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ACA Repeal/Replace: Progressives Face Moral Dilemma
#1
There are two ways that progressives can proceed going forward:

The first one involves abandoning federal remedies altogether and concentrating on what can be done on the state level - unless of course the final ACA repeal bill includes a ban on any state versions of the ACA or anything substantially similar.  Then any state solutions will have to be designed differently, most likely with emphasis on charity-care reimbursements to hospitals and other health care facilities; i.e., community health centers, particularly in states that have legalized recreational marijuana use.  Private charitable organizations, most notably the Catholic Church, can also be called upon to help in the effort - and Pope Francis would undoubtably be interested.

The second approach involves doing nothing so that progressives have it as an issue to use against the conservatives in 2018 and especially 2020.  If enough people die due to the ACA's repeal - and especially if enough "nice," read, white, non-poor people, die - it will be a powerful issue indeed.  But could progressives live with themselves that they were complicit in the death of perhaps hundreds of thousands of people?

But they do not have much time to decide.
"It was better with them that were slain by the sword, than with them that died with hunger, for these pined away being consumed for want of the fruits of the earth" - Lamentations 4:9
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#2
I don't understand why politicians are making this health care thing more complicated than it needs to be. Just expand Medicare for everyone. it's not that complicated.
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#3
It's simple, but it fails at the one priority of economic elites: maximization of profits.

Medicare for all will make the for-profit bureaucracies in the private insurance business irrelevant. Because it will make costs public, the government will be under pressure to contain costs.

The insurance companies abandoned the elderly as a potential market because it did not want to pay the costs of elderly people. As a general rule, the last year of most people;s lives is more expensive in medical care than the others combined.

Profit will be the only acceptable virtue in Trump's America.
The ideal subject of totalitarian rule is not the convinced Nazi or the dedicated Communist  but instead the people for whom the distinction between fact and fiction, true and false, no longer exists -- Hannah Arendt.


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#4
(01-14-2017, 10:18 AM)flbones too Wrote: I don't understand why politicians are making this health care thing more complicated than it needs to be. Just expand Medicare for everyone. it's not that complicated.

A lot of people already get insurance through their employer and those people don't want to pay the higher taxes needed for a single payer system. It's "I've got mine, fuck you".
#MakeTheDemocratsGreatAgain
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#5
Medicare for all is probably the long-term answer, but without some serious reform in how Medicare spends its money this could prove an even more costly debacle.
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#6
Democrats may get a political advantage from a repeal without replacement. They can be shown resisting the repeal and rejecting a grossly-inadequate replacement (like Health Savings Accounts). Getting the presidency and both Houses of Congress in 2021 they get to come up with something even better than Obamacare.

This is not so much a strategy as a silver lining, and it comes with the risk of Republicans consolidating complete, crushing power in the 2018 and 2020 elections and establishing as tight a single-Party state as China has now. Of course it is unconscionable ass it would result in people enduring medical deaths due to the lack of finances, but unconscionability rarely stops people on the totalitarian road.
The ideal subject of totalitarian rule is not the convinced Nazi or the dedicated Communist  but instead the people for whom the distinction between fact and fiction, true and false, no longer exists -- Hannah Arendt.


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#7
(01-14-2017, 11:03 PM)Odin Wrote:
(01-14-2017, 10:18 AM)flbones too Wrote: I don't understand why politicians are making this health care thing more complicated than it needs to be. Just expand Medicare for everyone. it's not that complicated.

A lot of people already get insurance through their employer and those people don't want to pay the higher taxes needed for a single payer system. It's "I've got mine, fuck you".
I'm not interested in a single payer system. I'm not interested in becoming part a single payer system by being forced to become part of one that favors the less fortunate (lower end tax bracket). I'm content with the healthcare that I  currently have and have had for years. Are you blind? Now, if you and fellow blues want to conjure up some sort of government funded system to provide healthcare for themselves without destroying/severely impacting and sharply increasing the costs/disrupting our healthcare in the process that's fine with me. If the liberal silliness continues, the liberals are going to find themselves stuck in a government system that's supported by the lower income tax bracket. Can you afford to have your taxes substantially increased to Tara's level/my parents level (1/3 of her income)?
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#8
(01-15-2017, 12:28 AM)Classic-Xer Wrote:
(01-14-2017, 11:03 PM)Odin Wrote:
(01-14-2017, 10:18 AM)flbones too Wrote: I don't understand why politicians are making this health care thing more complicated than it needs to be. Just expand Medicare for everyone. it's not that complicated.

