, and thereby make Obama a one-term President.

Reread that last sentence, please, those of you who claim not to understand how heinous the modern-day Republican Party has become.
  #46  
Old 10-07-2019, 04:02 PM
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Originally Posted by Cheesesteak View Post
Obamacare has had, frankly, a stunning level of success.

Let us recall that this is a HUGE piece of legislation. Not just in total size of the text, but that it impacts nearly 20% of the country's GDP. This type of legislation isn't the sort of thing you put down on paper and walk away for the next 8 years.

It needs to be managed, you need to see where things go right and things go wrong and make the necessary changes so it operates smoothly. You don't need to do this because the legislation was faulty, you need to do this because it was written by human beings, not gods.

Obamacare had NONE of that. Soon after it was passed the House turned Republican and that house of Congress actively sought Obamacare's destruction, casting dozens upon dozens of votes to fully or partially dismantle the ACA. Forget about passing legislation to fix anything that went wrong with it.

So, this legislation which absolutely required active management, was continuously attacked and undermined by the legislature, yet it STILL remains, despite its most rabid opponents holding all three parts of government required to eliminate it.

The only thing scandalous about it was the GOP's craven attacks, failure to manage, and failure to repeal and replace.
That's a good summary of the political situation. Any bill that does as much as the ACA, historically, has needed a refresh/fix/update to fix unforeseen problems and make it better and more efficient. This bill never had any of that, due to Republican opposition.

Last edited by survinga; 10-07-2019 at 04:02 PM.
  #47  
Old 10-07-2019, 04:12 PM
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Originally Posted by Fentoine Lum View Post
Yeah, because they blew it the first time, if you accept that they ever really wanted to do a better for the people. Just like Don's promises of what he would do with healthcare. Silent on healthcare since his election even though he had both houses for 2 years.

"Running on" and delivering are very different things.
Don't you remember the farce about repeal of ACA? Don and his fellow travelers couldn't come up with anything remotely plausible. They talked about it, just not rationally.
  #48  
Old 10-07-2019, 04:14 PM
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Originally Posted by puddleglum View Post
Obamacare had two objectives. 1. Expand coverage so fewer people went without insurance 2. Bend the cost curve so that healthcare spending would be cheaper. Both have failed.

The percentage of Americans without health insurance is 13.7% and when Obama was elected it was 14.6%. This is at a time of record low unemployment.

Premiums have been increasing at the same rate they were before Obamacare.

These failures are why Democrat candidates for president are running on Medicare for All, instead of Obamacare.
Quote:
Originally Posted by DSeid View Post
Uninsured rates. https://www.google.com/amp/s/www.vox...care-medicaidy

16.1 as the law was signed. 18.0 just before the ACA exchanges opened. Down to 10.9 as Trump was elected.

Back up to 13.7 as GOP attempts to kneecap it got implemented.

Premiums are not all healthcare spending. You know that. https://www.ama-assn.org/about/resea...-care-spending Growth rate of spending has decreased and is at levels last seen in the ‘60s despite our aging population.
....
These two replies are so much in conflict that I'd love to get some clarification. puddleglum, you have the floor -- care to defend your statement or refute DSeid's? Because from here, your post looks (maybe) technically true but misleading to the point of false.
  #49  
Old 10-07-2019, 04:30 PM
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Quote:
Originally Posted by Cheesesteak View Post
Obamacare has had, frankly, a stunning level of success.

Let us recall that this is a HUGE piece of legislation. Not just in total size of the text, but that it impacts nearly 20% of the country's GDP. This type of legislation isn't the sort of thing you put down on paper and walk away for the next 8 years.

It needs to be managed, you need to see where things go right and things go wrong and make the necessary changes so it operates smoothly. You don't need to do this because the legislation was faulty, you need to do this because it was written by human beings, not gods.

Obamacare had NONE of that. Soon after it was passed the House turned Republican and that house of Congress actively sought Obamacare's destruction, casting dozens upon dozens of votes to fully or partially dismantle the ACA. Forget about passing legislation to fix anything that went wrong with it.

So, this legislation which absolutely required active management, was continuously attacked and undermined by the legislature, yet it STILL remains, despite its most rabid opponents holding all three parts of government required to eliminate it.

The only thing scandalous about it was the GOP's craven attacks, failure to manage, and failure to repeal and replace.
Obama also expanded SCHIP by 4 million children, so expansion of health insurance under Obama was the greatest since LBJ who created medicare and medicaid.

Dseid mentioned how the uninsured rate dropped 7% from 18% down to 11%. Thats about 20-25 million people gaining coverage under the Obama years.

Having said that, I don't know if I'd call the ACA a stunning success. One problem with the ACA is that it acts like a band aid and may make people think our health system is better than it really is. We still pay twice as much as any other developed nation for health care and other than people on public plans or with amazing private coverage, most people don't 'really' know if they have health insurance. In between deductibles, copays, balance billing, exclusions, denials, out of network charges, etc. you have no idea if you go into a hospital if your bill will be $10 or 10 thousand when all is said and done.

Also underinsurance is still a gigantic issue in teh US. A lot of politicians seem to want to say as long as you have insurance you're fine. Even if that insurance costs you $800 a month, has a $6000 deductible and will find ways to avoid paying the bills when you actually need it, they want to say insurance = health care when the two are totally different things.

Also pretty much everything that would've actually bent the US health care costs curve was taken out. A public option, allowing reimportation of pharmaceuticals, public negotiation of medical supplies and drugs, etc. these were all taken out of the ACA. Other things like encouraging visits to overseas providers for expensive care (expensive surgery or long term care) that would've also reduced costs were'nt included. The reality is the democrats didn't want to offend the health care industry so anything that would have actually worked to reduce the cost curve was taken out, since reducing the cost curve cuts into the business model of a multi trillion dollar a year industry. Our health care system is still bankrupting federal government, state government, private industry and citizens all at the same time because politicians on both the state and federal level refuse to enact reforms that will actually reduce costs, since the only truly effective reforms will be opposed tooth and nail by pharma, medical device manufactures, hospitals, medical labor groups, health insurance companies etc. as genuine reform will cut into their business model and profits.

So there were massive failures in the ACA, and sadly for a lot of people one of the best things we can say is 'well it was better than nothing'.

Also, even though the texas judge who overturned it will hopefully be overruled, he may not and the entire law may go down.
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Last edited by Wesley Clark; 10-07-2019 at 04:33 PM.
  #50  
Old 10-07-2019, 08:34 PM
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Originally Posted by puddleglum View Post

The percentage of Americans without health insurance is 13.7% and when Obama was elected it was 14.6%. This is at a time of record low unemployment.
Below is a link to the census data from 2018 (just released in Sept 2019) on uninsured rate. Page 17 has 2008 through 2018. In 2008, just prior to the economic collapse, the uninsured rate was just over 14%, and stayed between 14-16% until 2014, when the exchanges kicked in. It's now 8.5%, according to the census. This is because of the ACA. I would note that the uninsured rate is 6.6% in states that expanded Medicaid, and over 12% in states that did not expand Medicaid.

https://www.census.gov/content/dam/C...mo/p60-267.pdf
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