Sid

Why not have Medicare for all?

will be able to be moved to their own ins. policies and get a bit better care.

The ACA subsidizes policies for poor people. If they're really poor, they still get Medicaid.

One step at a time. Can't switch from one system to a totally different system overnight. If you sit down with a piece of paper and try to work it out...how to transfer everyone's coverage from one system to another, without payments for medical bills, nursing homes, mental care, surgeries, Medicaid, Medicare, private insurance, employer group ins. being missed, you will quickly see the logistics problem, as well as the enormous cost.

The ACA, while not providing the care for all that good people want, does in fact help get health care to millions more people. That's a great thing that was miraculous it got passed.

Right now, yu can go to the fed gov site and get to a site where you can plug in your stats and get pages of comparable policies with estimated costs for you to see what's available. And everyone qualifies, even if they have a pre-existing condition. Before, you'd have to contact different companies and fill out those stupid forms and wait for them to spam you to death with fake quotes (like auto insurance quotes work). Now, we are in the driver's seat, and can get information with a few clicks and shop for coverage.

My mother was unable to get coverage after heart trouble developed. That would no longer be the case (she's gone, now).

If you've not been able to get coverage, but now can, you can appreciate the good thing that has been done. Truly.

If your mother had gotten "coverage," would she then have had access to actual care? The cheap bronze plans have high deductibles, and pay only 60% after that, which means she would not have been able to use her insurance without spending a great deal of money first.

for high risk people.

If you have ever not had any health care, you would appreciate a high deductible and 60% coverage.

Of course, if you're used to big steaks, a hamburger patty may not seem like much to you. If you haven't had any food, though, a hamburger patty looks pretty good. Is the glass half full or half empty?

We don't have universal health care, which is what I and millions other want. But that was never realistically possible. A good first step has been made, though. The fight should continue, but appreciation for advances along the way are in order, IMO. Constant negativity on improvements is not the way to go, IMO. Being glad for those who have been helped is natural to me.

If you have not had any health care, a high deductible plan will PREVENT you from ever getting any. The premium will strip your pocket book so that you can't even afford cash on the barrelhead for a doctor visit.

I could. Lots of others can, and lots of others wouldn't be able to.

I am glad for those the ACA has helped. If i'm laid off, and I might be, I'll get ins. through COBRA for I think 18 mos. Then I will be able to shop for a policy through the fed. govt. website. I will probably go for a high deductible policy, to keep the premium down as much as possible.

You know, low deductibles and ins. policies paying for everyday, routine procedures isn't the way insurance used to be. That's had a lot to do with ins. premiums getting so high. People don't want to pay anything for medical care, so they end up with high premiums.

By the time my COBRA expires, more parts of the ACA will have been enacted, so maybe there will be some benefit I'm not aware of. I won't be poor enough to get a subsidy, but lots of people are poor enough to qualify for that, I think.

The ACA is the best thing that has come along for our health care since Medicare.

No deductibles and universal health care paying for EVERYTHING is how all other civilized, industrialized countries handle things.

ACA does nothing but make crappy, overpriced underinsurance the norm, forcing us to have mass murderers as the interface between us and our providers.

BTW, in MA, which has had a version of ACA for a number of years now, medical bankruptcies have dropped from 59% of all bankruptcies to 50%. This means that the vast majority of actual sick people in MA have been fucked over badly, though a small minority has received help. The 85% majority which will never get expensively sick remain happy ignoramuses. They think they have good insurance, and their opinion on this is worth exactly what their opinion of how good their fire extinguishers are is--that is to say nothing whatsoever.

a lot of people.

No matter what was passed, or will pass in teh future, one thing is certain: People like you will complain about it. That is because nothing is perfect in the eyes of everyone. Absolutely nothing.

Thanks for all your astuteness regarding this issue.

Why is everyone so ecstatic about the medical bankruptcy rate dropping from 59% of all bankruptcies to 50%? I think that sucks, personally, even if the percentage is lower.

