Re: I used to be disgusted, and now I try to be amused.
 

Actually it's more like 80% of America had a Ford Pinto and you lot worried about getting the other 20% a tricycle, so now we all have just one roller skate.

Re: I used to be disgusted, and now I try to be amused.
 

If that were actually true, that would be bad.

Re: I used to be disgusted, and now I try to be amused.
 

the worst of ACA ain't happening so "true" has no meaning. OAN how many conversations have you had with people reporting to you about why their HC is worse than it was? And if your answer to the question is "I did" , did you mention the option of HSAs?

Re: I used to be disgusted, and now I try to be amused.
 

I'm not blaming ACA for making healthcare too expensive for most Americans. I'm simply contesting the notion that it improved things, with a couple of admittedly important exceptions.

Re: I used to be disgusted, and now I try to be amused.
 

Try flipping the 80% and the 20% and you will be closer to accurate. Except that 30% still have the Pinto.

Re: I used to be disgusted, and now I try to be amused.
 

Option for how many?

Re: I used to be disgusted, and now I try to be amused.
 

You are the only person I know who thinks the ACA made their health care worse. The blue-helmeted UN bureaucrat who assigns me to my doctor has always done a good job of finding me someone who seems to care.

Re: I used to be disgusted, and now I try to be amused.
 

Can someone who understands financial stuff explain how Trump's election has caused the stock market to go up?

Re: I used to be disgusted, and now I try to be amused.
 

i wanted to quote this so it is preserved after you come off whatever bender made your fingers type this. When Sebby talks about the people who spout political views of all sorts at smart cocktail parties, I can't help but wonder if there's a little bit of bullshit going on. With what you say here, I'm not wondering.

Re: I used to be disgusted, and now I try to be amused.
 

For lots of people who had good HC and now don't. ACA did not fix the problem of lack of HC, it just mixes the problem around. Like when there's only two squares of TP and you just had a runny shit.

Re: I used to be disgusted, and now I try to be amused.
 

Perception there will be

Increased spending on infrastructure
Tax cuts and looser regulation

Plus when stuff goes up, people think the market is hot and buy. Don't forget Asia shit the fucking bed overnight. Yours truly was up all night unloading shit then rebuying when it was apparent that it was all going up.

Source:
http://www.nytimes.com/2016/11/10/bu...-election.html

Re: I used to be disgusted, and now I try to be amused.
 

I really don't understand what you're talking about. You're more than welcome to try to explain.

I get the people who think that healthcare is too expensive. The ACA helped slow the rate of increase in healthcare costs, and it gives some people subsidies, but if you're not getting a subsidy then your costs are still going up.

Re: I used to be disgusted, and now I try to be amused.
 

With the exception of perhaps a nuclear war, it will inevitably react positively to every event.

Re: I used to be disgusted, and now I try to be amused.
 

I said they're cocktail parties. Only some are smart. And if people are properly availing themselves of the bar, the smart fades quickly.

Re: I used to be disgusted, and now I try to be amused.
 

Yep. That's it in a nutshell.

People who lost non-compliant policies which could no longer be offered under ACA have good reason to be pissed. People who've been forced to wait longer because massive #s of new entrants have started consuming services have a right to be pissed.

Re: I used to be disgusted, and now I try to be amused.
 

It's absolutely true. The ACA was all about getting the uninsured health care. Paring future costs for all was important, but secondary.

Re: For Hank
 

2!!!

Re: I used to be disgusted, and now I try to be amused.
 

I agree with this completely. Most of the excuses for racism, the suggestions that if we complained less about racism and worked more on jobs, are bs. Throw the punches, stand up for what you believe in.

Re: For Hank
 

These kind of practically helpful but politically problematic ideas are the sort of thing that costs the Dems a lot of seats (but might get better healthcare for a lot of people).

Re: I used to be disgusted, and now I try to be amused.
 

