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You know, before you start blab blab blabbing about how indebted the US is, why don't you look at the above chart showing debt as a % of GDP. That is the only debt measurement that matters. Note that we have been embroiled in two unnecessary wars. Note that we had a massive economic meltdown that started in late '08. Looks like we're on par with Depression era debt, which completely makes sense given that the private sector decided to stop spending, and the Feds were about the only people still putting cash into the economy. Things would have been far, far worse without that spending. That isn't hypothetical, it's just math. Without private sector spending (since everyone was fearfully hoarding their cash on the sidelines for several years), you have layoffs, production cutbacks, consumer debt default, and on and on. Now tell me again how broke we are. Because you're full of ****, buddy. It's called facts.
The ACA was a compromise, and it was in large part modeled after ROMNEYCARE! Mitt Romney was, if you recall, the GOP candidate in an obscure contest called the US Presidential election. The fact that a program modeled after a GOP governor's signature piece of legislation failed to get any GOP votes is strictly the GOP's problem. And frankly, if today's Democrats had their way we'd have had single payer model instead, which would be a far better approach if only for that doctors could spend a greater share of their practice's total workload practicing medicine rather than arguing with actuaries.
A compromise? It had zero GOP support.
Sounds like some of the rats are already jumping ship:
The dem rep in Oregon says Obama was "grossly misleading,'" and Bill Clinton says Obama needs to keep his commitment to the people he promised could keep their plans.
It was modeled after Romney's Massachussetts legislation. Romney is a Republican, no? A bill voted for by Democrats, modeled after a Republican governor's signature piece of legislation is a compromise, regardless of whether the House GOP voted for it or not. House Republicans inexplicably made a choice to disparage the kinds of policies enacted by their own Presidential candidate, so clearly their definition of compromise is suspect. BAM!
The ACA will make quality health insurance, and therefore access to care - which has been gobbling up peoples' paychecks at an increasing rate for decades - vastly more affordable for households making less than 400% of the federal poverty limit. Family policies have almost doubled as a proportion of househould spending in the past decade. That is a gigantic blow to the economy.
The final cost of a policy cannot exceed 9.5% of income, and will be heavily subsidized for the very poor, with subsidies phased out at 400% of the poverty limit. That means 2 things:
1) The individual mandate will be largely paid for by progressive taxes on people earning more than $250k, device manufacturers, and so forth, which helps to mitigate some of the extreme upward redisitribution of wealth of the past three decades, at a time when the wages of the median worker have dropped from the roughly $40k in the mid 70s (adjusted for today's dollars) to less than $34k.
2) Those extra dollars that aren't being spent on insurance by everyone making less than 400% of the poverty limit can finally be put to an economically productive use in the broader economy, and families' earnings picture can start to look more like it did a couple decades ago. That is huge.
It was modeled after Romney's Massachussetts legislation. Romney is a Republican, no? A bill voted for by Democrats, modeled after a Republican governor's signature piece of legislation is a compromise, regardless of whether the House GOP voted for it or not. House Republicans inexplicably made a choice to disparage the kinds of policies enacted by their own Presidential candidate, so clearly their definition of compromise is suspect. BAM!
The ACA will make quality health insurance, and therefore access to care - which has been gobbling up peoples' paychecks at an increasing rate for decades - vastly more affordable for households making less than 400% of the federal poverty limit. Family policies have almost doubled as a proportion of househould spending in the past decade. That is a gigantic blow to the economy.
The final cost of a policy cannot exceed 9.5% of income, and will be heavily subsidized for the very poor, with subsidies phased out at 400% of the poverty limit. That means 2 things:
1) The individual mandate will be largely paid for by progressive taxes on people earning more than $250k, device manufacturers, and so forth, which helps to mitigate some of the extreme upward redisitribution of wealth of the past three decades, at a time when the wages of the median worker have dropped from the roughly $40k in the mid 70s (adjusted for today's dollars) to less than $34k.
2) Those extra dollars that aren't being spent on insurance by everyone making less than 400% of the poverty limit can finally be put to an economically productive use in the broader economy, and families' earnings picture can start to look more like it did a couple decades ago. That is huge.
You've now changed the definition of compromise to encompass no votes from the GOP for legislation equals a compromise. But I understand Obama recently redefined what it means to lie, so that's how you guys roll, I get it.
That's a pretty chart, but at this point I'll wait to see what actually happens before accepting this administration's best case scenarios for the ACA. I mean, they estimated at least 500,000 would have signed up for now and we have less than 50,000. They said if you like your plan you can keep it. They said they would save $2,500 per family, etc., etc., etc.
Re the slow enrollment, big deal. 123 people enrolled in Romneycare during its first month, and Romneycare is far from being a failure. The website issues have zero relationship to the law's benefits.
What I don't understand is why it's okay for a GOP governor to put Romneycare into law, but it ISN'T okay for the President to put essentially the same law into effect nationwide. How could the GOP NOT support a law that was passed by their own Presidential candidate in his home state? That simply does not make sense at all, unless there are other motives. What, for instance, could be politically worse for the GOP than a Democratic President making a measurable dent on the out of control prices families pay for health insurance premiums? People just might like that and decide it benefits them. Hmmmmmmmmmmmmmmmmmmmmm.
But you wanted something tangible, huh? Okay. Here:
The highest price shown, for a "GOLD" plan, from Anthem BCBS, is $1050. If you make $50,000 - a very average MO income - and have a family of 4 you are eligible for a $3976 subsidy. Which means you can receive the best "GOLD" plan for $718 a month, or a "SILVER" plan for about $350 a month. That is far better than what was previously available.