A lot of people already get insurance through their employer and those people don't want to pay the higher taxes needed for a single payer system. It's "I've got mine, fuck you".
I'm not interested in a single payer system. I'm not interested in becoming part a single payer system by being forced to become part of one that favors the less fortunate (lower end tax bracket). I'm content with the healthcare that I  currently have and have had for years. Are you blind? Now, if you and fellow blues want to conjure up some sort of government funded system to provide healthcare for themselves without destroying/severely impacting and sharply increasing the costs/disrupting our healthcare in the process that's fine with me. If the liberal silliness continues, the liberals are going to find themselves stuck in a government system that's supported by the lower income tax bracket. Can you afford to have your taxes substantially increased to Tara's level/my parents level  (1/3 of her income)?

Tell me about all the high-tax refugees coming to America.

Do you know any poor people? Do you realize how expensive medical insurance is for people over 60, when almost all careers are in decline?  When I had private health care insurance the payments were higher than the payments on a Mercedes-Benz. I am taking some chances by not buying such insurance, but buying American health-care insurance is a losing proposition. Poor as I am, death solves my problems -- especially with a reactionary government that considers me vermin for not being rich.

Yes, if Donald Trump knew about me he would probably want me rubbed out for my political beliefs.
The ideal subject of totalitarian rule is not the convinced Nazi or the dedicated Communist  but instead the people for whom the distinction between fact and fiction, true and false, no longer exists -- Hannah Arendt.


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#9
(01-15-2017, 01:03 AM)pbrower2a Wrote:
(01-15-2017, 12:28 AM)Classic-Xer Wrote:
(01-14-2017, 11:03 PM)Odin Wrote:
(01-14-2017, 10:18 AM)flbones too Wrote: I don't understand why politicians are making this health care thing more complicated than it needs to be. Just expand Medicare for everyone. it's not that complicated.

A lot of people already get insurance through their employer and those people don't want to pay the higher taxes needed for a single payer system. It's "I've got mine, fuck you".
I'm not interested in a single payer system. I'm not interested in becoming part a single payer system by being forced to become part of one that favors the less fortunate (lower end tax bracket). I'm content with the healthcare that I  currently have and have had for years. Are you blind? Now, if you and fellow blues want to conjure up some sort of government funded system to provide healthcare for themselves without destroying/severely impacting and sharply increasing the costs/disrupting our healthcare in the process that's fine with me. If the liberal silliness continues, the liberals are going to find themselves stuck in a government system that's supported by the lower income tax bracket. Can you afford to have your taxes substantially increased to Tara's level/my parents level  (1/3 of her income)?

Tell me about all the high-tax refugees coming to America.

Do you know any poor people? Do you realize how expensive medical insurance is for people over 60, when almost all careers are in decline?  When I had private health care insurance the payments were higher than the payments on a Mercedes-Benz. I am taking some chances by not buying such insurance, but buying American health-care insurance is a losing proposition. Poor as I am, death solves my problems -- especially with a reactionary government that considers me vermin for not being rich.

Yes, if Donald Trump knew about me he would probably want me rubbed out for my political beliefs.
I know how much health insurance costs. I'm currently paying for health insurance for my family ( a couple of 50 year old's and a teenager). I assume that I'm paying more for health insurance than a 60 year old. I wish I was just a 60 year old but I'm not just a 60 year old or a twenty something like Odin. Did you know braces cost as much as an ATV today? Did you know the average cost of raising a kid is as much as a house? I knew a lot more poor people while growing up. I don't know as many of them personally today. I had school friends who lived in the poor part of town. My grandmother was poor. My best friend was poor. I had friends who went through divorces and a got a taste of what being poor felt like. I got a taste what it felt like myself after my father died during my young teenage years.
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#10
(01-15-2017, 12:28 AM)Classic-Xer Wrote:
(01-14-2017, 11:03 PM)Odin Wrote:
(01-14-2017, 10:18 AM)flbones too Wrote: I don't understand why politicians are making this health care thing more complicated than it needs to be. Just expand Medicare for everyone. it's not that complicated.

