# The Repeal of Obamacare/ACA: Step-bystep, Inch-by-inch **URL:** \ **Category:** The BBQ Pit\ **Created:** [January 2, 2017, 5:06pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146 "2017-01-02T17:06:13Z")\ **Posts on this page:** 20\ **Page:** 14
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 9, 2017, 1:38am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/261 "2017-01-09T01:38:30Z")
Someone named Lauren DeStefano on Twitter: “100-200 years ago, people ate organic unprocessed food and didn’t have vaccines and lived to the ripe old age of died in childbirth.” ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [January 9, 2017, 2:17am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/262 "2017-01-09T02:17:22Z")
> [@Fenris](#): > > :rolleyes: > > Blah-blah-blah. I can’t wait 'till you’re Reeder-ruled or banned. What is “Reeder-ruled”? ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [January 9, 2017, 2:54am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/263 "2017-01-09T02:54:18Z")
> [@foolsguinea](#): > > What is “Reeder-ruled”? Reeder was a former poster who was constantly starting threads about Bush (like every few days). Eventually the mods told him that he was only allowed to have one Bush thread open at a time. ---
**Author:** ![Weisshund](https://avatars.discourse-cdn.com/v4/letter/w/ba8739/32.png) [@Weisshund](https://boards.straightdope.com/u/Weisshund)\ **Post date:** [January 9, 2017, 3:37am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/264 "2017-01-09T03:37:54Z")
> [@wolfpup](#): > > Your ignorance of medicine is obvious but that doesn’t make your idiotic beliefs correct. Not all surgeries are major; not all medical interventions are catastrophic and life-threatening. Just for one example, many lifesaving procedures that used to involve major surgery are increasingly being done with minimally invasive techniques involving precision robotics and advanced imaging and sensing technologies. Not for you, though. High-tech ORs with that kind of equipment cost millions of dollars. You’re only covered for stitches. > > Yours. Again. As usual. Are you truly that dense? Seriously? I understand medicine just fine, i know how the human body works just fine, i know what the damned thing looks like turned inside out and spread all over the ground. You still haven’t comprehended a word i said, not one, and they are not even complicated, and yet you call me stupid? Yes you have a lovely 3d ultrasound imaging system, and a pretty new MRI unit, and a lovely cardio-pulmonary bypass unit and a thousand other very expensive items. Great You want to use them, fine, that’s your prerogative, all my blessings I don’t want you using them on me I don’t want you doing surgery on me I don’t want you doing some kind of intervention on me I will tell you want i want done which isn’t much you wont even need anything special, and if i can not tell you, you do nothing, yes really nothing, it’s ok. If you have doubts that it’s ok, just check my bracelet necklace or ICE, there ya go, clear conscience. Yes, i might die, i might not. If i do, it was on my own terms, and that is fine. Must i really have to pay 784 dollars for that? The only good thing on it was it covered vaginal exams. Say that’s something, if i ever mysterious grow a vagina i’m covered. Just give me back what i had that i never used anyways. Do you honestly not get that? ---
**Author:** ![Weisshund](https://avatars.discourse-cdn.com/v4/letter/w/ba8739/32.png) [@Weisshund](https://boards.straightdope.com/u/Weisshund)\ **Post date:** [January 9, 2017, 3:50am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/265 "2017-01-09T03:50:42Z")
> [@raventhief](#): > > So no palliative care? Does your advanced directive say “nothing more than stitches”? No, no palliative care, no hospice, no surgery of any type, no resuscitation of any sort etc etc etc. Mud and leeches? I doubt the hospitals have mud, and mud from here would be a bad idea probably, lot of “wee beasties” in it. And leeches i can get for free at home, sometimes whether i like it or not, but since i dont plan on getting a skin graft or some such, and there are better natural blood thinners, and the fish dont seem to like them so i doubt they are much help. ---
**Author:** ![Elendil\_s\_Heir](https://avatars.discourse-cdn.com/v4/letter/e/7cd45c/32.png) [@Elendil\_s\_Heir](https://boards.straightdope.com/u/Elendil_s_Heir)\ **Post date:** [January 9, 2017, 4:25am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/266 "2017-01-09T04:25:17Z")
> [@madsircool](#): > > You realize he is a columnist, not a reporter, right? I did not say otherwise, and he is writing about figures compiled by others. ---
**Author:** ![Budget\_Player\_Cadet](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/budget_player_cadet/32/205_2.png) [@Budget\_Player\_Cadet](https://boards.straightdope.com/u/Budget_Player_Cadet)\ **Post date:** [January 9, 2017, 5:23am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/267 "2017-01-09T05:23:45Z")
> [@Weisshund](#): > > Now whose stupidity is on display > You assume i would let you do heart surgery on me, or half kill me to try to cure cancer and what? make me sick as hell to die anyways when i could have made better use of the functional time i had left to begin with? …Mercola or Natural News reader? ---
