A Honky Like Me.

ElQueso - [background=rgb(252, 252, 252)]That's a big one for a LOT of people. Too many price rises for something that was supposed to make things better. Too many people not able to work with it the way it was promised. Too many exchanges noncompetitive - and most of all - yes, a lot of people covered that weren't before, at the cost of everyone else, while many, many people who already had health coverage are dropping it and paying the fines - or even ignoring the fines altogether.[/background]

[background=rgb(252, 252, 252)]My career experience is in the US health industry as a participant for 40 years on both sides of the table, gov't and private, and at a variety of levels. [/background][background=rgb(252, 252, 252)]In general terms, [/background][background=rgb(252, 252, 252)]I agree with your observations on this particular subject. [/background][background=rgb(252, 252, 252)]But I think the pros and cons on the issue of ACA are much more complex.[/background][background=rgb(252, 252, 252)] [/background]

Lots of complexity, yes, but one thing about it is very simple. To succeed as planned, the mix of policyholders had to fit the age curve of the general population, meaning that lots of young, healthy people had to sign up and pay premiums to offset the outgo expected for lots of older, less healthy. My understanding is that that didn't happen: lots of less-healthy getting benefits, but fewer healthy people paying in (some, as noted, choosing to pay fines instead).

To the extent that this is true, the system is unsustainably skewed and the costs will continue to rise uncontrollably and eventually become unaffordable for the people it was designed to help.

Anyone have facts to the contrary?
 
To the extent that this is true, the system is unsustainably skewed and the costs will continue to rise uncontrollably and eventually become unaffordable for the people it was designed to help.

But can't the fine (and enforcement of it) be increased to either increase participation of the young and healthy or offset their lack of participation? (I am no fan of the ACA by the way but since I cash my social security checks and take advantage of Medicare I have to be careful about how loudly I criticize liberal ideas.)

Bob
 
But can't the fine (and enforcement of it) be increased to either increase participation of the young and healthy or offset their lack of participation? (I am no fan of the ACA by the way but since I cash my social security checks and take advantage of Medicare I have to be careful about how loudly I criticize liberal ideas.)

Bob

Same boat, so I can appreciate your concern. Note that my comment was non-judgemental and takes no political position: if my analysis is correct (and I invite alternative views), the ACA in this respect is fatally flawed in concept, meaning that bandaids or small tweaks can't fix it.

I'll now say something very silly: just what if both parties in Congress were frightened enough by this election to actually decide they'd better do something worthwhile? There is an historical opportunity staring at us in a good-faith effort to rethink and redesign the ACA program. Wouldn't it be astonishing if they put down their knives just long enough to make this work?

Disclaimer: I'm libertarian-leaning, so I'd rather the government wasn't in the insurance business at all, but since that isn't happening any time soon, next-best would be a workable, fiscally-responsible system - and that's within the purview and capabilities of a Congress afraid for their jobs.

Let's hope they're terrified.
 
Not to worry,folks.
The NYTimes reports today that Brooklynite and Democratic senator Chuck Ellis Schumer is heading a group of democrats to align with the Republicans on a series of issues.If you can't beat them,join them?
Not a bad idea.Kissinger also said that Trump is already the president and it's time to see about working together I believe that Schumer has had some previous contacts with Argentina as well.
On the BA homefront,my Parque Lezama/San Telmo neighbors (a traditional but not a "barrio bien") were just tickled when I explained to them what a "red neck" was.One of them said without hesitation,"Ay,como la Resistencia Kirchnerista".
Many thanks also. for the Elton John blast from past.
 