Of course, there are no shortage of times when covering the healthcare problem that costs more than $5700 is a massively big deal, that kind of catastrophic problem is not at all uncommon.

I advocate ACA as an incrementalist: making things perfect shouldn't be the enemy of making things better. And covering the catastrophic situations is making things better, and $75 a month for that kind of coverage is indeed a bargain.

Would I love a constitutional amendment to provide healthcare as a right, so at least basic and critical care became national costs funded by a national budget and revenue stream (like Medicaid is but broader)? I spent a couple days in a negotiation where there was a Portuguese woman on the other side who, during the breaks and lunches, was expressing how just absolutely appalled she was that the US didn't have a provision like Portugal providing healthcare as a right. I'd love it - but I watched Ted Kennedy spend 50 years trying to build a coalition to do such a thing, and we're going to need a very different political world to get it done here. Until we do, Medicaid expansion will still help millions.

Re: I used to be disgusted, and now I try to be amused.
 

Re: I used to be disgusted, and now I try to be amused.
 

It's easily fixed. Make it actual insurance instead of a TPA. And mandate medical costs be published by providers.

Right now, we have a TPA paying (or maybe not) for people's elective care. This naturally inflates prices, as the purchaser doesn't know the cost and has no incentive to learn it. It also screws the poor consumer who only finds out after the fact that his care wasn't covered!

Could you imagine going to your mechanic and having him say, "I'll do the work, and maybe you'll have to pay for it, or maybe not. By the way, I have no idea what it'll cost until it's done." That's our "health insurance" system.

And why do we have this, rather than actual insurance, that only pays for necessary non-elective care? Because brilliant policy-heads decided the average person is not sophisticated enough to purchase elective healthcare on his own. It's too complicated for him, so he needs a TPA.

Nevermind that the only real way to drive down costs would be to put elective care on the patient. Let the patient and doctor negotiate on price directly and you'll see the unit price drop like a stone.

Let me guess the rebuttal: "Oh, but then we'd have less consumption of preventative care, and people would be sicker!" Bullshit. Entirely speculative bullshit.

Re: I used to be disgusted, and now I try to be amused.
 

Speculation is fact in these here parts! Look at Ty: people who have seen rates, co-pays and deductibles spike up under ACA aren't getting more expensive, worse, coverage. BECAUSE if not for ACA HC would have gotten more expensive anyway. See?

Re: I used to be disgusted, and now I try to be amused.
 

You don't stand for nothing, Sebby.

You stand for sitting by doing nothing while the house burns.

I've said it before, I'll say it again. Fuck you.

Re: I used to be disgusted, and now I try to be amused.
 

Oh come on. It's a clever bit of prose.

ETA: You stand for further testing the law of unintended consequences. Health care should be like anything else. People can buy it like they buy anything else, and get insurance to cover services to cover expensive acute or chronic care. But no. We can't have that. We have to have a TPA system, and tie it to employment. The system's a three dollar bill from the start. Because, as always, some well intentioned policy-heads decided they knew what was best.

Re: I used to be disgusted, and now I try to be amused.
 

This is why Trump voters didn't like the ACA. People like you would rather talk about the giving-other-people-stuff-they-might-or-might-not-deserve stuff in the ACA than about the making-health-care-work-better stuff in the ACA. They're both in there, but only one part of it interests you.

Re: I used to be disgusted, and now I try to be amused.
 

SMH. That you have been put in a position of major responsibility is actually more concerning to me than some of Trump's cabinet choices..

Re: I used to be disgusted, and now I try to be amused.
 

Not to mention all the employers who shitcanned better policies when the ACA gave them cover for putting in the Walmart-level of benefits.

Re: I used to be disgusted, and now I try to be amused.
 

I agree with you that ACA may have provided an improvement for people who are hit with catastrophic health issues in some cases. But the vast majority of people don't get those sort of catastrophic illnesses and if they do, they die long before they get any benefits because they can't afford to pay for care to keep them alive until they meet a $5000 deductible.

