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Defeat of Obamacare repeal good news for Massachusetts


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My plan renews in May, the broker said he got lucky with only a 17.7% increase, I thought Obama said costs would decrease.

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He said we need to control costs.

Want to know how much my employer insurance went up this year, in addition to how much worse my coverage got?

If I could get their contribution as payment, I'd be on Obamacare/Romneycare in a heartbeat.

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It's bad news! If you enjoy paying higher taxes for abusers who take advantage of federal assistance that is too highly involved, then its a good plan.

I work for a living and seen my ER increase from $35 to a $100!! My copays have doubled including my prescription costs!!

More fake news provided by WBUR!! The media no longer can be trusted!!

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It's the best system around, at least in the US, at least until we get to single payer. And maybe next fall you should shop around during open enrollment.

I admit it: We're on an Obamacare plan. Our copays haven't gone up over the past three years. Our drug prices actually went down, even though that meant we now had to drive all the way to CVS (you know how uncommon those are). The one thing that did suck: Our insurer was going to raise our rates $200+/month this year, so we had to switch to another insurer, which meant we had to find new primary-care doctors (since our new insurer didn't cover the health center we were using). That's annoying.

Maybe we're just plum lucky ducks. And I realize there are issues for folks who make too much to qualify for Obamacare and who don't have a generous employer. But you know what? Your rates were going to go up even more without Obamacare - maybe you've forgotten what health insurance was like pre-Romneycare, but I haven't - fairly sizeable annual increases in premiums were the norm back then.

And frankly, fuck the Republicans who wanted to send health insurance go back to the old days, with plans that didn't cover anything much beyond a box of tissues and maybe some aspirin.

I'm glad I live in a state that, however imperfectly (you do realize Romneycare was a Heritage Foundation idea, right?), is trying to ensure people don't just die in the streets, where even the Republican governor (who knows a bit more about health insurance than most of us) vowed to try to keep that idea going even if a bunch of congressman proved they had the intellectual honesty of the most horrible thing you could think of and after eight years of whining still couldn't get anything done.

Don't like WBUR? Go find Breitbart.

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It's a stack of good intentions and theories that have yielded what:

a massive money-suck on the middle class

great salaries for insurance and hospital administrators

disappearing g.p.'s

diminished access to specialties like mental health

little evidence of improvement in health outcomes.

Obamacare basically hooked the body of the middle class up to a hospital system that will drain the body dry and will never stop no matter how bloated it gets. Cutting health care costs will always be hard. If you have seen someone die you know what kind of decisions have to be made at that stage of life. Now the government and insurance have colluded to drive anybody else out of the market. The political system is put in charge of those decisions, deciding how many and when people can die, a political system not designed for that. How can we expect the government to do a better job with more power and responsibility? Not made for it.

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All healthcare sucks unless you can afford a nice Cadillac plan, or work for someone who buys it for you.

The ACA had a lot of protections and cost bending laws stripped out of it by Republicans to get their votes and make it more "market oriented". They could be put back in, in addition to new laws to force competition suck as buying across state lines.

But 8 years of obstruction is better than giving the majority of the American people a W. Because a bipartisan W is a W the Dems get to share in, and can't have that for the enemy libruls.

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Can't do the cost bending because it will price control doctors out of the profession. Has already done this to g.p.'s

Mandate (tax on young and healthy) is unpopular, probably cost Hillary the election.

It's a collusion between government and insurers which uses the energy of bleeding hearts to drive up premiums.

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Mandate (tax on young and healthy) is unpopular, probably cost Hillary the election.

It might have been one of the reasons - one of the things Obama royally screwed up was the "you can keep your old plan" thing, which was just wrong because so many people's old plans were crap, barely worth the paper they were written on, that didn't comply with the Obamacare requirement to pay for certain specific benefits (such as emergency-room visits).

But let's also not forget James Comey, the whole "but her e-mails" stuff and, if we're being honest, the fact that Clinton was the wrong gender for many people. Besides, young people voted overwhelmingly for Clinton, it was their parents who swung the election in those three key states.

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You might try reading up on what Trump was proposing. Hint: Your premium would have gone up even faster according to the CBO.

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The current administration has made it clear they intend to do everything in their power to destroy healthcare on the basis that if they can't repeal ACA right now at least they can cripple it. (Crippled ACA is still preferable to the nightmare they had been proposing but it's painful either way to Boston's healthcare/biotech industry.)

If the GOP loses the house or even senate in 2018, expect the lame duck session to use the opportunity to ram through an even worst version of Trumpcare when they've got nothing left to lose.

The GOP's ineptitude bough ACA some time but it's still on death row.

