Effect of the Supreme Court on ACA on the election?

[Evil_Captor]

@jtgain

Isn’t that the exact problem this bill tries to solve? I mean, honestly, we aren’t going to let people die outside of the ER doors, so this person who foolishly chose not to purchase insurance will bleed his savings dry and then be part of Medicaid.

Same problem, but then you will create new side problems. Take your typical 23 year old who thinks he is immortal and pogo sticks out of bed on his hard dick every morning. He doesn’t pay the $300/mo for health insurance through his job because he doesn’t think he needs it.

Then one day he gets hit by a drunk driver. The drunk’s insurance pays for all of his medical bills, but he has continuous pain in his back. Even though the drunk’s insurance will pay for all follow up back pain visits, what would stop an insurance company from turning him down when he’s 40 for this pre-existing condition (under your plan)?

My personal preference for the entire market was the HSA with a catastrophic insurance plan. If we could transition all young people into those it would do wonders for the market. Routine medical care would be subject to market conditions because you would be paying out of pocket. We’ve all seen these outrageous bills that the doctor submits to the insurance. No way in hell would they be that high if the free market controlled. The prices are so high precisely because you don’t give a damn what the doctor charges. You pay your $20 co-pay and move on. He can bill the insurance company a million for all you care.

But I digress.

well, actually, this is the problem that HMOs were designed to address – to be a third party that would keep medical costs down. You see how well they’ve done …

[Evil_Captor]

If the Supreme Court kills ACA, they will do the same favor to the Democrats that the Supreme Court did to the Republicans with Roe v. Wade. It will ensure Democratic governance for another twenty years at least. Well, in combination with Citizens United, another wildly unpopular and clearly partisan Supreme Court decision. I imagine that Republicans will be begging the Supremes to only gut PART of the ACA for that reason.

[Chronos]

well, actually, this is the problem that HMOs were designed to address – to be a third party that would keep medical costs down. You see how well they’ve done …

Quite well, in some cases. Kaiser, for instance, would be considered an HMO, except that nobody thinks of them that way because everyone knows HMOs are failures.

[Really_Not_All_That_Bright]

@Evil_Captor

well, actually, this is the problem that HMOs were designed to address – to be a third party that would keep medical costs down. You see how well they’ve done …

@Chronos

Quite well, in some cases. Kaiser, for instance, would be considered an HMO, except that nobody thinks of them that way because everyone knows HMOs are failures.

Sure, but the HMO model generally is dying. Kaiser’s strength is that its providers are salaried, so they have no incentive to perform unnecessary procedures ( and also no incentive to push patients out the door as quickly as possible).

[Evil_Captor]

My experience of HMOs is that they stick relatively untrained people between you and your doctor, who consistently advocate for lower cost care, whether or not it is what you really need. It is annoying to have someone like that second-guessing your doctor, and the burden somehow always seems to fall on the patient in terms of lesser care.

[Really_Not_All_That_Bright]

Well, that’s one thing that the HSA/HDHP model doesn’t share: there’s nobody between you and your doctors. You can go see more or less whoever you want, whenever you want.

The problem with HSA/HDHPs is that medical providers don’t know off the tops of their heads which contracted rate to charge you, so you generally have no idea how much a medical visit (other than things you’ve done before, like see your PCP for a cold) will cost you.