Originally Posted by Bri2k

The scary thing about the ACA (Obamacare) is the way the subsidies are paid out. If I understand it correctly, one has to pay the monthly premium in full and then gets reimbursed via tax credits when their tax return is processed the following year. I don't know how it is for most people, but I'd be unable to afford to add another $350 monthly bill to my budget. Even after one pays the premium, the coverage is very poor for the two least expensive plans and involves a lot of out of pocket expense and a high deductible. I fear the ACA will be unworkable for many if not most working people.

Bri2k

Depending on where you live, it varies. Here's the website that might help: https://www.healthcare.gov/quick-answers/#step-1

I am covered by my employer, so ACA does not affect me at this point, although it's made a huge, positive difference for a number of my students (I teach college).

After reading your post I looked over ACA in my state. I live in IL, so I checked out those options. I entered my actual age (48-64) and that I had no dependents,which are true, I said I was self-employed and that I made under $49,000, neither of which are accurate. The first thing indicated is that I may be eligible for aid due to that income.

You also have choices regarding plans, depending on what deductible you choose. The Bronze plan, for example, has the lowest monthly cost but the highest deductible. I don't know if in your state it would be $350 a month. It may be lower, given your income and depending on if your state government has chosen to expand medicaid.

As someone who would prefer a national health care plan like that in Canada or the UK, ACA is not my preference. But it is an improvement. It may be that you choose to pay the tax penalty rather than sign up. But I suspect your premiums may not be as high as you think. They will, however, be higher than having no health insurance at all. That is a decision you need to make.

I would be fine with paying more in taxes for national health care. I don't see that happening soon,

Since I had no health insurance from age 21 (and from age 25-27 it was the university health center) to age 31, I get it. I had self-employed health insurance for a year to the tune of $150 a month in 1990. But back then I could go to the doctor for $35 a pop. I had no dental care from age 21 to age 31 until it got so bad I had to find a dentist who would take payments. I went w/out a dental cleaning for 10 years. Fortunately, I don't get cavities. Unfortunately, I couldn't get my wisdom teeth out and that wreaked havoc. I have gum disease exacerbated by years of lack of dental care.

A self-employed friend had to pay $650 a month with a $5000 deductible with Blue Cross and had to lie about pre-existing conditions. That is highway fncking robbery. Since she never made a claim. The insurance handler at one dr's office I go to had a moment of breakdown, calling all insurance companies thieves. She'd snapped.

For all Playwrites' obnoxiousness about magic pony poop and sheeple, he does seem to have an excellent grasp of Obamacare. He may be a great resource.

And every MD and medical professional I know personally supports health insurance reform. Most support national health care. They all seem to loathe insurance companies.

Please keep us posted about your experience with this change. It's important to know.

Ann

Originally Posted by annla899

A self-employed friend had to pay $650 a month with a $5000 deductible with Blue Cross and had to lie about pre-existing conditions. That is highway fncking robbery. Since she never made a claim. The insurance handler at one dr's office I go to had a moment of breakdown, calling all insurance companies thieves. She'd snapped.

This part isn't going to change. While they can't deny you coverage for having a pre-existing condition, they sure can jack up your premium rates. Playing around with the insurance calculator, I can get it as high as $600-$800 for an individual with a chronic auto-immune disease.

Then of course, there's the problem that little detail about ACA bronze plans: they don't really cover anything. They'll bill you at least a hundred bucks a month per young, healthy member, but then every expense you have comes out of the deductible and out-of-pocket costs - up to $12,700 for a family plan! You can get subsidies for the premium if you're low income, but no one's going to help with the leftover OOP & deductible costs.

So let's look at what happens under ACA for a median, self-employed household that is otherwise healthy when applying for family coverage:

$50,000 income
27% for federal taxes - includes payroll
10% for state & local taxes
$4800 for annual premiums
$12,700 for health expenses

That's basically the budget I have to look at for having a kid under the ACA. It leaves around $14,000 a year for food, rent, utilities, transport, entertainment, repairs, etc... The total cost of [government + healthcare] in America makes western Europe look like some kind of low-cost libertarian paradise.