Re the slow enrollment, big deal. 123 people enrolled in Romneycare during its first month, and Romneycare is far from being a failure. The website issues have zero relationship to the law's benefits.
What I don't understand is why it's okay for a GOP governor to put Romneycare into law, but it ISN'T okay for the President to put essentially the same law into effect nationwide. How could the GOP NOT support a law that was passed by their own Presidential candidate in his home state? That simply does not make sense at all, unless there are other motives. What, for instance, could be politically worse for the GOP than a Democratic President making a measurable dent on the out of control prices families pay for health insurance premiums? People just might like that and decide it benefits them. Hmmmmmmmmmmmmmmmmmmmmm.
But you wanted something tangible, huh? Okay. Here:
The highest price shown, for a "GOLD" plan, from Anthem BCBS, is $1050. If you make $50,000 - a very average MO income - and have a family of 4 you are eligible for a $3976 subsidy. Which means you can receive the best "GOLD" plan for $718 a month, or a "SILVER" plan for about $350 a month. That is far better than what was previously available.
1) Why are you wasting peoples' time with a posting from a libertarian think tank? I wonder if that link might be biased? Hmmmmmmmmmmmmmmm.
2) They compared the five least expensive policies in each given market, pre ACA. That means the five weakest policies, most likely not meeting the minimum care requirements.
3) Furthermore, they are comparing UNsubsidized costs, which are not reflective of what most people below 400% of the poverty limit will pay. In terms of the impact on actual users' bottom line, that whole report is inaccurate at best, deliberately deceptive at worst.
4) A key purpose of the ACA has always been to have a leveling effect on premiums across age ranges and disease states. The 3:1 old/young maximum differential is a part of that. But thanks to subsidies, underemployed millennials, median wage earners with families, low income workers, and the self-employed will finally have access to insurance that is not only inexpensive, but actually provides coverage.
So, what was it you were saying? That's right. You have no case.
The ACA was a compromise, and it was in large part modeled after ROMNEYCARE! Mitt Romney was, if you recall, the GOP candidate in an obscure contest called the US Presidential election. The fact that a program modeled after a GOP governor's signature piece of legislation failed to get any GOP votes is strictly the GOP's problem. And frankly, if today's Democrats had their way we'd have had single payer model instead, which would be a far better approach if only for that doctors could spend a greater share of their practice's total workload practicing medicine rather than arguing with actuaries.
Romneycare was an experiment, and tried in the correct way- at the state level. It was a massive failure, coming in at over three times the projected cost and only leading to the insurance of a few additional percent of Massachusetts residents. Romney saw this and like an intelligent person, decided that extending the failed Romneycare experiment to the entire nation would be a bad idea. That is why he and the GOP did not support Obamacare.
The main thing doctors are wasting their time with today are all of the Medicare mandates. Electronic medical records and "meaningful use" are at the top of that time-wasting mandate heap. Spending three times as long to do a worse job clicking out notes on the computer doesn't improve healthcare one bit. Just go look at an older note which was dictated vs. a new EMR click-templated one and tell me which one is more useful. Next would be the reams of prior authorizations, which are MUCH more numerous and onerous from Medicare than from any commercial carrier. The "patient centered medical home" garbage is a huge time waster too. Hey, lets take 10 extra minutes to click in the computer what we already do! Brilliant! Plus, the mandatory audits, CMS inspections, dubious "quality" metric collection- all of that crap just adds on extra time and expense. Let's not even talk about ICD-10 codes- being able to say if a fall occurred from a spacecraft or a turtle is so important that we need to root through an additional 100,00 codes in our lovely EMRs! Being able to ditch Medicare and go back to practicing actual medicine is a goal of most practicing physicians out there.
98% of MA residents now have health insurance, and 67% support the program. While it had higher than expected startup costs - which is the case with anything new, be it a business, a product, or a government program - costs are now in line with initial estimates.
If 2/3 of the population approves, and it greatly reduces the number of uninsured, what's not to like?
Regarding electronic medical forms and so on, you can b**** and moan about how awful the templates are, or work with the regulatory bodies to make the templates more useful. Which is it going to be? Your choice. Standardized, digitally accessible record keeping is here to stay. As a patient, I prefer not to have a folder full of scraps of paper and randomly formatted documents; it's my medical history versus the doc's convenience. Anyway, what is the old saying? Lead, follow, or get out of the way? One thing that will helps docs, is that there is a much greater degree of standardization in terms of what policies now must cover, so there should be lower admin costs from the back and forth of do they cover this or don't they.
98% of MA residents now have health insurance, and 67% support the program. While it had higher than expected startup costs - which is the case with anything new, be it a business, a product, or a government program - costs are now in line with initial estimates.
If 2/3 of the population approves, and it greatly reduces the number of uninsured, what's not to like?
Regarding electronic medical forms and so on, you can b**** and moan about how awful the templates are, or work with the regulatory bodies to make the templates more useful. Which is it going to be? Your choice. Standardized, digitally accessible record keeping is here to stay. As a patient, I prefer not to have a folder full of scraps of paper and randomly formatted documents; it's my medical history versus the doc's convenience. Anyway, what is the old saying? Lead, follow, or get out of the way? One thing that will helps docs, is that there is a much greater degree of standardization in terms of what policies now must cover, so there should be lower admin costs from the back and forth of do they cover this or don't they.
Thanks
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