EJLarson.....[background=rgb(252, 252, 252)] [/background][background=rgb(252, 252, 252)]I second your motion [/background][background=rgb(252, 252, 252)]for [/background][background=rgb(252, 252, 252)]a workable, fiscally-responsible system - and that's within the purview and capabilities of a Congress afraid for their jobs. [/background][background=rgb(252, 252, 252)]Let's hope they're terrified.[/background]
 
Not to worry,folks.
The NYTimes reports today that Brooklynite and Democratic senator Chuck Ellis Schumer is heading a group of democrats to align with the Republicans on a series of issues.If you can't beat them,join them?
Not a bad idea.Kissinger also said that Trump is already the president and it's time to see about working together I believe that Schumer has had some previous contacts with Argentina as well.

Kissinger? You've got me confused. Who does he say should be working together? Dems and Repubs, or US and Argentina? I'm for it either way.

Schumer is an extremely bright guy, and may well be more likely to work across the aisle than the very happily retiring Harry Reid. Harry's not someone you want around if building bridges is the goal.
 
I don't think anyone who didn't vote for Trump - and can't believe he won - understands what the deal is. I'm amazed that people have to ask. I'm amazed that people couldn't see it coming (I certainly knew why, I just didn't think there were enough people who felt like me in general to produce such a shift in the election). And I'm getting pretty tired of being called an idiot, a racist, a rust-belt farmer or a steel-mill wannabe.

People who don't agree with the Democratic party as a whole are sick and tired of being called those things as well. I didn't used to feel this way, but these days I feel like Democrats as a whole (I know many, many individuals who are great people and count many among my friends) are mean, shrill, arrogant and think they know a whole lot more than anyone else and will do what it takes to ensure that they get done what they want done, and to hell with the other 50% of us stupid hicks - they'll drag us kicking and screaming into their world whether we like it or not.

The truth is, Trump had a lot of problems, or he would have had a complete landslide. Very few "real" Republicans will vote Democratic, and this year, there were only a relatively small percentage of people who couldn't vote for Trump at all (which I guarantee you on the Republican side were few no matter what they said - or even more came out than usual to counter those people who wouldn't vote for Trump). If someone more controlled that was not part of the establishment had gone for it on the Republican side, I don't think the election would have been close. Had the Republicans put up any other candidate that ran in the primaries, I think Hillary would have won.

Many, many people are actually sick of what Democrats (or at least Obama and would have been Hillary) have been trying to push on the country (and I keep going back to Nancy Pelosi and the way she was determined to get ACA passed no matter what the rest of the country thought about it - think about that arrogance and elitist thinking right there! It's what we're talking about!). I've talked until I'm blue in the face about ACA, and still so many Democrats talk about how we have to make it work, it's so important, blah blah blah. That's a big one for a LOT of people. Too many price rises for something that was supposed to make things better. Too many people not able to work with it the way it was promised. Too many exchanges noncompetitive - and most of all - yes, a lot of people covered that weren't before, at the cost of everyone else, while many, many people who already had health coverage are dropping it and paying the fines - or even ignoring the fines altogether.

A huge national debt, which is certainly not only on the Democrats - yet it's the Democrats who want to keep pushing for things like ACA, that we simply can't afford (while yes, the Republicans want to be kings of the world [the Democrats want to too - they just talk about pulling us back but never do anything] and spend far too much money on keeping our presence around the world in everyone's face, which I believe hurts far more than helps). It is indeed Democrats who push for more taxes on evil corporations and evil rich people, while the reality is that the middle class gets more and more of the burden on their shoulders because in reality both sides of the aisle are liars who will do and say anything to get into and stay in power.

The US has the highest corporate tax rate in the world among developed nations already. People are not blind automatons, that will just absorb loss after loss "patriotically" and keep industries in the US, and buy much more expensive Made-in-the US-of-A products no matter what - we have to make ourselves competitive again and that won't happen with more and more regulation and higher taxes to pay for more and more entitlements, which make less and less of our population want to work hard (some people really need to go look at the studies that have been done on how entitlements affect people mentally - it ain't with a "thank you for helping me I'll soon be back on my feet", but rather "man, I can't believe I'm getting free shit, sign me up for more!").