A lot of people already get insurance through their employer and those people don't want to pay the higher taxes needed for a single payer system. It's "I've got mine, fuck you".
I'm not interested in a single payer system. I'm not interested in becoming part a single payer system by being forced to become part of one that favors the less fortunate (lower end tax bracket). I'm content with the healthcare that I  currently have and have had for years. Are you blind? Now, if you and fellow blues want to conjure up some sort of government funded system to provide healthcare for themselves without destroying/severely impacting and sharply increasing the costs/disrupting our healthcare in the process that's fine with me. If the liberal silliness continues, the liberals are going to find themselves stuck in a government system that's supported by the lower income tax bracket. Can you afford to have your taxes substantially increased to Tara's level/my parents level  (1/3 of her income)?

So you admit to "I've got mine, fuck you". Fucking cake eater.
#MakeTheDemocratsGreatAgain
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#11
(01-14-2017, 11:03 PM)Odin Wrote:
(01-14-2017, 10:18 AM)flbones too Wrote: I don't understand why politicians are making this health care thing more complicated than it needs to be. Just expand Medicare for everyone. it's not that complicated.

A lot of people already get insurance through their employer and those people don't want to pay the higher taxes needed for a single payer system. It's "I've got mine, fuck you".

More like, "I'd rather keep paying for my efficient private insurance than pay more for an inferior public monopoly like the VA or NHS."

Medicare as it currently exists can't even survive retirement of the full baby boom; even now, it has gotten sufficiently inadequate that supplemental insurance is pretty much required.
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#12
(01-14-2017, 10:18 AM)flbones too Wrote: I don't understand why politicians are making this health care thing more complicated than it needs to be. Just expand Medicare for everyone. it's not that complicated.

Show me even one Republican wiling to go with that option ... just one.
Intelligence is not knowledge and knowledge is not wisdom, but they all play well together.
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#13
(01-14-2017, 11:07 PM)SomeGuy Wrote: Medicare for all is probably the long-term answer, but without some serious reform in how Medicare spends its money this could prove an even more costly debacle.

That's already happening.  Let's be honest, though.  Some of the built-in inefficiencies are fully intentional.  Part D was created the way it was to get Big Pharma on board.  Physicians wanted to maintain their monopolies on service provision too, but that's already breaking down.  When the few huge health corporations and Big Pharma are on one side and everyone else is on the other, we might get change.
Intelligence is not knowledge and knowledge is not wisdom, but they all play well together.
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#14
(01-15-2017, 03:07 AM)Classic-Xer Wrote: I know how much health insurance costs. I'm currently paying for health insurance for my family ( a couple of 50 year old's and a teenager). I assume that I'm paying more for health insurance than a 60 year old. I wish I was just a 60 year old but I'm not just a 60 year old or a twenty something like Odin. Did you know braces cost as much as an ATV today? Did you know the average cost of raising a kid is as much as a house? I knew a lot more poor people while growing up. I don't know as many of them personally today. I had school friends who lived in the poor part of town. My grandmother was poor. My best friend was poor. I had friends who went through divorces and a got a taste of what being poor felt like. I got a taste what it felt like myself after my father died during my young teenage years.

FWIW, I'm 69 years old.  I have standard Medicare Parts A and B with a Medigap Plan G, and a Part D Drug plan.  I pay about $120/month for Medicare Part B, $90 for the Medigap Plan and $35 for the Drug Plan ... a monthly total of $245.  Medicare doesn't offer dental coverage at all, but I'm covered by my wife.  Inexpensive commercial plans are available for people on Medicare if you want them.