**Author:** ![ThelmaLou](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thelmalou/32/390_2.png) [@ThelmaLou](https://boards.straightdope.com/u/ThelmaLou)\ **Post date:** [January 10, 2017, 5:21am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/268 "2017-01-10T05:21:16Z")
What? A spanner in the works? This could get interesting. **The Republicans Trying to Slow Down Obamacare Repeal** \*GOP Governors John Kasich of Ohio and Rick Snyder of Michigan urge lawmakers to protect the Medicaid expansions they say are working in their states. \* > [@](#): > > Congressional Republicans knew their push for an immediate repeal of the Affordable Care Act would draw howls of protest from Democrats. But they are now hearing warnings from elected officials who may be harder for them to ignore: Republican governors. > > In the last week, GOP Governors John Kasich of Ohio and Rick Snyder of Michigan have raised concerns about the impact a full repeal of the health law would have on their states, which rely on billions of dollars in additional federal funding to cover an expansion of Medicaid they carried out as part of Obamacare. Kasich in particular questioned the plans by Republican leaders in Congress to scrap the law without immediately replacing it. > > “It’s a serious matter,” Kasich told reporters in Ohio last week. “Our hospitals needed Medicaid expansion. It has worked very well in this state.” The former GOP presidential candidate noted that about 700,000 Ohioans had secured coverage under the law, many of whom, he said, have serious health problems. “There’s room for improvement, but to repeal and not to replace, I just want to know what’s going to happen to all these people who find themselves left out in the cold,” Kasich said… > > [Cite](https://www.theatlantic.com/politics/archive/2017/01/the-republicans-trying-to-slow-down-obamacare-repeal/512459/?utm_source=feedburner&utm_medium=feed&utm_campaign=feed%3a+theatlantic+%28the+atlantic+-+master+feed%29) Sigh. We knew we liked John Kasich. ---
**Author:** ![ThelmaLou](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thelmalou/32/390_2.png) [@ThelmaLou](https://boards.straightdope.com/u/ThelmaLou)\ **Post date:** [January 10, 2017, 5:29am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/269 "2017-01-10T05:29:37Z")
Chaos ahead. (My bold.) [Muted Response From Health Lobby as Affordable Care Act Faces Repeal](http://www.nytimes.com/2017/01/09/us/politics/affordable-care-act-health-care-lobby.html?partner=rss&emc=rss&_r=0) > [@](#): > > WASHINGTON — The speed of Republican efforts to repeal the Affordable Care Act has stunned health industry lobbyists, leaving representatives of insurance companies, hospitals, doctors and pharmaceutical makers in disarray and struggling for a response to a legislative quick strike that would upend much of the American health care system. > … > But far from reflecting the magnitude of the moment, the most prominent message from lobbyists that lawmakers saw in their first week back at work was a narrowly focused advertisement from the U.S. Chamber of Commerce demanding the repeal of “Obamacare taxes,” especially an annual fee imposed on health insurance companies to help pay for the expansion of coverage under the health law. > > “More than 20 million people could lose their health insurance, and states could lose billions of dollars in Medicaid money,” said Kenneth E. Raske, the president of the Greater New York Hospital Association. But, he added, **many health care executives “don’t want to get on the wrong side of the new administration or the Republican majority in Congress.”** > > Health care professionals are not totally silent, but industries that were integral to the creation of the Affordable Care Act in 2010 \*\*are keeping their voices down \*\*as Republicans rush to dismantle it. > … > Doctors are telling Congress to proceed with caution, insisting that no one should lose coverage. The American College of Physicians, representing 148,000 specialists in internal medicine, has sent letters to senators urging them to “vote no” this week on the budget resolution. > > Hospitals were expecting to receive tens of billions of dollars in additional revenue for treating people who were newly insured under the health law, and they are alarmed at the prospect that it may now be repealed. But, they say, if Congress goes ahead and rolls back the expansion of coverage, it must also restore tens of billions of dollars that the health law cut from Medicare payments to hospitals. > … It’s like no one believed it was really going to happen. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [January 10, 2017, 6:51am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/270 "2017-01-10T06:51:25Z")
Well, shit, remember the sequester? Which was _deliberately_ set up because it was so awful they were sure to come to their senses and vote it down. What a plan! Even if you don’t remember what happened, you could probably guess. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [January 10, 2017, 2:33pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/271 "2017-01-10T14:33:41Z")
