You mean…
(a) 51st vote - a 50-50 vote goes to the Vice-President’s party
(b) 60th vote - the “no more filibusters” applies only to judicial appointments
(c) 67th vote - there’s no way Obama doesn’t veto any repeal attempt, since it’s pretty much the only thing standing in the way of being branded a “do-nothing President,” and if the Republicans had the 67 Senate votes to override a veto, I have a feeling they would find an excuse to impeach Obama and remove him from office.
Recently, I realized something; in 2016, every Vietnam veteran who was in the Army at the time of the Tet Offensive will be 65 or older. I have a feeling that the worse the health care problem gets, the more likely the people will vote for Representatives and Senators who will go beyond ACA and into some form of single-payer system paid for in the most part by the rich. I also expect to see an increase in commercials on CNN from foreign countries touting their lower corporate taxes…
The President has been able to adjust the ACA laws by including the people that had their insurance canceled due to the new policy rules that dictated what was to be covered into a new slot of people that now qualify for help due to income.
The law will take effect President Obama is solid on doing that, but now the cost is a factor with only one million people signing up out of a estimated 7 million people that are suppose to sign up by March 31st.
I would like to see a way to shop for insurance instead of giving them all of my information and even my debit card number just to see what it would cost. They must have already figured out that people would be scared off due to the cost, but give us a break we just want to see what it s all about without promising our first born.
Congress will have to step in and adjust the law to satisfy the many that have not signed up. It will become all about the votes and who will look good come election time.
I really, really hope ACA works out for America and of course the next President will have to answer a lot of questions on his or her way to the White House.
Even if death spirals were to ever actually become a possibility, they wouldn’t even begin to materialize until year four or five of the program. There are just too many mechanisms built into the ACA already that were designed to guard against issues related to the risk pool.
As written, the ACA affects large employers, small employers, and those who bought insurance as individuals. Large employers have to buy coverage for their employees or pay a fine. Small employers have their own exchange on which to buy coverage. Individual purchasers have the exchanges that have gotten all the attention.
President Obama chose to delay the mandate for large employers and delay the opening of the exchange for small employers. In both cases, the delay was for one year. So only the changes in the individual marketplace went into effect. All the bad news that’s come out in the past three months has dealt only with the individual marketplace.
Next year, right as we head into election season, the implementation of Obamacare will begin for the much larger employment-based marketplace. Many employers will cut back on hiring or shift workers from full time to part time in order to avoid the mandate. Others will ditch high-quality coverage for lower-quality coverage as prices rise.
President clearly stated, that if you like your insurance, you can keep your insurance.
So, I wouldn’t concern your purty little head with such things. A few hundred dollars more a month doesn’t sound like that much, plus, it’s for your benefit anyway.
But the law seems to be subject to infinite changing at the president’s whim-could Obama just decide to put the whole thing on hold? The website is still not working. so I would expect major revisions (via Presidential fiat).
No there aren’t. There are opportunities for a few doctors to make similar money to what they currently make, but the overwhelming majority of them will not make as much money if they cease using their primary skill.
I agree. We’ve apparently decided that President Obama can simply make whatever changes he wants to the law, the deadlines, and the regulations, without bothering to consult Congress. I’d expect him to continue doing so throughout the next year. Indeed, probably throughout the rest of his term.
The situation will vary from one doctor to the next, and I don’t claim to be any sort of expert on this issue, but there are certainly some ways that doctors can make money after leaving their practice. For example, there’s plastic surgery. It’s possible to make a lot of money there. Of course it comes with less prestige than honest medicine.
By the way, it was exactly 4 years ago today (well, 4 years and one day), since the day we’ve been assured by Barack Hussein Obama that no one would have to change their health coverage. Absolutely no one.
To quote:
“First, if you are among the hundreds of millions of Americans who already have health insurance through your job, or Medicare, or Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. (Applause.) Let me repeat this: Nothing in our plan requires you to change what you have”
Which part of this statement is false? No individual who has health insurance through your job, or Medicare, or Medicaid, or the VA is required to change their coverage or their doctor, nor is their employer required to do the same.
