ACA Repeal/Replace: Progressives Face Moral Dilemma

[Warren Dew]

(08-01-2017, 09:24 AM)David Horn Wrote:

(07-28-2017, 04:45 PM)Warren Dew Wrote:

(07-28-2017, 12:56 PM)Eric the Green Wrote: What puzzled me is why 9 senators voted down the repeal and replace bill, and then only 2 of them (plus McCain who had voted FOR the repeal and replace bill) voted against the skinny repeal bill in hopes of something better emerging out of a conference with the House. But what could have emerged except another bill like they had already voted down? Especially since the House bill was much worse.

Only 3 of the 49 voted for "skinny repeal" because they hoped something better would emerge.  Probably most to all of the other 46 actually preferred "skinny repeal" to any of the alternatives offered.

I mean, seriously:

- Medicaid expansion untouched, which gave the moderate Republicans everything they could hope for.
- The individual mandate, hated by all, repealed.
- The employer mandate, which prevents creation of full time entry level jobs, repealed.

The exchanges are already in a death spiral; tanking them a little faster or a little slower won't make much difference.

I heard Jeff Flake saying much the same on Morning Joe this morning.  The only problem: it's totally unworkable.  Once mandates are removed, the healthy young avoid insurance, or buy something so thin that it's of little value.

The mandates aren't saving the PPACA.  Premiums are skyrocketing; insurers are withdrawing right and left.  Let's face it:  the PPACA is totally unworkable with or without the mandates.  So why drag everyone down with it?

Quote:Those needing insurance then see their insurance costs go through the roof, because the heath care system, as opposed to the insurance market, still eats 18% of GDP.  The money doesn't just rain down from heaven.

The reason it's so expensive isn't because it's needed.  It's because third party payer causes prices to skyrocket, because there is no one to make a tradeoff between costs and benefits.  As a result, the medical system - as opposed to health - has a strong incentive to use the most expensive treatments possible, and a strong disincentive to keep people healthy, since healthy people consumer little in the way of medical care.  More here:

https://medium.com/@RosenthalHealth/how-...81c51d6436

Quote:If it's OK with you that the not-quite-elderly are left to die so the young can have shit jobs, then I guess it works at that level.

I myself am in the "not-quite-elderly" category, so I have a strong incentive to give us the best system.  However, the best system is not one that makes us sick and then gives us expensive, counterproductive medical care by bankrupting the next generation.

The best system is one that keeps us healthy.  That involves better diet and lifestyle, not more medical care.  The more money you throw at the medical system, the worse it gets.