> [@Broomstick](#): > > First of all, he said expand _Medicaid_, not _Medicare_. They are not the same program and they are not interchangable. > > Medicaid is state-by-state and varies considerably between states. > > Medicare is Federal and the same everywhere, and would be a better program to expand. > > It would help if you used terms correctly, and remember what other people have said. Ok, fine. He said Medicaid. And YOU said Medicare. So what? You seem to be against expanding Medicare because then “It wouldn’t be Medicare” How about you argue against the expansion of already in place programs, instead of getting hung up on the NAMES of the programs? > [@](#): > > It’s not so much “don’t want to use UHC” as “want more than UHC offers” - such, as noted, private rooms or other personal perks. Most countries don’t have a two-tier system where the best doctors are all private and the dross are left for those on the public system. Something like purely cosmetic surgery wouldn’t be covered by the public system, but reconstructive surgery would. Not that I know, but is that what millionaires in London do? Go down to the local doctor’s office or whatever to get looked at? There are not private doctors that can be used instead? ---
**Author:** ![Trinopus](https://avatars.discourse-cdn.com/v4/letter/t/2bfe46/32.png) [@Trinopus](https://boards.straightdope.com/u/Trinopus)\ **Post date:** [January 10, 2017, 8:53pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/272 "2017-01-10T20:53:48Z")
> [@Slash1972](#): > > . . . Not that I know, but is that what millionaires in London do? Go down to the local doctor’s office or whatever to get looked at? There are not private doctors that can be used instead? I don’t know about Britain, but Australia has private doctors that millionaires visit. The visit is taxed pretty deeply, and this money goes to help fund the general program, the one millionaires don’t use. It works for everyone; there’s still an incentive to strive for the better plan, but no one goes untreated (or has to go to an emergency room with a clinic-treatable ear infection because they have no access to a clinic, as here in the U.S.) I believe (but do not know for sure) that Canada also has supplemental plans, so that people who can afford to pay can get fancier medical treatment. They can’t jump the line to get treatment ahead of other people, but they can get into a private clinic with prettier rooms, less crowding, better food, more experienced nurses, etc. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [January 10, 2017, 9:33pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/273 "2017-01-10T21:33:12Z")
> [@Trinopus](#): > > I don’t know about Britain, but Australia has private doctors that millionaires visit. The visit is taxed pretty deeply, and this money goes to help fund the general program, the one millionaires don’t use. It works for everyone; there’s still an incentive to strive for the better plan, but no one goes untreated (or has to go to an emergency room with a clinic-treatable ear infection because they have no access to a clinic, as here in the U.S.) > > I believe (but do not know for sure) that Canada also has supplemental plans, so that people who can afford to pay can get fancier medical treatment. They can’t jump the line to get treatment ahead of other people, but they can get into a private clinic with prettier rooms, less crowding, better food, more experienced nurses, etc. Cool, thanks for the info. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [January 10, 2017, 10:39pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/274 "2017-01-10T22:39:48Z")
> [@Trinopus](#): > > I believe (but do not know for sure) that Canada also has supplemental plans, so that people who can afford to pay can get fancier medical treatment. They can’t jump the line to get treatment ahead of other people, but they can get into a private clinic with prettier rooms, less crowding, better food, more experienced nurses, etc. Not exactly. Yes, there are supplemental insurance plans in Canada – usually employer-provided – but the key operative principle is that private insurance cannot apply to medically necessary procedures. The most common uses for supplemental insurance are for private hospital rooms, drug plans for those of less than retirement age, eyeglasses, dental, and a few random amenities. The key principle of the Canada Health Act is that the single-payer plan is payment in full for all medically necessary procedures at the pre-negotiated set rates, and except for non-residents who must pay their own way, neither extra billing nor any form of private insurance is allowed. Hospital billing departments are there to process any extras and to deal with non-residents – most patients walk out after hospital stays without paying a dime or even talking to the billing department – all they need is the health card number they took when you were admitted. The only real expense of a Canadian hospital stay is the famed parking ripoff, if you were silly enough to drive there and leave your car in the visitors’ lot for an extended period! Which is doubly silly because in any sort of even marginal emergency, ambulance services are generally subsidized – in Ontario the flat fee is $45, and even that is waived for certain categories of patients. ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [January 10, 2017, 10:47pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/275 "2017-01-10T22:47:57Z")
