Obamacare, Healthcare, etc.

[ringthree]

You guys talk like Romney has already been Inaugurated...

I think they are just wondering about the scenario, not about the probability.

[dejet]

Estimates and statistics are fun, the problem is that till we see it in action we have no real clue.

Talk all we want, I'm very skeptical the government can make any corporation do something they don't want to.

Loop holes will be made in future law and the system will be about as efficient as any other government program.

Hope I'm wrong and the tax, law, mandate whatever leads to great things.

[ringthree]

This could be repealed the same way it was passed, through reconciliation, meaning only 51 votes would be necessary.

Also, I don't think Romney could just not collect the "tax" if he decided to, but I think he could tell congress "screw you, I don't want your delegation of powers" as to the rule making stuff.

Two reasons it can't be passed through reconciliation.

First, the CBO has already parsed the legislation as being budget negative (meaning it saves money) and the repeal would be budget positive (meaning it would cost money). The current rules of reconciliation only allow it to be used to pass budget negative bills.

Second, and the more politically relevant reason, they could only use reconciliation to remove the budget aspects of the laws, they would not be able to remove the coverage aspects (up to 26 coverage for children, no denial because of pre-existing conditions, etc.). The insurance companies would absolutely lose it if they removed the mandatory increased coverage (which is where they are going to make their money). They need the increased pool of insured people to offset the costs of expanded expensive coverage.

[As a side note, I heard a discussion of what could have happened if the mandate had been struck down but the rest of the bill remained. The insurance companies would demand that the Congress increase the pool of insured to offset their costs, most likely through massively expanding Medicare, which in essence would be a public option, because any kind of mandate would be off the table. This would leave us with the public option that many liberals wanted at the beginning of the whole debate.]

In the end, the parts they could repeal are the only thing keeping the insurance companies on board, and no one wants to lose insurance company's money from their campaign coffers.

Romney would have some control over the rule making true, but the guidelines to most of this is either a congressional power or a state power. He could effect things on the fringes, but the core of the bill will be untouched.

[Dotsudoku]

First, the CBO has already parsed the legislation as being budget negative (meaning it saves money) and the repeal would be budget positive (meaning it would cost money).

Mind sourcing this?

[ringthree]

Mind sourcing this?

http://cbo.gov/publication/43076

[Dotsudoku]

Thanks!

[Kurokikaze]

http://peterjsullivan.files.wordpres.../gop_tears.jpg

[Ragnus]

That just made me laugh harder than I should have in work.

[Pirian]

Ohh is it picture time?



courtesy of Takei

[Acturus]

the gf is going into nursing soon and that is what worries me.

I think it's great that people will have access to medical care that they can afford, and I am for it all the way. But some dick is gonna cut his staff before he cuts his pay.

The demand for trained medical staff trumps staff cuts. You can't see patients if you don't have the staff to cover all of those visits. I expect to see administrative costs decrease because of the MLR rules. i.e. more jobs for medical records and authorizations and case management shipped overseas to call centers.

If anything, there is a concern of clinical shortages over the next 10 years, partly because of this, partly because of aging baby boomers. I believe your girlfriend will not only be fine finding an RN job, but she may even benefit through higher competitive pay if she proves to be a valuable asset.

[Callisto]

Can someone help me out here? Trying to tell how a system where the people who are better off and can afford insurance have some of what they pay in go towards subsidies for people who can't afford insurance fundamentally differs from one where the people who are better off and can afford insurance have some of what they pay in go towards increased premiums when the hospitals price-gouge insurance companies to cover losses from uncompensated care on patients who can't afford insurance, and the insurance providers transfer the increased costs to their customers.

Granted I dropped out of school before I completed my economics degree, but it seems like healthcare is already socialized, but just with greater expenses because there's a for-profit middleman involved.

[Acturus]

Can someone help me out here? Trying to tell how a system where the people who are better off and can afford insurance have some of what they pay in go towards subsidies for people who can't afford insurance fundamentally differs from one where the people who are better off and can afford insurance have some of what they pay in go towards increased premiums when the hospitals price-gouge insurance companies to cover losses from uncompensated care on patients who can't afford insurance and the insurance providers transfer the increased costs to their customers?

Granted I dropped out of school before I completed my economics degree, but it seems like healthcare is already socialized, but just with greater expenses because there's a for-profit middleman involved.

Healthcare is partially socialized already because Medicare and Medicaid exist. Medicare is the largest payor of healthcare claims in the country. But to answer your question, cost shifting is not socialization. It's free market (somehow).

The statement that I heard that best describes the long-term implications of the ACA is simply that we have, as a nation, indebted ourselves to private insurance presence in healthcare through this act.

[ringthree]

Can someone help me out here? Trying to tell how a system where the people who are better off and can afford insurance have some of what they pay in go towards subsidies for people who can't afford insurance fundamentally differs from one where the people who are better off and can afford insurance have some of what they pay in go towards increased premiums when the hospitals price-gouge insurance companies to cover losses from uncompensated care on patients who can't afford insurance, and the insurance providers transfer the increased costs to their customers.