But hey, it's good for the people who matter: insurance investors!!!

Health insurance giant Wellpoint today announced a 38% profit increase in the 4th quarter of 2012, as compared to last year, for a total $2.7 billion in net profits for 2012. The insurance company continues to pad its profits even as the growth of health care costs remains at record-low levels and the company is forcing double-digit premium increases on consumers and small businesses across the country

http://yubanet.com/california/Wellpo...p#.Uj75c4ZQE8o

In order to arouse sympathy, the aristocracy was obliged to lose sight, apparently, of its own interests, and to formulate their indictment against the bourgeoisie in the interest of the exploited working class alone. Thus, the aristocracy took their revenge by singing lampoons on their new masters and whispering in his ears sinister prophesies of coming catastrophe.

In this way arose feudal Socialism: half lamentation, half lampoon; half an echo of the past, half menace of the future; at times, by its bitter, witty and incisive criticism, striking the bourgeoisie to the very heart’s core; but always ludicrous in its effect, through total incapacity to comprehend the march of modern history.

The aristocracy, in order to rally the people to them, waved the proletarian alms-bag in front for a banner. But the people, so often as it joined them, saw on their hindquarters the old feudal coats of arms, and deserted with loud and irreverent laughter.

Well, some of you folks voted for him and this is what we get. No one in my town, including me wanted him as president in the first place.

The health care issue is an embarrassment. It's ALREADY a government run boondoggle, and has been for decades. Can't we at least take a look at the dozens of other industrialized nation's experiences with health care, and see if we can't make it a halfway efficient boondoggle? People might be surprised to learn that there are lots of countries that manage a national insurance system with LESS government spending and administration than what we've got presently.

Originally Posted by 1995 Millennial

Well, some of you folks voted for him and this is what we get. No one in my town wanted him as president in the first place.

Obamacare is basically the same thing as Romneycare - except Massachusetts has more generous subsidies & assistance for low income residents.

What reason is there to believe we would have gotten a different deal if Romeny had been elected? Lobbyists get what lobbyists want.

Originally Posted by Bri2k

The scary thing about the ACA (Obamacare) is the way the subsidies are paid out. If I understand it correctly, one has to pay the monthly premium in full and then gets reimbursed via tax credits when their tax return is processed the following year. I don't know how it is for most people, but I'd be unable to afford to add another $350 monthly bill to my budget. Even after one pays the premium, the coverage is very poor for the two least expensive plans and involves a lot of out of pocket expense and a high deductible. I fear the ACA will be unworkable for many if not most working people.

Bri2k

I've noted this before, but let me give it in fuller context -

How the subsidy works. The subsidy for health insurance is technically a tax credit, which would normally reflect on a taxpayer’s returns each year. However, since many low- and middle-income families can’t afford to pay insurance premiums without help upfront, this credit works differently.

Instead of applying when they file their taxes, eligible individuals and families can apply for this tax credit when they sign up for insurance. The government will calculate how much is owed in the tax credit, and the amount will be paid directly to the insurance company. Then, the insured person only needs to pay the remaining portion of the premium (normally paid out in monthly installments) to the insurer.

If individuals or families choose to apply for the credit when they file their taxes, this will be a refundable credit. Those who can afford to pay their health insurance premiums throughout the year may take that route, in which case the subsidy will first pay down any taxes the individual has due, and whatever is left over will be distributed as a tax refund.

While the first option – receiving the payout upfront – is more manageable for many families, make sure to calculate your income correctly. If your income increases, and it turns out that your advance payment was too large, you’ll have to repay at least a portion of the overpayment. How much of the overpayment you’ll be required to repay will depend on how far above the FPL you are.

The key is that the subsidy is a tax credit which means it reduces your tax burden dollar for dollar; no fancy tax tables or percentages figure into the calculation. If not much has changed in your finances in 2014 compared to 2013, your subsidy just reduces your 2014 tax burden by the exact same amount as the subsidy.

