What would you fix about the ACA (enemy, drug, health care system)

[Proud2beAMom]

I'm not looking for trashing Obama.. trashing liberals and even trashing conservatives in this thread. I'm looking for a serious discussion about the law and where we can IMPROVE it.. not dismantle it.

I will say that I am a defender of it, but the ACA is not the most ideal reform that I wanted. However, I'm personally grateful for it's inception. BUt I recognize that it's not perfect (and never claimed it to be).

So, I would like to hear from those with serious thoughts about what they would change about the law or where they would improve it.

Here's what I would have liked to see:

1. I would have liked to see a medicare for all option. I think it might have offered some serious competition to insurance companies giving them more incentive to lower their prices.

2. I would have opened insurance across state lines. This would help those in rural areas where only two options are available, have more choices thereby pushing down prices.

3. I would have added tort reform.

4. I would have tied the law in with some sort of relief to doctors and education costs.

I may have more ideas down the line, but I would like to hear some of yours.. without the trashing, etc.

[NCN]

I am serious. Free enterprise system does not need socialized medicine. Throw it out and throw out anybody that voted for it. They are not true Americans.

[Proud2beAMom]

Originally Posted by NCN

I am serious. Free enterprise system does not need socialized medicine. Throw it out and throw out anybody that voted for it. They are not true Americans.

I get that is what the opposition feels. But healthcare is the difference between life and death. I get that insruance created a middle man that created high prices. But, short of doing away with the middle man and then having to pay for services directly, that isn't neccesarily possible because costs can't be reduced or deflated.

So, you are saying it needs to be thrown out all together? Okay.. but then how do you envision that would effect people, prices, doctors, innovation, drug prices.. etc?

[fairlaker]

Things like tort reform and selling across state lines are merely sops to the insurance companies. They do nothing to improve health care, access to health care, or the cost of health care. If it were up to me, I would put the bulk of the 1099 reporting requirements back in, and I would relax the standards and ask the technical people to see if they couldn't come up with a viable long-term care plan after all.

[NCN]

Originally Posted by Proud2beAMom

I get that is what the opposition feels. But healthcare is the difference between life and death. I get that insruance created a middle man that created high prices. But, short of doing away with the middle man and then having to pay for services directly, that isn't neccesarily possible because costs can't be reduced or deflated.

So, you are saying it needs to be thrown out all together? Okay.. but then how do you envision that would effect people, prices, doctors, innovation, drug prices.. etc?

The quality of medicine would improve and with competition the cost of medical care would go down. We have not had real competition of insurance for years since these co-ops began.

When I was young a person could go into the hospital and end up with extra money if they had more than one policy. Then we started letting insurance companies and the government manage what our doctor was allowed to do and medical care has gone downhill and gotten more expensive from so many law suits. We need to go back to the 50's when we and our doctors were in charge of our health.

Government has no business telling either me or my doctor how to manage my health.

[Proud2beAMom]

Originally Posted by NCN

The quality of medicine would improve and with competition the cost of medical care would go down. We have not had real competition of insurance for years since these co-ops began.

Okay.. still not seeing it. The most common procedure, an angioplasty, currently costs anyhere from $5K to 200,000 for the procedure alone. Hospital stay is $600 to $2,000 a day .

if we did away with insurance companies tomorrow, would this price suddenly drop. OR would people have to take out a "mortgage" like loan to pay for the surgery.

You can't really dial back prices. So, wouldn't those that can't afford it not be able to get service and die.. adn how many of us can afford something with such a high price tag?

And.. with something that means the difference between life and death - price gouging is completly possible. How can you deflate an entire chain of products/services etc to a price that would be something affordable.. like a consumer product like a TV?

If it's not priced like a television , phone or something like that.. than most are not going to be able to afford it. Don't you think it would become somethign that is available only to the very wealthy but the rest of us wouldn't have access at all?

NOt everyone can afford a house.. so they rent because its more affordable. But how do you "rent" an angioplasty..

Do you see what i'm trying to get at .

Cancer treatments as well.. very pricy.

I just don't see how a completely free market would really work here. Medicine is unique because it is often the difference between life and death and how do you put a pricetag on that? It's not something some one can just decide not to need.

Maybe give me some example - more detailed - to how you see it happening.

And thanks...

[MrRational]

Start over.

Eliminate employer based HI policies.
Eliminate HI companies as the backbone of the system.

Create a backdoor into Medicare based on diagnosis.
Over time, expand Medicare to age 60, then age 55, then age 50, etc.
That might be enough.

Prior to age 50 and absent a serious situation/diagnosis very few of us need much "coverage".

[fairlaker]

You can't start over. You have to start from where we are. And if you go too quickly people start dying because they fall through the cracks that you open up. The proverbial journey of a thousand miles begins with a single step. Make sure that step is on solid ground and headed in the right direction. PPACA is that.

[fairlaker]

The so-called free market approach gives us Gilded Age health care. We have concierges for some, and witch doctors for the others. Not much of a health care system really.

[MrRational]

Originally Posted by fairlaker

You can't start over. You have to start from where we are.
And if you go too quickly people start dying because they fall through the cracks that you open up.

And perfection is the enemy of good enough.