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Trump is right that it's going to implode under its own weight. They should have fixed the weak points (for example, at my age my family doesn't need maternity care and really not likely we will ever need addiction services - let us opt out of that coverage).

Then focus like a laser beam on costs, starting with going out of state to buy policies etc. Etc. Etc.

Lots of core good in Obamacare, most of which is rooted in Romneycare. Universal coverage, no preexisting conditions and more. Keep that and keep making it better rather than try throwing the baby out w the bathwater.

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for example, at my age my family doesn't need maternity care and really not likely we will ever need addiction services - let us opt out of that coverage

Then, only people who will likely have babies will opt in on maternity care. And insurance companies will have to pay for that pool of people when they use the maternity care, so premiums will rise to match the costs for that pool. Thus, premiums will match the actual cost of having babies because the only people in that pool will be people having babies. So, you don't need insurance any more, because why would you pay just in case you might have a baby? And the beat goes on. Every little pool will only have people in it that are going to use those services. The insurance company isn't going to subsidize those people itself, so it'll raise rates and people will either be unable to afford it or unwilling to pay an intermediary if they're going to pay the same amount of money.

Your idea (and that of the Republican Party in their redesign the night before the non-vote) is dumb and not how insurance has to be to function correctly. And in reality, things like maternity care shouldn't be something you "insure against". It should just be subsidized, period. Which is why it sounds crazy for you to carry maternity care on your insurance policy even though you know you're not going to use it. This is why we should all pay a bit more in taxes, but never have to pay another health insurance premium ever again. The entire country becomes the "pool" and we all pay a little to get service if and when we need it. You need cancer treatment? Some 20 year old helped you pay for it. The 20 year old needs maternity care? You helped them pay for it.

Furthermore, insurance companies are already allowed to sell out of state in a number of states. They have chosen not to. They have enough issues meeting their current demands in-state. They can't complicate that by understanding an entirely different infrastructure in another state too without adding costs.

The correct way forwards is "Medicaid for all" with private insurers providing additional coverage to those that want it for whatever other needs they feel are unmet.

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For example, my car is old so I'm willing to take the risk personally that if I wreck it, I fix it or replace it out of pocket. What you are describing is essentially comprehensive coverage that everyone pays into. That's reasonable for certain kinds of coverage like a kidney stone or broken leg. My risk of hitting a deer is probably about the same as everyone's, so I get that coverage and it pays if I hit an animal, less my deductible. I have no risk of fathering a child, so why should I be forced to insure against that? That's not insurance, that's a payment system forcing me to subsidize the personal choices of others (which I already do in many other ways). To take your example further, you are effectively socializing childbirth.

So everyone pays for having kids that wants them. Maybe you do end up paying the "market rate" for typical services but buy insurance against complications. Many ways to structure this. The difference is liberals want a government controlled payment system. Conservatives want free market insurance. There's probably a reasonable middle ground somewhere by stratifying payments with out of pocket, private insurance and public reinsurance (or something similar). I think our main difference is you want the government to be the insurer of first resort. I want them to be the insurer of last resort.

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I would've thought you understand how risk pools and insurance work.

And I would've thought you realize that Obamacare in fact IS a private-insurance system. Yes, there are government subsidies and expanded Medicaid for people at the low end, but the very core of the system are the marketplaces that connect individuals and small businesses to private insurance providers (yes, we're a bit unusual here in that our insurers are mostly non-profit).

In fact, you may recall that one of the first things the Democrats gave up with Obamacare was the idea of a public option on the marketplaces (and then they were forced to give up the idea of mandatory Medicaid expansion).

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Not sure what I misunderstood about risk pools etc. The point is that no sane person buys insurance for a risk s/he doesn't face or that they are willing to pay for out of pocket. I have no risk of having a kid and in the extremely remote chance I suffer from an addiction, I'm willing to risk paying out of pocket. I can choose not to be in those pools. For similar reasons I regularly counsel young single people not to buy life insurance. They might die, but there's no financial risk. Why should they be in the pool even if they are at risk of an insurable event?

As for the rest, not sure where I commented otherwise.

As I said, there are a lot of good things in Obamacare. And some klunkers. And it's expensive. Focus on that stuff, and not the crap that was in this bill. (Apparently part of the problem is that they tried to cram a bill through on the reconciliation process which is designed for budget issues but tried to address a lot of non-budget issues in the bill essentially trying to squeeze a square peg in a round hole)

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And put down the Ayn "accepted SS payments" Rand for a change. Your policy and systems knowledge-deprived ideology-driven postings from bizarro world are getting tiresome.

NYT: https://www.nytimes.com/2017/03/15/upshot/obamacare-isnt-in-a-death-spir...