Nothing wrong with plastic surgery - they do good things for people with disfiguring traumas, bad burns, etc. in addition to the elective cash based tummy tucks and such.
However, I do think it is true that more that docs may opt out of taking insurance and focus on cash based practice instead. Opting out of insurance is a lot more lucrative, and less of a hassle.
As it is, a lot of doctors choose to see few or no Medicaid patients, in part because of the low reimbursement they receive (although that link also refers to a study finding that there were other issues too).
Doctors who are not residency or fellowship trained in PRS generally cannot perform it. Guess what, there’s scant handful of doctors in the U.S. even allowed to train in PRS per year. About 100. Whether you’ve been a doctor for a long time, or just out of med school, you can’t be a plastic surgeon unless someone lets you into one of the training programs.
Now, legally, this isn’t strictly true. A doctor can legally perform the procedures if they want to, however, without the 3+ years of training, they are going to probably not be as good at it.
A few doctors do minor plastics work without the training just fine.
However, there’s a finite market for this. 100 doctors (out of the 1 million or so out there) can train to do PRS every year, it’s just as I said.
Public perception of the PPACA will be highly dependent not only on pocketbook issues but also access to care.
There are some provisions in the PPACA to encourage providing some routine care by nurse practitioners or physician assistants. Still, about half of the public prefer primary care by a physician.
It takes more time and money to train physicians than NPs or PAs. This is at a time when primary care physician ranks are already low in the United States. IMHO, the long term needs of the health care system will require reforming how we pay for medical training.
I think the PPACA has a long road ahead to public acceptance as it stands. And based upon how the roll out has gone so far, I think we have not seen the last of the major problems. By election time I believe there will be pressure put on Dems in swing districts to pledge to vote to repeal.
Democrats OWN health care as an issue, period. For better or worse, the GOP has gone to enormous lengths in order to ensure that the Dems are the party of health care; to assume that they would do such a huge about-face and desperately try to divorce themselves from their greatest achievement as a party since the Johnson administration is absolute stupidity.
Plus, you’re making the age-old fallacy of presuming that something (that you perceive to be) bad currently happening is fundamentally bad and WILL ALWAYS BE bad in perpetuity. There’s this little thing called “nuance” that begins to take shape whenever a person starts to take the long view on a given issue.
No fallacy. Perception is reality. And voter memory is terribly short.
I do agree that Dems have taken ownership of the health care reform issue.
If things are running more or less smoothly and more voters have better coverage than before then the Dems stand to get more of the credit.
What constitutes “better” coverage is, as always, in the eye of the beholder - their personal perception will guide their beliefs on the issue.
Some people will focus solely on the premium. My premium went up. That’s bad! or I got a cheaper premium. That’s good!
Others may place greater importance on the network My doctor is not in-network on my new insurance. That’s bad! or Hey, my new policy has the great research hospital in town as in-network. That’s good!
Perhaps details of coverage that is very individualistic will be more important. *
My wife’s expensive medication is not on the insurer’s formulary and is not covered. That’s bad! or Wow, my husband’s gastric bypass procedure is covered under my new plan. That’s good!*
But if 2014 is spent lurching from one crisis to the next related to the PPACA then Dems stand to get more of the blame.
The rollout process for the PPACA is long, particularly with the one year delay to the employer mandate. That may focus attention on the issue right around the mid-term elections.
Some Democrats, particularly those from red districts who are considered more vulnerable, have already sided with Republicans in a recent vote to “fix” the PPACA. I stand behind my prediction that there will be pressure placed on Democrats to pledge to repeal the PPACA, primarily in key swing areas.
Of course what we consider to be the big issues today might not be the defining issues come election day. Perhaps come November 2014 voters’ attention will be focused on something else entirely.