I rate as middling to high the likelihood that any repeal does not restore the Medicare cuts mentioned in the quoted article above. Might that actually make Congress an enemy of the massive health care industry? ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [January 10, 2017, 10:50pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/276 "2017-01-10T22:50:22Z")
> [@Slash1972](#): > > Not that I know, but is that what millionaires in London do? Go down to the local doctor’s office or whatever to get looked at? There are not private doctors that can be used instead? There is private health insurance, BUPA, and I believe private physicians. Canada is unusual in leaving little space for private health care. Most developed nations have a thriving private healthcare sector. In Norway, it is quite common for it to bid on surgeries alongside the public actors. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [January 10, 2017, 11:37pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/277 "2017-01-10T23:37:58Z")
> [@Slash1972](#): > > Ok, fine. He said Medicaid. And YOU said Medicare. So what? They are two different programs, funded and managed in two different manners. That’s why it matters. Here’s a couple of differences my family has experienced: Medic_aid_ paid for my spouse to have IV antibiotics administered at home, instead of insisting he remain in a hospital for that. Medi_care_ does not fund home IV treatment and would have insisted he stay in the hospital Medi_care_ paid for a home nebulizer for my mother when she had chronic obstructive lung disease. Medic_aid_ (in my state, at least) will not pay for that. Medic_aid_ does not pay for kidney dialysis. You get that from Medi_care_. Medi_care_ is a Federal program with uniform rules across the entire country. Medic_aid_ varies by state, meaning there are 50 different sets of rules. That’s just off the top of my head. I’m sure if anyone cares to google the two programs they’ll find even more differences. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [January 11, 2017, 2:05am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/278 "2017-01-11T02:05:49Z")
Again, so what? If MediCAID was expanded to cover more people, that would be good. Or, if MediCARE was expanded to cover more people, that would be good. Why are you hung up on that? ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [January 11, 2017, 2:37am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/279 "2017-01-11T02:37:45Z")
> [@Grim\_Render](#): > > Canada is unusual in leaving little space for private health care. Most developed nations have a thriving private healthcare sector. In Norway, it is quite common for it to bid on surgeries alongside the public actors. Not true – Canada is unusual in leaving little space for private health _ **insurance** _, relegating it only to supplementary services, for good and valid reason. But Canada most definitely has a thriving private health care sector – indeed the entire health care provider sector is almost entirely private. Hospitals are usually (but not always) non-profit institutions, but they are independent entities not owned or operated by the government, and the majority of doctors are in private practice while virtually all clinics and medical labs are private businesses. Canada does not, however, have a two-tier public-private health care system in which private insurance supports an exclusive tier of providers accessible only to the privately insured, and this is by design and is indeed a foundational principle of the Canada Health Act. The reasons for this are partly historic and largely attributable to the proximity of the US health care market, where massively capitalized health insurers and an enormously profitable health care provider system are like wolves howling at the door, seeking any possible excuse or loophole to establish a profitable American-style health care tier to which access is governed entirely by ability to pay. ---
**Author:** ![Hey\_Hey\_Paula](https://avatars.discourse-cdn.com/v4/letter/h/85e7bf/32.png) [@Hey\_Hey\_Paula](https://boards.straightdope.com/u/Hey_Hey_Paula)\ **Post date:** [January 11, 2017, 2:41am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/280 "2017-01-11T02:41:03Z")
> [@Weisshund](#): > > No, no palliative care, no hospice, no surgery of any type, no resuscitation of any sort etc etc etc. > Mud and leeches? > I doubt the hospitals have mud, and mud from here would be a bad idea probably, lot of “wee beasties” in it. > > And leeches i can get for free at home, sometimes whether i like it or not, but since i dont plan on getting a skin graft or some such, and there are better natural blood thinners, and the fish dont seem to like them so i doubt they are much help. No hospice? Really? Dying slowly and painfully sucks, and hospice care makes it suck a bit less - you wouldn’t want that? [Previous page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=13) [Next page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=15)