Seattle Times: http://www.seattleweekly.com/news/washington-your-health-care-is-safe-un...

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Once again the article you link to proves my two major points:

1-there are fixable problems with Obamacare. No need to repeal and replace. Just change some things.

2-financial footing of Obamacate remains shaky and if it's on firmer ground, that is a very recent phenomenon and only stabilizing because premiums have dramatically increased. (Something I can attest to personally). Any forecast it's stabilizing is pure crystal ball gazing, even as the NYT article states.

And finally please keep in mind that I was a fervent opponent of this most recent bill which was a piece of crap. There are lots of potential improvements to obamacare. Almost none of them were in that trash heap called the AHCA.

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(for example, at my age my family doesn't need maternity care and really not likely we will ever need addiction services - let us opt out of that coverage)

No one expects to become addicted. If people can wait until need care to buy insurance it's not longer insurance, it's simple an expensive service offered at a discount price.

As for Maternity care, maybe YOU don't need it but your mom did.

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These are not insurance programs. They are payment structures. I'm perfectly willing and financially able to take the risk of having a child or getting addicted to something. I don't need insurance for that and other taxes I pay already subsidize those who can't take on that risk and are at higher risk

Socialized medicine is not insurance. Liberals want socialized medicine. Conservatives want government out of health care as much as possible - (at least philosophically until they have Medicare or find themselves needing Medicaid when their tune magically changes).

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Heath insurance isn't like other insurance. If only younger women looking to have a child need to buy this policy it would be extremely expensive and only the wealthy could afford it. No one would ever buy a substance abuse policy and no company would write one.

You points are not without merit but that's why we need a single payer system. Leave insurance to cover things people have more control over and don't affect society as a whole.

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Pretty sure he just inadvertently asked for a single payer system where.you can also buy additional policy coverage.

Which would great.

As for maternity care, both society and the government have a vested interest in citizens raising children. Capitalism can't work without a stead flow children or emigration. There's a reason why it's part of healthcare and insurance, just as there's a reason it's in the tax code.

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This was a comment posted today in the New York Times:

"There are two competing visions: that you should let people fend for themselves, including as regards paying for medical care, or that the community--the society, the government--cooperatively figures out how care gets distributed so that the most vulnerable get the most help, and that everybody gets adequate coverage."

Those who would pick and choose only the healthcare "items" they feel are necessary to themselves appear to have forgotten about society and community.

For example, you may plan not to have children but by contributing to a system that supports maternity care for your community, you're making sure that those who need maternity care are able to get the resources they need. And whether you came from a test tube or your mother's womb, somewhere along the line YOU were taken care of as well.

There are so many areas where the health care costs are outrageous and unnecessary - prescription medicine, end-of-life care, and let's not forget that it's been shown that 1 of every $3 of health insurance goes to "administrative costs". That's not 1 in 20 or 1 in 10.

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Even ignoring the altruistic / morality side of caring for the community at large -- which should be a good enough argument, but people are shitty and selfish --

Poor people do desperate things. Someone who is denied medicine for their sick kid will resort to theft, crime, etc, to either obtain it or the cash to buy it. Desperate people destabilize the community in ways even the wealthy and well-insured cannot negate completely, and drive up mutual costs (police, homeowners insurance, cost of goods to cover shrinkage) for other goods.

If your moral philosophy is "fuck you I got mine", maybe consider enlightened self interest, "fuck them but I don't want them to take mine and giving children dental care is cheaper in the long run"

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God Bless the Republican Congressmen who blocked this bill. A huge win for conservatives. The Democrats and RINOs like Ryan will be responsible when Obamacare fails on its face. Democrat Congressmen would have been smart to throw a few votes to pass the bill and blame the disaster on Republicans. Thankfully, they didn't and it will not be known as Trumpcare.

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It was bad policy, not poor tactics or negotiating skills, that doomed the GOP’s efforts to repeal and replace Obamacare.

Under Trumpcare, 24 million would lose heath insurance and the top 2% of income earners in the US would get $337 billion in tax cuts. The bill was polling at 17% for, 56% against by voters.

Read all about it.

So far we're winning. Trump isn't. Ryan isn't. People who need affordable health insurance are. I'm not sick of winning yet. Conservativism has become about rolling back the new deal and civil rights. Progress, they want to burn it all down.

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Conservatives (especially the extremists in their flanks!) have been wanting to roll back progress for a very, very long time. They thought they'd found their chance, but the Democrats fought back just in time.

It's a drag to say this, however, but had the Democrats at large maintained a more vigilant attitude and been more combative overall, we wouldn't have had this kind of close call, nor would we have ended up with Trump in the White House, either.

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