Since everyone knows this, they set up the program so that the health exchanges/insurers will do the paperwork upfront and just reduce your premium by the amount of the subsidy and the govt pays them the subsidy directly. The trick will be setting up the 2014 tax forms and the supporting data base to make this as relatively straightforward as possible to the tax payer. Hopefully, you will see no difference in your 2014 form from your 2012 form and it will all be done by data bases in the background. All you may know is your insurance premium is going to look like a bargain compared to those in higher income brackets.

Originally Posted by JohnMc82

This part isn't going to change. While they can't deny you coverage for having a pre-existing condition, they sure can jack up your premium rates. Playing around with the insurance calculator, I can get it as high as $600-$800 for an individual with a chronic auto-immune disease.

Then of course, there's the problem that little detail about ACA bronze plans: they don't really cover anything. They'll bill you at least a hundred bucks a month per young, healthy member, but then every expense you have comes out of the deductible and out-of-pocket costs - up to $12,700 for a family plan! You can get subsidies for the premium if you're low income, but no one's going to help with the leftover OOP & deductible costs.

So let's look at what happens under ACA for a median, self-employed household that is otherwise healthy when applying for family coverage:

$50,000 income
27% for federal taxes - includes payroll
10% for state & local taxes
$4800 for annual premiums
$12,700 for health expenses

That's basically the budget I have to look at for having a kid under the ACA. It leaves around $14,000 a year for food, rent, utilities, transport, entertainment, repairs, etc... The total cost of [government + healthcare] in America makes western Europe look like some kind of low-cost libertarian paradise.

But hey, it's good for the people who matter: insurance investors!!!

Something in your scenario doesn't seem right.

You say this is what you "have to look at for having a kid under the ACA." Is your scenario that you already have a kid so your premium of $400/mo reflects a family of three or is your scenario that you are just a couple yet to have a kid and for just the two of you, your premium is $400/mo. Is this the premium with or without a subsidy?

Further, you say the "ACA bronze plans: they don't really cover anything' - good news, every Bronze Plan out there has to cover 60% of your actual cost. That means that up to your maximum $12,700 out-of-pocket (OOP) costs, the insurer is paying $19,050 - that means you are having medical bills of over $30,000. And from there, the insurer will be paying the full load.

Is $30K+ event typical? If you're having a $30K+ event, you feel you would be better off not having insurance?

Yes, there is the magic pony world of single payer, but have you notice these people called t-baggers lately? Do you really think that if we gave up on Obamacare (which the baggers are presently threatening to shut down the govt or have it default if we don't) that we are going to catapult ourselves into the magic pony land of single payer?

While I'm a little puzzled by your scenaio's numbers, I'm even more puzzled by what you are suggesting should be the alternative. If it's just more whining about life outside of magic pony land, don't you think going on four years is enough time to get it out of your system? I guess current events suggest otherwise.

Originally Posted by JordanGoodspeed

The health care issue is an embarrassment. It's ALREADY a government run boondoggle, and has been for decades. Can't we at least take a look at the dozens of other industrialized nation's experiences with health care, and see if we can't make it a halfway efficient boondoggle? People might be surprised to learn that there are lots of countries that manage a national insurance system with LESS government spending and administration than what we've got presently.

Outside of the French and Switzerland systems, nearly all other nations have a much greater role for government that what we have now or what we will have after the ACA is fully engaged. The French and Swiss are basically private-public partnerships like what our ACA will be.

So I'm not sure what you're angling for. It seems you want less govt but then you reference others that have more government. And is efficiency the right measure for deciding if your mom should get her needed medicine?

Originally Posted by playwrite

Something in your scenario doesn't seem right.

You say this is what you "have to look at for having a kid under the ACA." Is your scenario that you already have a kid so your premium of $400/mo reflects a family of three or is your scenario that you are just a couple yet to have a kid and for just the two of you, your premium is $400/mo. Is this the premium with or without a subsidy?

$400 is for a family of two plus maternity-related coverage. When the kid is born, they tend to add person to the premium calculation immediately, so those rates go up. Also, all of the pre-natal care and most of the delivery is charged to the mothers' insurance - pretty much to the point of hitting out of pocket costs. At that moment of birth though, the new charges are all going to the kid. So it's actually pretty easy for a couple having a kid to hit the annual family maximum.