So you get people who are forced to choose between losing their job or spending all day in a clinic if they get pancreatitis or have an arrhythmia. The clinic is packed with people who are suffering from everything between diabetes, heart disease, and allergies and morphine withdrawal. So everybody gets a minimal look-see and a scrip for extra-strength Tylenol, a set of x-rays, and an order to make another appointment, which they may or may not get because the clinic hits capacity for the day by 8:00 so the appointment gets canceled.

If I have $30/week in income after rent, day care, almost enough food, and utilities, how am I going to pull together the $125 a real doctor will require to see me, let alone pay for the $175 prescription? I'm dead long before I ever make the $5000 deductible.

I agree you can't make the perfect the enemy of the better. But if poor people still can't see a doctor, can't get basic wellness care or care for a chronic disease, and can't pay for the drugs they need to manage disease, where is this "better" of which you speak?

Re: I used to be disgusted, and now I try to be amused.
 

Which, if you read back, is something Hank told you would happen. perfect cover: Obama says this is good so that's what we are going to!

Re: I used to be disgusted, and now I try to be amused.
 

Just another rich white man thinking he's cute because he's never met a single person who had to put their kid to bed hungry. Fuck him and his smug bullshit.

Re: I used to be disgusted, and now I try to be amused.
 

You don't see who it is who is really the one full of smug bullshit?

Re: I used to be disgusted, and now I try to be amused.
 

What Trump voters think or don't think has nothing to do with this discussion. What I wrote is a fact.

They are both in there. But one's there a whole lot more than the other. Which is all I said.

Re: I used to be disgusted, and now I try to be amused.
 

He grew up poor in Ohio, and endorsed Hillary this election, on the basis she was more Republican than Trump.

Re: I used to be disgusted, and now I try to be amused.
 

The ACA was at best a thing that might work while acting as a door opener to single payer, at worst a thing the failure of which would create a situation where single payer became a politically possible solution. The former didn't happen and the latter is now impossible, as it required a single-payer-friendly political climate.

Re: I used to be disgusted, and now I try to be amused.
 

That was a feature, not a bug.

Re: I used to be disgusted, and now I try to be amused.
 

The figure I'd like to see is:

$ paid in by the 30mil new consumers created by ACA - $ spent for care for them

You can pull that from tax records and provider reimbursements.

Re: I used to be disgusted, and now I try to be amused.
 

It's like you just forgot that health care costs were increasing before the ACA. You probably blame your teeth on Obama too.

Re: I used to be disgusted, and now I try to be amused.
 

Objectively, I don't know what that sentence is supposed to mean or how you'd ever prove it. Subjectively, it means that you care about one more than the other, but we all knew that already.

Re: I used to be disgusted, and now I try to be amused.
 

I'll prove (or disprove) it like this. Compare the cost savings accruing from ACA to date (offsetting the well documented decrease in HC spending since 2008 caused by the financial crisis) to the amount spent to date to provide HC insurance under the ACA to those 30 million new consumers. It's an imperfect measure, but that ratio would be telling.

And stop trying to paint me as a Trump voter. It's quite transparent, and cheesy, particularly coming from someone like you, who obviously knows better. If you could put 46 million people w/o HC insurance, largely because they cannot afford it, onto a plan and create savings for all, I'd happily pay extra taxes for it! What I don't like about the ACA is the fact that it's bullshit, because what I just wrote is impossible. I don't like being told to "embrace complexity" in the numbers because some pack of policy twits think either:

1. They can perform financial alchemy; or,
2. Slide a doomed bill past the goalie because, hey, voters and Congress are pretty stupid.

Voters and Congress are generally not that bright. But in a circle like this one, where we've a few extra brain cells to spare, please - don't try to sell the bullshit that this plan would've created savings in excess of the cost of adding tens of millions of people to the rolls most of whom can barely afford the rent.

The only thing more annoying than being lied to is being lied to badly.