I'm an oncology nurse. Medicare reimburses us $0.47 on the dollar for our care costs. At those rates, how do you update technology, give raises, and subsidize the patients who can't pay at all? The only thing keeping our head above water is reimbursement for BCBS patients. If all of our patients were Medicare, we'd have had to close years ago.

Medicare would need a completely redefined reimbursement model before they ever considered covering everyone.

First, there isn't a specific rate that Medicare uses to reimburse health care providers. A more accurate number would be in the neighborhood of $0.93 - $0.97 on the dollar for the lowest subsidies relative to underlying cost. Since at least 17% of each health care dollar in the U.S. goes to overhead and profits for the health care providers and insurance companies, and Medicare overhead rates are about 5%, taxpayers actually pay an effective rate of $1.05 to $1.08 to hospitals for each $1.00 of care.

Second, if health care providers were able to spend their time treating patients instead of jumping through the hoops required to bill the various entities involved (hospitals, doctors, medical groups, insurance companies, Medicare, Medicaid, and various state based programs), the cost per patient would drop dramatically. The amount spent each per capita in the U.S. is about twice what it is in other countries that have more efficient systems (and healthier citizens). Much of the additional expenditure comes from the inefficiencies inherent to the U.S. system, and streamlining it could reduce the cost of health care by 50%.

It's absolutely NOT true that Medicare would have to "redefine its reimbursement model" before it could cover everyone. What's needed is changes to the healthcare industry itself. Again, the problem is NOT with Medicare, but instead with our broken system.

thanks to medicares low reimbursments my wifes clinic was forced to close
now who sees the poor women she was seeing? no one does
47 cents is pretty good from my experience and i would bet that the billings were usually 3 months in front of the payments
and another thing people who dont know the business side of medicine miss is the insurance companies base what they pay on what medicare pays
there will be i am sure many who will reply saying i am wrong
maybe i am
i only have my own years long experiences dealing with medicare to go on and i may be totally confused

Welcome to the ranks of us humbled humans who have thought we understood something, only to have had our heads rearranged by experience. And congrats on the insurance!

There's no cost control for private plans or public option in the ACA. It was a total low-ball sell-out to the insurance industry.

I'm glad that there's some incremental benefit to some, but this outcome isn't wasn't what we put Obama into office for.

that things would be a helluva lot worse for a whole lot of people were it not for the ACA.

It's hard for me not to see the health insurance industry as a corrupt, parasitic system that makes its profits by minimizing services to enrollees and payments to providers.

Her ins. co. dropped her, and she was unable to get coverage for a while. She finally did get some small coverage, but it excluded anything heart related and was very expensive. Thank goodness she had money.

I see the new healthcare bill from that perspective. Getting health care to people who could not get it before, whether for pre-existing condition or because of cost.

The ACA doesn't get health care to everyone, but it gets it to millions more. And that's a great start. I'll be voting for anyone in the future who wants to expand that bill.

Cheaper overpriced insurance is still overpriced for most.

...who can afford to buy expensive PEC insurance from Private For Profit Corporations.
There are far, FAR more (80%?) unhappy anecdotes from Working Class American with PECs who can NOT afford the premiums for these policies. Depending on the state, these policies run from $300 - $700 PER MONTH.

Its the "Uniquely American Solution."


Did you know that the term "Medical Bankruptcy" in unknown in civilized countries?
Medical Bankruptcy will STILL be Big Business in the USA even after all the provisions of the ACA are activated.
It will probably be even BIGGER Business as 40 - 70 Million Americans
actually try to access Health Care with the "Bronze" (junk) policies they are forced to buy on "The Exchange".





You will know them by their WORKS,
not by their excuses.
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In 2014 (two years from now), anybody not covered through an employer will be able to shop for regular insurance on their state exchange. If you earn up to 400% of the poverty level ($73,240 for a family of three), you will receive a subsidy, on a sliding scale (more subsidy the less income you have).

It's better than what we have now. If you need private insurance and you have anything in your medical history—from high blood pressure to a hangnail—you will be rejected outright. That alone will be a a thing of the past.