Without a single for profit or non profit health insurance company even entering the picture. American doctors nurses and hospitals already charge more to treat the medicare, medicaid etc. subset of patients than their European counterparts charge to treat the entire population.
Rearranging insurance schemes us rearranging deck chairs.
In round numbers it works like this:
Q.What do American doctors and nurses and hospitals charge to treat a subset of the population that uses no private insurance.
A. $4,000
What do Euro doctors and nurses and hospitals charge to treat the ENTIRE population?
A. Less than $4,000.
A reasonable person cannot look at that and blame insurers.
What a shame, according to the linked article, a majority of Americans want more government involvement in their health care. Have they seen a V A hospital? Depending on which V A hospital a veteran is treated, quality may widely vary.
Thanks to government interference, no one can be turned away from an emergency department. It’s for actual emergencies, not follow up visits or minor problems that can be treated in an urgent care center or public health clinic.
The Medicaid expansion is something there just aren’t unlimited state funds to cover, and the whole “Affordable” care Act has penalized those who have held onto jobs that provide group health benefits, both forcing them to settle for higher deductible policies to pay for not only their own care ,but others’ care as well. It’s also penalized those who had individual policies, forcing them onto Medicaid or into buying policies that met government standards. Why can’t those with individual policies pick those that work for them and not some federal government official?
The whole thing needs to go. I’m all for allowing those needing individual coverage, as in the linked article, having available plans that don’t meet government standards. What child free, for instance, wants to be forced onto a policy that offers maternity care & pediatric dental coverage for kids under 12?! Medicaid should not be offered to those with a group health policy to choose, nor those not at least looking for jobs.
And that’s just for starters. That’s where I stand on the whole “Affordable Care” Act. It’s a big shame Republicans caved in on its total repeal.
State mandate? Great.
Each state governor has a clue, most likely, about his own demographic and the percentage of uninsured in that state.
The federal mandate simply has not worked. Those young, relatively healthy who lack individual coverage, rather than buy a policy per the mandate, opted out, paying the tax instead to remain uninsured.
Good riddance to it!
the wholesale generalization about sticking it to the middle class doesn’t make a whole lot of sense in this context: most people get their healthcare through their employers, not on the ACA exchanges.
Are you not generalizing? Not all employers are publicly traded mega million dollar corporations.
Like the plumber, electrician, lawn care guy who comes to your house. Wife does the books. He has two crews, 4 employees?
Many of them cannot afford to pay up to $500.00 per month in premiums. Some of them not even for themselves, nevermind the deducible and co-pays.
How do you think an employee making $15.00 an hour is going to afford any kind of deductible or co-pay?
Man, talk about closing the “donut hole”. No one talks about the one created by the ACA for hard working Americans who are simply getting by. Not everyone can be wealthy.
What donut hole are you talking about? There is a pretty solid continuum of subsidization for people through all levels of income. Those low income people would either qualify for Medicaid if they’re really poor or get highly subsidized premiums and potentially subsidies to pay their deductibles too.
I am talking about hard working Americans who make too much to qualify for a subsidy. Or people who cannot afford to pay the deductible and co-pays.
Except in the states that refused Medicaid expansion. A lot of people in those states make too much money to qualify for Medicaid and don’t make enough to qualify for ACA.
But that is the fault of states who chose not to expand Medicaid, not the fault of the law.
An individual earner has to make nearly $50,000 to get out of subsidy range. They can’t afford health insurance for one person at $50k?
Sure, take away a mortgage payment, car payment, food, taxes and cost of raising children or perhaps an aging parent(s) and you should be able to afford a non-subsided program so you can subsidize someone else.
Well when you start adding dependents, the threshold for getting subsidies goes up too, so be careful what you’re counting here.
If an individual can’t afford insurance premiums and pay their bills for only one person at nearly median family income, they need to re-examine their spending patterns because their priorities don’t seem very well aligned.
This is a problem which could be fixed, except instead of fixing it - the Republican Congress made it worse by getting rid of the individual mandate and the CSRs. Now people who don’t qualify for a subsidy will pay much more and their costs will go up every year.
Winning!!!
I think repealing it without a viable replacement was lazy and very partisan. The ACA was a flawed piece of legislation that needed to be fixed. For years Republicans symbolically voted and voted and voted for its repeal and not once during that entire time did they come up with ANYTHING useful to fix the problems. Secondly I think President Obama and the democrats did a piss poor job explaining and marketing the benefits. Thirdly, I wish both sides would have put aside their partisan ■■■■■■■■ and actually worked together. This is suppose to help the American people and that is all that should matter. The repeal without a suitable replacement shows clearly that the GOP and to a certain degree the dems are all full of crap and really don’t care about US and they’re suppose to be working for US.
Are you not generalizing? Not all employers are publicly traded mega million dollar corporations.
Like the plumber, electrician, lawn care guy who comes to your house. Wife does the books. He has two crews, 4 employees?
It wasn’t just a generalization: it’s an empirical fact. Most Americans, even middle class ones, get their health insurance from their employers, not on the exchanges. And those employers are not all “publicly traded mega million dollar corporations”(?) and the people who get those plans are not generally “rich.” It’s a matter of perspective and context: people often discuss the ACA as if everyone is on the exchanges, which is obviously not true.
How do you think an employee making $15.00 an hour is going to afford any kind of deductible or co-pay?
In my state, a person (who doesn’t get healthcare through an employer) making $31,200 a year ($15 an hour) would be eligible for subsidies. The deductibles and co-pays would vary by plan.
I absolutely concede that the ACA is a big, messy technocratic kludge; like many large pieces of legislation, or any political and policy choice made in reality, it created winners and losers. There’s a lot to criticize. But I don’t think anything the GOP did or proposed (overall) in 2017 would do much to mitigate that, even as other decisions (e.g., the status of the CSRs) probably make things worse.
Seeing as they’ve mostly given up, my question was about where to go from here, politically and policy-wise.
Do you benefit from subsidized insurance premiums?
Most working people ARE insured through their employers. What are you arguing about?
No, unless one counts a group health policy.
That’s just it. Unless someone comes up with a viable alternative, it’s very difficult to get such legislation repealed.
It’s subsidized, meaning you’re not paying what you would pay if you had to get your insurance as an individual.
what exactly can they do when they hold zero houses?