Further, you say the "ACA bronze plans: they don't really cover anything' - good news, every Bronze Plan out there has to cover 60% of your actual cost. That means that up to your maximum $12,700 out-of-pocket (OOP) costs, the insurer is paying $19,050 - that means you are having medical bills of over $30,000. And from there, the insurer will be paying the full load.

Well then, I'm going to have to go back and look at what the premium costs are after this goes in to effect on Oct. 1. Because the plans and premiums I'm quoting were actually based on a pre-compliant policy that had $3,500 deductibles and $3,500 OOP ($7,000 out of network) before covering a 100%. The associated family plan capped at $14,000 after that.

But yeah, a plan with a 40-60 split on the whole way up the deductible and out of pocket costs? That increases the premium by 50-80%. I guess it's just about that fun time of year to go shopping again.

Yes, there is the magic pony world of single payer, but have you notice these people called t-baggers lately? Do you really think that if we gave up on Obamacare (which the baggers are presently threatening to shut down the govt or have it default if we don't) that we are going to catapult ourselves into the magic pony land of single payer?

While I'm a little puzzled by your scenaio's numbers, I'm even more puzzled by what you are suggesting should be the alternative. If it's just more whining about life outside of magic pony land, don't you think going on four years is enough time to get it out of your system? I guess current events suggest otherwise.

You know how natural monopolies work, mayor magic pony. Convince those tea partiers that their hospital should run like their power plant or plumbing (you'd be surprised how many red-state utilities are socialized, and how cheap they are, and how viciously the conservative true believers will fight to protect their public utilities from private profiteers)

Mostly though, you just have to convince all the millionaires (and temporarily embarrassed millionaires) that having a free clinic won't necessitate closing the Mayo or Sinai. Europe's got a whole continent of effective, cost-effective, and universal systems that allow for private competition that we could be trying to emulate, but we picked the most expensive one and found a way to make it even more expensive than that.

Is it better than what we had in the past? Marginally? Maybe. It's hard to tell because so much of the big picture remains intact, and there's a pretty zero-sum tradeoff between those who win and those who lose. None of the cost incentives change, except maybe that insurers have even more reason to increase premiums. The costs might be a little better distributed through society, but only if you really think the millies haven't been carrying their fair share between taxes, social security, and student loan debt. It would be one thing if Millennials were getting jobs that could support the 50+ crowd, but they're being asked to subsidize the lifestyles of people who already make & have a lot more than they do.

Mostly though, the costs of getting sick remains with the sick. While they can't drop you, they can definitely raise your rates to an unaffordable level - especially when a slack labor market makes it easy for employers to dump employees who miss work due to illness. Remember: most medical bankruptcies in America are among those who had insurance at the time their illness was diagnosed. Maybe it doesn't mean much to you, but $8,000 here, $12,000 there, for a couple of years, is more than enough to put the median American family under.

Originally Posted by playwrite

Outside of the French and Switzerland systems, nearly all other nations have a much greater role for government that what we have now or what we will have after the ACA is fully engaged. The French and Swiss are basically private-public partnerships like what our ACA will be.

So I'm not sure what you're angling for. It seems you want less govt but then you reference others that have more government. And is efficiency the right measure for deciding if your mom should get her needed medicine?

You misunderstand where I am going. I have no problem with a national health insurance system, ala France or the Netherlands or a few others. What I have a problem with are government administered healthcare systems like the NIH or the VA, namely because I and my family and friends have personal experience with them and don't like them.

As for efficiency, it's where we're going anyways. The rise in medical costs needs to be brought down, and more and more services need to be provided by Nurse Practitioners and other allied health professionals. I had a skin tag removed a couple of weeks ago by the nurse at my school health clinic, and when she asked if I had health insurance and wanted to go to a dermatologist, I asked her what the point was. It doesn't take 10 years of specialized training for a shot of lidocaine and a couple of minutes with a pair of surgical scissors. The type of thing Walmart is doing with its clinics, or if you'd like a government example what the Army does with its aid stations, is a better way to handle routine medical care.