For my money, I pay a single annual copay of $166 a year, and $7 a refill for prescriptions (mine are not exotic in any way) -- and that's it!  I go to any doctor I wish, and never get a an out-of-network charge (or any other charge for that matter) ... ever!  Beat that with a commercial plan.
Intelligence is not knowledge and knowledge is not wisdom, but they all play well together.
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#15
(01-15-2017, 10:56 AM)Warren Dew Wrote: More like, "I'd rather keep paying for my efficient private insurance than pay more for an inferior public monopoly like the VA or NHS."

Medicare as it currently exists can't even survive retirement of the full baby boom; even now, it has gotten sufficiently inadequate that supplemental insurance is pretty much required.

See my previous post, and understand that Medicare cost control is not complete yet, but it still beats the living hell out of commercial insurance.  I've had both.  Medicare is vastly superior.
Intelligence is not knowledge and knowledge is not wisdom, but they all play well together.
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#16
My memories are a little hazy because I was a child, but my parents (both Republicans) assure me that heath care in France and the Netherlands was quite good as well, and both of them use universal social insurance to provide healthcare through private providers.  My experiences with the VA make me less enamored of a government-run system like Britain's NHS, although both the army and some of the colleges I went to convinced me that most medical services should not be handled by doctors.

So, am gonna agree with Dave on this one.  Universal social insurance based on Medicare with reforms to payments (acceptable care providers, drug prices, etc) and the option to buy private supplementary insurance as you please.
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#17
(01-15-2017, 12:27 PM)David Horn Wrote:
(01-15-2017, 03:07 AM)Classic-Xer Wrote: I know how much health insurance costs. I'm currently paying for health insurance for my family ( a couple of 50 year old's and a teenager). I assume that I'm paying more for health insurance than a 60 year old. I wish I was just a 60 year old but I'm not just a 60 year old or a twenty something like Odin. Did you know braces cost as much as an ATV today? Did you know the average cost of raising a kid is as much as a house? I knew a lot more poor people while growing up. I don't know as many of them personally today. I had school friends who lived in the poor part of town. My grandmother was poor. My best friend was poor. I had friends who went through divorces and a got a taste of what being poor felt like. I got a taste what it felt like myself after my father died during my young teenage years.

FWIW, I'm 69 years old.  I have standard Medicare Parts A and B with a Medigap Plan G, and a Part D Drug plan.  I pay about $120/month for Medicare Part B, $90 for the Medigap Plan and $35 for the Drug Plan ... a monthly total of $245.  Medicare doesn't offer dental coverage at all, but I'm covered by my wife.  Inexpensive commercial plans are available for people on Medicare if you want them.

For my money, I pay a single annual copay of $166 a year, and $7 a refill for prescriptions (mine are not exotic in any way) -- and that's it!  I go to any doctor I wish, and never get a an out-of-network charge (or any other charge for that matter) ... ever!  Beat that with a commercial plan.
You're getting a hell of a deal and you are receiving a hell of deal because you are in a specific age group (fully retired workers) in a government system that's limited to your specific age group. I hope when I'm 69, I can get a hell of deal like you are getting now too. Do I expect to receive the hell of a deal that you are now? No, I expect to pay more money to receive less than you are entitled/accustomed to receiving and having available to you now. As I told you before, you should be thanking us for your healthcare because we are the ones who are paying for it and covering/taking on the debt associated with your losses. Where is your sense of gratitude? Did you loose it or didn't you ever have one? Didn't your parents or at least one of your parents ever tell you to shut up and be grateful for what you have?
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#18
(01-15-2017, 01:36 PM)Classic-Xer Wrote: You're getting a hell of a deal and you are receiving a hell of deal because you are in a specific age group (fully retired workers) in a government system that's limited to your specific age group. I hope when I'm 69, I can get a hell of deal like you are getting now too. Do I expect to receive the hell of a deal that you are now? No, I expect to pay more money to receive less than you are entitled/accustomed to receiving and having available to you now. As I told you before, you should be thanking us for your healthcare because we are the ones who are paying for it and covering/taking on the debt associated with your losses. Where is your sense of gratitude? Did you loose it or didn't you ever have one? Didn't your parents or at least one of your parents ever tell you to shut up and be grateful for what you have?

