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

Unlike you, because my HC insurance costs are dollars my family would otherwise put in our pockets, I actually watch the number pretty closely. I see no unusual increase caused by the ACA. The upward trajectory of costs has been pretty constant since 2007.

Other business owners I know have very different stories. A lot of them echo Hank's.

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

You are a big part of Trump's victory. Stop denying it. We will all call you out for it.

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

No, but if you're living in a town where there are no jobs, why are you staying?

And it's not just a rural/urban. The rust belt is pretty urban, but still full of towns and cities whose time is in the past.

This is a really weird superstition you have. And it's wrong. Moving people into cities and out of long car trips has pretty strong positive environmental effects.

It's not the family farm you need. It's sustainable farming.

And probably some Pigovian taxes on crap food.

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

It's preparing for a orgy of government spending and tax cuts.

It apparently does not believe in monetary offset.

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

I count myself very lucky because it's been about 20 years since I or any member of my family have had to make doctor/food choices, and I know you almost always choose food and then wait for the shit to hit the fan and the trip to the E/R. This is hardest by far on those with chronic but not catastrophic issues. But I do think there is a lot of better here.

The trip to the E/R after you've chosen food over doctor quite frequently results in the bill well beyond the $5000 deductible, assuming there is a need for some imaging and a few days stay, and the fact that the excess is insured rather than in the free care pool (at least in places like the Northeast, where we have the free care pool) improves the care and keeps the house from getting foreclosed on by the healthcare providers as a result of getting care. It doesn't replace the income lost, and no healthcare plan I've seen would.

20 million new insured is nothing to sneeze at; yes, that insurance is a difficult cost for many of them. A lot more difficult than the expenses Hank is whining about. But I don't think those catastrophic cases are all that rare.

The difference between the folks we know who have to deal with these issues despite barely making ends meet may well be that many of the people I know dealing with these struggles I've met in connection with our mutual catastrophic illnesses.

By the way, the biggest impact on cost of care for people dealing with chronic conditions is likely still to come, if it doesn't get killed before then. That is the change in focus to outcome oriented payments.

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.

On the other hand, I know lots of cancer patients who say it made things a lot better.

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

At the end of 2015, white unemployment in Wisconsin was 3.5%, in Michigan was 3.7%, and in Pennsylvania was 4.3%. California is 4.5% and Massachusetts is 3.5%.

Where are these rural white communities without jobs?

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

No they don't.

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

Unless there's something weird about you specific situation, it goes a lot farther back than that.

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

One of the local alternative non-profit media outlets ran a post-election, "where there's economic anxiety in Minnesota" story, focusing on Koochiching County, way up by the Canadian border. It contrasted economic conditions in the metro (idk 3-4% unemployment) to up there, where things were really different, at 6.9%.

6.9%. That's not good or anything, but when you're picking out the worst available rural county (where something like 13K people live), that's not a shockingly high number.

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

You cannot be fucking serious.

TM

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

No it is not. Compare to black unemployment numbers.

The Trumpsters are not leading a revolt of the proletariat. This is the entitled lumpenbourgeoisie, and it's as much about racism as economics.

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

I'd missed that (Sebby's "People who've been forced to wait longer because massive #s of new entrants have started consuming services have a right to be pissed.").

That is a stunning statement on Trumpism today. Let's face it, what he means is "I'm comfortable, but if I have to wait a little longer because black folks are also getting benefits, I'm going to be pissed." This is the voice of the entitled lumpenbourgeoisie I was just referring to - his problem is not with whether or not he gets healthcare, it is the fact that he doesn't want others to have it if he even imagines it might inconvenience him.

At the end of the day, this narcissistic self-involved parasites identify with Trump, and that's the core of it.

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

We've litigated that dull topic to death. Let's agree to disagree. I see your point. You do not see mine.

Perhaps a better assessment of Ty's accusation is, he's claiming I'm a Calvinist. It's pretty clear I'm about as fond of the Protestant Work Ethic as I am of colonoscopies. It's a total bullshit scam sold to workers to keep them complacent -- a device for controlling the masses on par with the Catholic Church's bit about poor workers inheriting a better "kingdom" after death.