And before you ask, my problem with the ACA is that it was a mediocre piece of legislation that barely got through despite the Dems having a huge mandate and control of both houses of Congress and the White House. If that's the best they can do under those circumstances, on an issue I happen to agree with them with, don't expect me to get too worked up about them as a party in the future.

Originally Posted by JohnMc82

$400 is for a family of two plus maternity-related coverage. When the kid is born, they tend to add person to the premium calculation immediately, so those rates go up. Also, all of the pre-natal care and most of the delivery is charged to the mothers' insurance - pretty much to the point of hitting out of pocket costs. At that moment of birth though, the new charges are all going to the kid. So it's actually pretty easy for a couple having a kid to hit the annual family maximum.

Not sure about all of this - it would take some time to figure out. I'm past the time where it would make any sense for me to have another kid. However, I do think the subsidy goes up as well as the premium with an additional family unit - need to check that. Also, up above somewhere, I posted the number of things that become free under the ACA to women and children with much of it centered around pre-natal and early life.

Originally Posted by JohnMc82

Well then, I'm going to have to go back and look at what the premium costs are after this goes in to effect on Oct. 1. Because the plans and premiums I'm quoting were actually based on a pre-compliant policy that had $3,500 deductibles and $3,500 OOP ($7,000 out of network) before covering a 100%. The associated family plan capped at $14,000 after that.

I found a recent study that showed the ACA would bring the average OOPs down considerable. One thing that study found is a lot of current plans' OPPs don't include the deductibles, I think it was more than 1/3 - tricky little bastards.

Originally Posted by JohnMc82

But yeah, a plan with a 40-60 split on the whole way up the deductible and out of pocket costs? That increases the premium by 50-80%. I guess it's just about that fun time of year to go shopping again.

Not sure I follow. You're saying if you max out, they will increase your premium 50-80% next time around? If that's what you're saying, where did you get that info?

Originally Posted by JohnMc82

You know how natural monopolies work, mayor magic pony. Convince those tea partiers that their hospital should run like their power plant or plumbing (you'd be surprised how many red-state utilities are socialized, and how cheap they are, and how viciously the conservative true believers will fight to protect their public utilities from private profiteers)

Yes, there's hope, but not until the Black guy is out of the WH, and who knows how bent out of shape they'll get should a woman replace him (I'm mean one with a brain, leaving out S. Palin). Given the wars and financial meltdowns that come with the choice that MIGHT lull them to sleep, I'm torn between the choice.

Originally Posted by JohnMc82

Mostly though, you just have to convince all the millionaires (and temporarily embarrassed millionaires) that having a free clinic won't necessitate closing the Mayo or Sinai. Europe's got a whole continent of effective, cost-effective, and universal systems that allow for private competition that we could be trying to emulate, but we picked the most expensive one and found a way to make it even more expensive than that.

I'm more hopeful about this. MMT thinking would help a lot in this regard (i.e. taxes don't actually pay for anything).

Originally Posted by JohnMc82

Is it better than what we had in the past? Marginally? Maybe. It's hard to tell because so much of the big picture remains intact, and there's a pretty zero-sum tradeoff between those who win and those who lose. None of the cost incentives change, except maybe that insurers have even more reason to increase premiums. The costs might be a little better distributed through society, but only if you really think the millies haven't been carrying their fair share between taxes, social security, and student loan debt. It would be one thing if Millennials were getting jobs that could support the 50+ crowd, but they're being asked to subsidize the lifestyles of people who already make & have a lot more than they do.

Particularly grading when the whole thing about subsidizing is a myth. The govt could pay single payer and not raise taxes a nickle, unless inflation would ensue and that's doubtful given that single payer comes with cost controls - see Krugman's latest graph that shows Medicaid cost, as opposed to Medicare and insurance-based health care, is more or less flat-lined for the next few decades. Sure be a lot of pissed off doctors and hospital administrators not being able to get a new Mercedes each year, however.