Granted I dropped out of school before I completed my economics degree, but it seems like healthcare is already socialized, but just with greater expenses because there's a for-profit middleman involved.

Honestly, you are generally correct. The best way to get rid of the high cost of health care in general is to remove the insurance middleman. It is an unnecessary step that was created before governments were able to deal (or wanted to deal) with health care.

But... ZOMG SOCIALISM!

[Callisto]

imo the only truly valid issue I've seen in all this is the number of insurance industry employees who would be rendered unemployed by us shifting to a single-payer system, assuming the bulk of them could not secure similar positions within the government bureaucracies set up to handle the new system, that seems like a very real economic concern to me.

[Restrat]

All that money going to them comes from people having to spend too much money for healthcare. That money could then be spent elsewhere, adding to different parts of the economy. So those people would lose jobs but other people would gain jobs.

[Outlaw]

I don't usually get in on political discussions but I'm going to on this.

When the new health care law was first proposed it sounded really good to me. Like not getting denied for pre existing conditions, etc. Now I'm not so sure. There are parts of it that really worry me. I'm going to refer to some of the details in that link posted a few pages back on Reddit as examples.

Already in effect:
-It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) ( Citation: An entire section of the bill, called Title VII, is devoted to this, starting on page 747 )

-It increases the rebates on drugs people get through Medicare (so drugs cost less)

That's great but.. In 2014..

A new tax on pharmaceutical companies.

Won't that have a negative effect on the above? If they are getting taxed more (and you can bet it's going to be a hefty amount) they mite cut back on the number of medicines they make or cut corners.

Medicare patients with chronic illnesses must be monitored more thoroughly.

That sounds like: "We will dictate what is immediately necessary. Your not having a heart attack right now are you?

-A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers.

-A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.

Do you think that they will still want to offer the same benefits after the government takes a big bite out of their ass?

Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.

Gives places an excuse to lay off people. "I'm sorry Bob. We just can't afford to keep you."

Doctors' pay will be determined by the quality of their care, not how many people they treat.

I know that a lot of doctors will hate this. I have talked to a few doctors before about the issue of more government involvement in health care and they do not like someone looking over their shoulder.

[Tyche]

I don't usually get in on political discussions but I'm going to on this.

When the new health care law was first proposed it sounded really good to me. Like not getting denied for pre existing conditions, etc. Now I'm not so sure. There are parts of it that really worry me. I'm going to refer to some of the details in that link posted a few pages back on Reddit as examples.



That's great but.. In 2014..



Won't that have a negative effect on the above? If they are getting taxed more (and you can bet it's going to be a hefty amount) they mite cut back on the number of medicines they make or cut corners.



That sounds like: "We will dictate what is immediately necessary. Your not having a heart attack right now are you?



Do you think that they will still want to offer the same benefits after the government takes a big bite out of their ass?



Gives places an excuse to lay off people. "I'm sorry Bob. We just can't afford to keep you."



I know that a lot of doctors will hate this. I have talked to a few doctors before about the issue of more government involvement in health care and they do not like someone looking over their shoulder.

A few things. I read the "patients must be monitored more closely" as patients need to be moved to a sstepdown unit or a critical care unit as opposed to being sent to a medical or telemetry unit. Could just be my nurse bias.

Employers can save money by not offering insurance and getting penalized. Refer back a few pages for this discussion. Could be good for businesses and employees (sounds strange, I know).

Almost unanimously, every medical society endorsed it.

[Acevalefor]

Of course they don't like someone looking over their shoulder. It means they have to actually diagnose and treat a patient to get paid instead of sending the nurse in to say "Yep, it looks like you have the flu. The doctor will be in to write you a perscription". Then the Doctor comes in with the script already written and doesn't even do an exam.

Or another instance where the doctors write prescriptions that are unnecessary but "harmless" just to get the kick back from the pharmaceutical rep that takes him on a quarterly cruise in the Bahamas.

The doctors that are doing it right have nothing to worry about. It's the ones that stretch the rules or outright break the rules for their own personal gain.

[Demosthenes11]

1. big pharma makes probably the most ridiculous profit of any industry in the US. seriously. If you looked into the great deals the government has cut them, the retarded patents they have, and the actual cost of the drugs, you would be shocked.

2. Medicare wants patients to take more preventative steps, because it a) is cheaper and b) keeps people alive longer

3. the insurance companies will now be regulated into providing certain services, so they cant just cut them.

4. "Businesses will be assholes" is never a reason not to do something, especially get more people health insurance.

5. how doctors are evaluated is a good point. I'm not sure the ramifications, but I can see the potential problems.

[ringthree]

Almost unanimously, every medical society endorsed it.

Those that had a problem with it only did so because the law did not go far enough.

This is why the bill polls poorly. You have the people that want it repealed, but you also have people that don't think it goes far enough. If the polls were changed to include the latter in the supporters it would have more supporters than not.