If you kill the system you never will.  Like most systems built on actuarial models, Medicare, and Social Security, require future recipients to pay for current ones, so the next gen can pay for them.  It isn't rocket science, but it does require adherence to good actuarial practice.  We have many pension plans in the US that are drastically underfunded, because short term returns looked good enough to allow the plans to reduce deposits ... including most 401ks and IRAs.  SS and Medicare avoided those traps.  A quick overview of the alternatives shows how truly excellent these two programs really are.

So I paid plenty for the GIs and Silents.  I paid when it cost me much more than I could afford.  Now it's your turn.  Quit whining.
Intelligence is not knowledge and knowledge is not wisdom, but they all play well together.
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#19
(01-15-2017, 12:27 PM)David Horn Wrote:
(01-15-2017, 03:07 AM)Classic-Xer Wrote: I know how much health insurance costs. I'm currently paying for health insurance for my family ( a couple of 50 year old's and a teenager). I assume that I'm paying more for health insurance than a 60 year old. I wish I was just a 60 year old but I'm not just a 60 year old or a twenty something like Odin. Did you know braces cost as much as an ATV today? Did you know the average cost of raising a kid is as much as a house? I knew a lot more poor people while growing up. I don't know as many of them personally today. I had school friends who lived in the poor part of town. My grandmother was poor. My best friend was poor. I had friends who went through divorces and a got a taste of what being poor felt like. I got a taste what it felt like myself after my father died during my young teenage years.

FWIW, I'm 69 years old.  I have standard Medicare Parts A and B with a Medigap Plan G, and a Part D Drug plan.  I pay about $120/month for Medicare Part B, $90 for the Medigap Plan and $35 for the Drug Plan ... a monthly total of $245.  Medicare doesn't offer dental coverage at all, but I'm covered by my wife.  Inexpensive commercial plans are available for people on Medicare if you want them.

For my money, I pay a single annual copay of $166 a year, and $7 a refill for prescriptions (mine are not exotic in any way) -- and that's it!  I go to any doctor I wish, and never get a an out-of-network charge (or any other charge for that matter) ... ever!  Beat that with a commercial plan.

Actually there are more and more doctors that do not accept Medicare.  With the current cost control system, which mostly consists of reducing reimbursements, it won't be too long before only hacks accept it.  You may not live long enough to see that, but I likely will.
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#20
(01-15-2017, 04:08 PM)David Horn Wrote:
(01-15-2017, 01:36 PM)Classic-Xer Wrote: You're getting a hell of a deal and you are receiving a hell of deal because you are in a specific age group (fully retired workers) in a government system that's limited to your specific age group. I hope when I'm 69, I can get a hell of deal like you are getting now too. Do I expect to receive the hell of a deal that you are now? No, I expect to pay more money to receive less than you are entitled/accustomed to receiving and having available to you now. As I told you before, you should be thanking us for your healthcare because we are the ones who are paying for it and covering/taking on the debt associated with your losses. Where is your sense of gratitude? Did you loose it or didn't you ever have one? Didn't your parents or at least one of your parents ever tell you to shut up and be grateful for what you have?

If you kill the system you never will.  Like most systems built on actuarial models, Medicare, and Social Security, require future recipients to pay for current ones, so the next gen can pay for them.  It isn't rocket science, but it does require adherence to good actuarial practice.  We have many pension plans in the US that are drastically underfunded, because short term returns looked good enough to allow the plans to reduce deposits ... including most 401ks and IRAs.  SS and Medicare avoided those traps.  A quick overview of the alternatives shows how truly excellent these two programs really are.

So I paid plenty for the GIs and Silents.  I paid when it cost me much more than I could afford.  Now it's your turn.  Quit whining.
1 wasn't whining. Shame on you, you keep screwing up and approaching me as if I'm a kid or something. I was trying to teach you some respect for those like me who are supporting you now. Like everything, obligations only extend so far and only last for so long.
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