Originally Posted by JohnMc82

Mostly though, the costs of getting sick remains with the sick. While they can't drop you, they can definitely raise your rates to an unaffordable level - especially when a slack labor market makes it easy for employers to dump employees who miss work due to illness. Remember: most medical bankruptcies in America are among those who had insurance at the time their illness was diagnosed. Maybe it doesn't mean much to you, but $8,000 here, $12,000 there, for a couple of years, is more than enough to put the median American family under.

I understand and can sympathize. I think the ACA makes it less likely but it doesn't take away the whole risk. There's a chart that shows 2% of the population represent about 30% of annual health care costs; take that to 5% of the population and your in the range of 80-90% of the costs. That's mostly old people but its not all. It's part of life and not an easy societal issue regardless of what many people assume.

One thing - when you get up to having a dozen kids or so, maybe one should just stop.

Originally Posted by JordanGoodspeed

You misunderstand where I am going. I have no problem with a national health insurance system, ala France or the Netherlands or a few others. What I have a problem with are government administered healthcare systems like the NIH or the VA, namely because I and my family and friends have personal experience with them and don't like them.

As for efficiency, it's where we're going anyways. The rise in medical costs needs to be brought down, and more and more services need to be provided by Nurse Practitioners and other allied health professionals. I had a skin tag removed a couple of weeks ago by the nurse at my school health clinic, and when she asked if I had health insurance and wanted to go to a dermatologist, I asked her what the point was. It doesn't take 10 years of specialized training for a shot of lidocaine and a couple of minutes with a pair of surgical scissors. The type of thing Walmart is doing with its clinics, or if you'd like a government example what the Army does with its aid stations, is a better way to handle routine medical care.

And before you ask, my problem with the ACA is that it was a mediocre piece of legislation that barely got through despite the Dems having a huge mandate and control of both houses of Congress and the White House. If that's the best they can do under those circumstances, on an issue I happen to agree with them with, don't expect me to get too worked up about them as a party in the future.

Little to disagree with here, except for the implicit assumption that the period of time they had 60 votes in the Senate was somehow an easy time for progressives and progressive values of most of today's Dems. You're basically establishing your future political support on Ted Kennedy's brain tumor and the now-gone DINOs Lieberman (who is also a big-time a-hole and Connecticut insurance corp whore), NB's moronic Ben Nelson and I'll-do-anything-to-get-re-elected Blanche Lincoln - those are the people that killed off single payer and the public option. I think ignoring that is very insulting to the rest of the Dems that tried everything to get something better particularly for the least fortunate in our society. Anyone directly involved to even a tiny degree understands that; it's the ones that at best have just enough energy to whine on Internet chat rooms of a lack of a better outcome that blame the vast majority of Dems that tried to actually get something done... and did.

Joan McCarter has a very good summary of the ACA and what it actually means for most people -

http://www.dailykos.com/story/2013/0...urance-options


A not-so-often-mentioned aspect is the availability of relatively cheap catastrophic insurance that will be offered to those under 30. It actually has the preventative elements of the ACA and in other ways is better than most such insurance available today - the primary one is that the insurer will be around when and if you come calling with the govt as the enforcer; not a sure thing prior to the ACA. It isn't eligible for any subsidy however.

Here's more on that offering here -

http://health.usnews.com/health-news...alth-insurance

I think many will be in my boat, dependent on the lower two levels of coverage. It's better than no coverage at all. When the insurance companies start charging more, after they can't reject pre-existing conditions, then ACA might get quite a bit of flak. I've heard, firsthand, some meds doubling in price. I think the insurance companies will milk this as long as they can. I do not think we will go back to an uninsured population, pre-ACA. More likely, a run of scandals will force us toward single-payer, over the next decade.

Little to disagree with here, except for the implicit assumption that the period of time they had 60 votes in the Senate was somehow an easy time for progressives and progressive values of most of today's Dems. You're basically establishing your future political support on Ted Kennedy's brain tumor and the now-gone DINOs Lieberman (who is also a big-time a-hole and Connecticut insurance corp whore), NB's moronic Ben Nelson and I'll-do-anything-to-get-re-elected Blanche Lincoln - those are the people that killed off single payer and the public option. I think ignoring that is very insulting to the rest of the Dems that tried everything to get something better particularly for the least fortunate in our society. Anyone directly involved to even a tiny degree understands that; it's the ones that at best have just enough energy to whine on Internet chat rooms of a lack of a better outcome that blame the vast majority of Dems that tried to actually get something done... and did.

