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pscot

(21,024 posts)
Fri Oct 18, 2013, 08:21 PM Oct 2013

Universalizing Medicare would have been

so much easier and more effective than the mess entailed in getting the exchanges up and running. It's a system that works and everyone understands it.

[div class= "excerpt"]
The lead story in the Oct. 13 New York Times details the ongoing problems of the Affordable Care Act’s websites intended to facilitate access by individuals to the law’s hallmark online health insurance marketplaces. Those problems continue.

To summarize, many of the state-run and all of the 36 federally run websites are currently experiencing significant problems providing access to the exchanges, and nobody seems willing or able to predict when they will be fixed. This failure to launch President Barack Obama’s signature domestic achievement is hugely embarrassing for the administration, and will undoubtedly provide a great deal of fodder for late-night comedians. It will also provide an almost unlimited source of talking points for tea partiers and other government-haters, who will cite this unfolding fiasco as more evidence that “government can’t get anything right.”

That would be incorrect.

In 1965 and the years following, I witnessed the implementation of Medicare, which enrolled 19 million beneficiaries almost seamlessly in less than a year, despite the formidable opposition of Southern hospitals wary of its requirements that they desegregate their wards. As I wrote last month, the problem with the ACA is not that the federal government is involved, but that literally thousands of private insurers have their fingers in the cookie jar, resulting in a law that is much too complicated for what it needs to accomplish, and too complex for anybody to administer efficiently and effectively.

http://bangordailynews.com/2013/10/17/health/acas-bungled-rollout-aside-government-health-insurance-works/

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Jackpine Radical

(45,274 posts)
2. All of this is true; however, given the exigencies of the time,
Fri Oct 18, 2013, 08:27 PM
Oct 2013

there is no way a single-payer system could have passed. In 1965, people still remembered the New Deal, Democrats had not been demonized, Congress wasn't entirely run by corporations, and people hadn't been poisoned against the workability and desirability of government programs.

The ACA is a complicated, writhing, and expensive mess just because it had to be designed to maintain the supply of cookies for all those greedy fingers in the jar.

And it is marginally better than what went before.

Jackpine Radical

(45,274 posts)
4. Yes. It extends coverage to more than had it before, but not everyone.
Fri Oct 18, 2013, 08:38 PM
Oct 2013

Further, the low-end Bronze plans will be hardly better than no insurance at all for many because of high co-pays and deductibles that will keep much medical care out of the financial reach of many people. Those at the bottom may get subsidized plans, but those plans are the least usable for the working poor.

pscot

(21,024 posts)
5. The exigencies of the time and the character of the Whitehouse
Fri Oct 18, 2013, 09:03 PM
Oct 2013

led them to piece off every special interest group that came calling, and the Whitehouse was open for business from the gitgo. The line formed behind Billy Tauzin. Pharma walked in, held out its hand and left grinning. That sent a clear signal; it looked like everything was in play. The Congress got the message too. Guys like Baucus started salivating. The President had no bottom line as long as he got a health care bill to sign at the end of it. And what we got was something marginally better than we had, along with a shitstorm of outrage from the lunatic right.

fadedrose

(10,044 posts)
11. Thank you, Jackpine Radical
Fri Oct 18, 2013, 09:40 PM
Oct 2013

for using a word I haven't seen in "real" use. Compliments on
your choice of the word. Can't understand why it's not used more often.

ex·i·gen·cy/ˈɛksɪdʒənsi, ɪgˈzɪdʒən-/ Show Spelled [ek-si-juhn-see, ig-zij-uhn-] noun, plural ex·i·gen·cies.
1. exigent state or character; urgency.
2. Usually, exigencies. the need, demand, or requirement intrinsic to a circumstance, condition, etc.: the exigencies of city life.
3. a case or situation that demands prompt action or remedy; emergency: He promised help in any exigency

My dog as an exigent need to pee outside.

Divine Discontent

(21,056 posts)
6. sadly
Fri Oct 18, 2013, 09:18 PM
Oct 2013

it's been shown it is the mess we all feared. I really don't know what they're doing, and why a roll out wasn't done to prevent this debacle. It's so frustrating for those of us it's effecting, as we don't know if there will be problems or not in a few months (and no one can say there won't be huge probs with the systems that the programs, as people swore the site wasn't that bad, and it was just bogged down by people trying to get on it, which was not the problem)

slipslidingaway

(21,210 posts)
7. AND we are still threatened with entitlement cuts ...
Fri Oct 18, 2013, 09:19 PM
Oct 2013


From the article ...

"...Politics is the only credible reason for retaining the complex and confusing web of private insurance plans in a health care system that aspires to cover everybody. In order to gain congressional approval, the ACA had to first accommodate the interests of the corporate medical-industrial complex, putting the interests of the American people in a distant second place. Congress’ approval rating now hovers around five percent.

We can do better. It took over 50 years from the time President Theodore Roosevelt first proposed national health insurance until Medicare and Medicaid were enacted. It took almost another 50 years for the ACA to be enacted, expanding insurance coverage and enacting some protections against some of the insurance industry’s predatory practices.

We have had to endure almost 100 years of acrimonious political debate, name-calling, disinformation and outright lies — much of it designed to protect and defend some doctors’ incomes and corporate health care companies’ windfall profits — to even approach what all other wealthy countries take for granted: health care as a human right.

We need expanded and improved Medicare-for-All. And we need to vote any politician who won’t advance us toward that goal out of office. We’re moving in the right direction. But we can’t afford to take another 100 years to get there..."


slipslidingaway

(21,210 posts)
13. Thanks, they should have connected the rising costs of Medicare ...
Fri Oct 18, 2013, 09:52 PM
Oct 2013

and the boomers and explained how we need a 'package deal' on HC to move the country forward ... we can dream. It has all been said before, but not forgotten.



BlueCheese

(2,522 posts)
12. I think the glitches will be worked out and eventually forgotten about.
Fri Oct 18, 2013, 09:50 PM
Oct 2013

It is amazing to me, however, that given 3.5 years lead time, they couldn't implement a better system than this one.

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