If the government would get out of the business of trying to create citizen clients, would quit worrying about telling us how to live every aspect of our lives, and would concentrate on a way to prevent special interests from pushing their selfish agendas over the top of justice and usually even common sense, the country would right itself in moments.

THAT's why people didn't vote for Hillary. All personal feelings of mine aside for the woman, she represents the way things are in so many ways, no matter which side of the aisle you actually vote on. Not to mention the fact that it was obvious even before leaks occurred that Hillary was going to be the Democratic candidate for president before the primaries even got going strong. How is that fair? She was promised this? She simply deserves it? Really?

Why did Trump beat every Republican in the primaries including Jeb Bush, who was originally the Republican favorite? ENOUGH NEPOTISM! And they were pretty much all the same thing as well, just of the Republican bent. It was the hardest thing I had to do to vote for Trump, to be perfectly honest. I don't like the man, I don't like his arrogance and I don't like the way he simply can't control his mouth (or at least didn't bother to do so). But do I think he is different from pretty much any other man as far as the way he talks? I don't know about other guys, but my guy friends are dirty, lewd and crude when no one thinks people who shouldn't be are listening. They're also some of the smartest people I've ever known and include at least 4 millionaires among them (and I hope to become the next, soon!).

Trump may not do a single thing he promised when he was campaigning, if only because everyone will be against him and not lift a finger, even if they believe in something he would like to see happen. That would be politics as usual in a way. But he will shake up the system quite a bit, and indeed I think he already has. It was so important to many of us fiscally conservative types to see someone other than a hellbent Democrats in office for yet another 4 or 8 years. But if Trump doesn't do anything in the next 4 years, it is almost certain to be better than if Hillary had been in office, as far as I'm concerned, i.e. if we just maintain the status quo.

And I'm sick to death of all the crying, the spoiled brat celebrities looking like Hitler was just elected, people thinking they have to flee the country, or go curl up in their protected space and pet a puppy. Unbelievable that these people consider themselves (or are considered by others) adults. I guess the entire constitution of the US was thrown out the window (or will be, rather, when Trump places his hand on the bible) and we're going to start dumping people out of planes into the bay, or lining up them damned foreigners and shoot them and plow them over. For crissake people pull your collective heads out of your collective asses!

So we have a lot of independent types in the rural and suburban areas, and according to some polls I saw, there is a much better chance that a person is Democrat if you live in an urban area. What I see in this are inner-city problems with black and latino people who are clients of the system, and the people who think the only way to help them is to legislate them into the future somehow, instead of concentrating on the things that are ALREADY LAW and prosecute people who break it. One of the biggest breaks, though, being the Michigan union folk that realized the Democrats are not making things any more likely for fabrication to return to the States (probably not possible at this point anyway, thanks to a lot of reasons). That was a big loss for the Democrats!

Let the people sort themselves out. It sure as hell hasn't worked that the government make dependents out of people, Why not give something else a chance? Is that racist? I don't think so. Many people will say so. I say creating laws that are supposed to target people with specific racial backgrounds IS RACIST and in the worst way, but that's just my opinion - well, maybe not just mine any more.

Anyway, the whole idea that Trump was raised to power by racists and ignorant rednecks is a dangerous thing to think if you are on the "other side", I guarantee. It means those people still haven't heard the word, the kind of thing that started with the Tea Party (which pretty much has the same kind of treatment that Trump got, even though both are different in many ways.), are going to continue to be bewildered in election after election - I hope.

I am guessing that you, like most people who think the ACA doesnt work, dont have it.
I do.
and it works great.
it works for me, and my kids.

as far as price increases- again- did you pay for your own health care?
Because I have been paying my own health care all my life.
I saw premiums go up, every year, since the 80s.
In the mid 2000's, my premiums were going up $100 per month increases, once a year, pretty much every year.
Before Obamacare, I was paying $1200 a month, with a $5000 deductible. (for my wife and i, who are both older than you, but too young for medicare)
My premiums under Obamacare went way down, and my deductible did too.
The last couple of years before Obamacare, at $1200 x 12 plus 3 to 5 grand in actual doctor bills, I was paying close to 30 grand some years.
That was the free market.
And I was still paying almost all the actual costs of my health care, as i almost never hit the deductible.
This was common.
I still go to the same doctors, get the same level of treatment.
I fill out ONE additional form per year.