I'm withholding my future political support until I have a better understanding of where the parties are going to stand for the next turning or so. We're about ready for another party system; Reaganism/Clintonism and the New Deal Coalition are about done for, and I don't know what's going to replace them yet.

As for the rest of it, hey, I'm not advocating that we shutdown the government and default on our debt in order to defund the damn thing.* I'm just not going to treat it as the New Deal come again, either.

*Well, I kinda do. Not because I think it would be good policy, but because i kind of think we need another crisis to effect a political realignment one way or another and I would like to get it over with while I am still young and have time on my GI Bill. It is also hugely exciting as a young man, just when i was coming to an age where I was accepting that radical change just isn't possible, to see middle aged men threatening Armageddon over what is in essence a change in the way our insurance regulations work.

Originally Posted by Bad Dog

I think many will be in my boat, dependent on the lower two levels of coverage. It's better than no coverage at all. When the insurance companies start charging more, after they can't reject pre-existing conditions, then ACA might get quite a bit of flak. I've heard, firsthand, some meds doubling in price. I think the insurance companies will milk this as long as they can. I do not think we will go back to an uninsured population, pre-ACA. More likely, a run of scandals will force us toward single-payer, over the next decade.

I'm waiting for the Millenials to take this country to a more just society. Millions of people who are left without health care and too many junk policies sold to bolster the insurance industry, will hopefully, not be tolerated by by our younger generation. May they usher in, either a new party, or Democrats that are to the Left, instead of the current Republicrats.

Pro-capitalists wrote the ACA and that's who will mainly benefit. While there will be improvements for some, it won't outweigh the high administrative fees, over the top CEO salaries, and the injustice of leaving millions of human beings without healthcare.

Originally Posted by JordanGoodspeed

... And before you ask, my problem with the ACA is that it was a mediocre piece of legislation that barely got through despite the Dems having a huge mandate and control of both houses of Congress and the White House. If that's the best they can do under those circumstances, on an issue I happen to agree with them with, don't expect me to get too worked up about them as a party in the future.

These are valid points. The difference between governance by Democrats circa 2008-10 and during their period of dominance in the 1930s-60s is the strength of leadership shown inside their caucuses in both houses of Congress. In that earlier time, the leadersip would have punsihed members for breaking faith on major issues, and made opponents in the other party even less comfortable. Funding can be easiliy redirected, if the leadership insists on it.

Today, the largess is just dispensed. To quote a mythical Congresscritter, "If my farmers get their subsidies regardless, why should I care? I'll get reelected."

This is Silent/Boomer leadership at its worst. The Silent Dems, with their go-along-to-get-along background now embraced as a leadership style, are out of their league trying to contend with the GOP Boomer bombast and Xer cynicism. Harry Reid and Nancy Pelosi need to step aside and let more aggressive people take their leadership positions.

Originally Posted by Deb C

I'm waiting for the Millenials to take this country to a more just society. Millions of people who are left without health care and too many junk policies sold to bolster the insurance industry, will hopefully, not be tolerated by by our younger generation. May they usher in, either a new party, or Democrats that are to the Left, instead of the current Republicrats.

May they do so, and soon enough! And the "new party" is, of course, already here.

Pro-capitalists wrote the ACA and that's who will mainly benefit. While there will be improvements for some, it won't outweigh the high administrative fees, over the top CEO salaries, and the injustice of leaving millions of human beings without healthcare.

The ACA/Obamacare is better than what was before, I am sure, but it was a watered-down reform, because we have ceded too much power to corporate wealth and to their Republican-DINO representatives. Medicare for all/single-payer is the best way. If we want the Democrats to represent us, as they are supposed to do, and not the insurance companies at al, then enough of we the people need to do our best to insist that they do. IF they don't, then they need to be "primaried" or challenged by a third party like the Greens.

Originally Posted by Eric the Green

May they do so, and soon enough! And the "new party" is, of course, already here.

The ACA/Obamacare is better than what was before, I am sure, but it was a watered-down reform, because we have ceded too much power to corporate wealth and to their Republican-DINO representatives. Medicare for all/single-payer is the best way. If we want the Democrats to represent us, as they are supposed to do, and not the insurance companies at al, then enough of we the people need to do our best to insist that they do. IF they don't, then they need to be "primaried" or challenged by a third party like the Greens.

Eric, we are dealing with right leaning Democrats. If we are to affect change then we best stop making excuses for their corporate ways, tell them we are on to their games and we have had enough of this baloney. They just love it when they can keep us thinking that ACA was the best they could do.

If you expect little change, then we will get exactly what we expect.

Originally Posted by Deb C

Eric, we are dealing with right leaning Democrats. If we are to affect change then we best stop making excuses for their corporate ways, tell them we are on to their games and we have had enough of this baloney. They just love it when they can keep us thinking that ACA was the best they could do.

If you expect little change, then we will get exactly what we expect.

The real problem is leadership. Both parties accept less than ideal members, if they win seats in districts/states that are otherwise safe for their opponents. The arguemnt that, " Our scumbag is better than their scumbag." has a lot of power to it. I just don't see that changing soon. The alternate choice is to make them behave when the chips are down. That's not happening now, and may be hard to implement after a decade or two of zero discipline ... but it has to happen if progress is to be made..

Originally Posted by Deb C

Eric, we are dealing with right leaning Democrats. If we are to affect change then we best stop making excuses for their corporate ways, tell them we are on to their games and we have had enough of this baloney. They just love it when they can keep us thinking that ACA was the best they could do.

If you expect little change, then we will get exactly what we expect.

“We always find something, eh Didi, to give us the impression we exist?” - Beckett 77


VLADIMIR:
Well? Shall we go?
ESTRAGON:
Yes, let's go.
[They do not move]
[Curtain]

Anyone surprised that the insurance industry is not too interested in including sick patients? Read and weep.


Lower Health Insurance Premiums to Come at Cost of Fewer Choices

Daniel R. Hawkins Jr., a senior vice president of the National Association of Community Health Centers, which represents 9,000 clinics around the country, said: “We serve the very population that will gain coverage — low-income, working class uninsured people. But insurers have shown little interest in including us in their provider networks.”

Dr. Bruce Siegel, the president of America’s Essential Hospitals, formerly known as the National Association of Public Hospitals and Health Systems, said insurers were telling his members: “We don’t want you in our network. We are worried about having your patients, who are sick and have complicated conditions.”

Many insurers are cutting costs by slicing doctors’ fees.

Dr. Barbara L. McAneny, a cancer specialist in Albuquerque, said that insurers in the New Mexico exchange were generally paying doctors at Medicare levels, which she said were “often below our cost of doing business, and definitely below commercial rates.”

Outsiders might expect insurance companies to expand their networks to treat additional patients next year. But many insurers see advantages in narrow networks, saying they can steer patients to less expensive doctors and hospitals that provide high-quality care.

Even though insurers will be forbidden to discriminate against people with pre-existing conditions, they could subtly discourage the enrollment of sicker patients by limiting the size of their provider networks.

More of the reality: http://www.nytimes.com/2013/09/23/he...anted=all&_r=0

Originally Posted by Marx & Lennon

The real problem is leadership. Both parties accept less than ideal members, if they win seats in districts/states that are otherwise safe for their opponents. The arguemnt that, " Our scumbag is better than their scumbag." has a lot of power to it. I just don't see that changing soon. The alternate choice is to make them behave when the chips are down. That's not happening now, and may be hard to implement after a decade or two of zero discipline ... but it has to happen if progress is to be made..

There are other ways in which persistent activism HAS worked, but doesn't seem to be occurring where our government is concerned. A prime example of what I am referring to was the crackdown on drunk driving. This took many years of pressure before culprits were hit with much more severe penalties than the proverbial "slap on the wrist". But it DID happen thanks to persistent public opinion.