In Washington State, it works great.

I have several friends who had horrible long term health problems and were too young for medicare.
Sure, emergency rooms will stitch you up for free, but before ACA, My friend Jeff, who had fallen off a roof ten years ago as a freelance carpenter, walked with 2 canes. After ACA, he got surgery, and physical therapy, and he can do some work again.
My friend Gary, a professional musician, could not play, his carpal and hand issues were so bad. Treatment was roughly twice his annual income.
He just suffered, until ACA, when he got surgery and physical therapy.
I know a bunch of people like that- people who earn too much for medicaid, who work, but could never afford $500 or more a month for health insurance.
ACA has been a godsend for these people.
And I live on a farm, nearest town is 135. These are rural people, by and large, I am talking about.

ACA has worked to get 20 million people who could not afford health insurance covered.
it has helped millions more like me, who by income are lower middle class, be able to afford better coverage, or not spend 1/3 or more of their income on insurance.
 
bobg.....[background=rgb(252, 252, 252)]But can't the fine (and enforcement of it) be increased to either increase participation of the young and healthy or offset their lack of participation? [/background]

There was an increase in the amount of the fine from 2015 to 2016.

https://www.healthca...-being-covered/

2016/2017: Fee for not having health insurance

What happens if I don't pay the fee?
The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee.

I am not against the principle behind ACA. One of the issues I question is the long term fiscal sustainability of the program.
 
bobg.....[background=rgb(252, 252, 252)]But can't the fine (and enforcement of it) be increased to either increase participation of the young and healthy or offset their lack of participation? [/background]

There was an increase in the amount of the fine from 2015 to 2016.

https://www.healthca...-being-covered/

2016/2017: Fee for not having health insurance

What happens if I don't pay the fee?
The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee.

I am not against the principle behind ACA. One of the issues I question is the long term fiscal sustainability of the program.
If people have healthcare, in the long run they will become healthier and healthier people cost less.
Re: fiscal sustainability, if the good old USA decided to take care of it's people i.e. health, education, infrastructure and NOT be a war machine, boy I think there might be a whole lot of money available.
Nancy
 
re: health care. Private, profit driven health care only works if you are employed by a company that provides you with health care and then you are and indentured servant to that company. Quit and you have no health care. If you paid your own health insurance it also meant you couldn't leave the state you bought your insurance in. There was no such thing as a national policy. So stuck working at a job you hate and/or living where you don't want to continue living.....to bad in the bad old days. We won't even talk about rising rates and very common technical refusal of coverage. Or hospitals going bankrupt because of "free" emergency room care". Or people going bankrupt because of reaching their "limit of coverage" or, or, or. In truth, single payer is the only health care system that works and that is in every other civilized country in the world. HEALTH CARE IS A HUMAN RIGHT.

re: President Obama's failure. On the day of President Obama's inauguration Mitch McConnell and other influential republicans met and agreed to be total obstructionists and "make President Obama a 1 term president". Thereafter followed 2 years of hundreds of more filibusters than ever in US history. The republicans were rewarded with a huge gain in the house in 2010. President Obama has been fighting this obstruction ever since. Had there been any thought for improving the US and the life of the American people and any cooperation from the congress the employment rate would have been down even more than it is and the GDP would have been up even more than it is. But instead we are rewarded with Trump. I guess we'll see what happens. Let's just hope his talk about using nukes was just one of his "campaign rhetorics". We can survive his lies, his sleaziness, his nepotism, even, God help us, Jeff Sessions as attorney general but a nuclear war...........

T/
 
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