I have no gripe with anyone getting subsidized health insurance. Just don't sell it to me like it's not a welfare program. It is. And there's nothing wrong with that. If we wish to vote for such benefits and entitlements, then they should be given to people. If the majority of us do not wish to give them, they should not be given. But have an honest debate. We're all adults here. If you tell me we can give the poor health care for a modest increase in taxes, I'm inclined to hear you out. Tell me you've a formula to give 46 million people largely if not near-exclusively subsidized coverage while creating offsetting cost savings and I'm smelling bullshit.

We need to break the fourth wall in politics. It's always pretexts. Why not just say, "I think we need to help people who can't afford health insurance more than we are. Here's how I plan to do it." Let the other side of the debate make the case for not wanting to do so. This would work a fuckload better than making the argument one about whether the ACA delivered real cost savings or was a Byzantine mess of creative accounting.

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

A guy who's paid in to his system for years has an honest complaint when the govt goes and tinkers with it, causing him to suffer any inconvenience. That may sound cold to you, but he does have a legitimate gripe.

I haven't seen a doctor in god knows how long. And when I last had a health issue, I paid out of pocket to a concierge practice. I've paid into the system, and then some. And it's real dollars. I actually a paid a year of premiums for my family out of pocket. Have you done that? What's your contribution been? Oh, right -- your employer paying for it for you.

Have you ever negotiated a policy on behalf of your workers? Missed your own paycheck to cover the costs of a group policy because your promised your employees an excellent plan and didn't break your word?

And you call me a parasite? By the way, you need to get off your moral high horse if you want to go around throwing "bourgeoisie" at others. Moral harrumphing is a hallmark of that caste, in which you fit more than perfectly than any other poster on this board.

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

Damn. He totally just called you a blood-sucking parasite. Damn. And you fire back by calling him a clown? That's weak, bro. You can do better. Go for the motherfucking jugular!

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

OMG, you edited your post as I was writing this. Now you're not even calling him a clown? You're politely asking him to get off his moral high horse? He called you a blood sucking parasite!!!! The type of thing that latches onto your ass and drinks your blood while simultaneously releasing the most vile of diseases into your system. And you fight back with a horse metaphor? Lets pick this shit up because I'm nodding off here.

Re:Maybe next time he'll call me a member of the Global Elite!!!
 

Dude, he called me bourgeois. That was his crushing repartee.

Do you know how hard I've worked to become a member in good standing of the bourgeoisie?

Winning!!

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

It's the fucking holidays. I'm not about to degrade the cheery spirit by calling anyone a wanna-be limousine liberal. Or tsk-tsking the use of "lumpen" as overused signalling of pseudo-intellects. I shall observe in the spirit of peace between all men that politics bring out the worst in people.

He's free to apologize for smearing me as a racist (note the insertion of "black people" in his last post), and for calling me a parasite. But even if he doesn't, I forgive him.

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

Pro-tip: I'm not sure how you haven't figured this out yet, but I'm about the last person in the world with whom you want to compare health care cost experiences.

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

Jesus, this admission only took what -- six, seven months?

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

That ratio doesn't tell you anything at all -- it's apples and oranges. One is a cost and the other is a change in a rate of increase, and different people are spending the money in each case.

I believe what I said is that you were repeating a trope that explained the way a lot Trump voters think, and I still think that's true.

The ACA did a bunch of things all at once. If you are going to pretend that the things that raised revenue and saved money didn't exist, then you're never going to admit that the whole thing worked from a budget perspective. I don't get why you're so insistent that those other parts of the ACA didn't exist, or that they're not important, or something.

I decide to but a new house, and sell the one I own now. You tell me, you can't afford that house! It's much too expensive. I say, yeah, it's a lot of house, but if I sell the one I'm in then I can afford it. You reply, this deal really isn't about the old house, it's about the new house, and you can't afford the new house.

I get it. You don't like the new house. Stop pretending it has anything to do with the budget.

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

Thank you. Here's a pro tip for you: If you haven't paid for it for your workers, you're only addressing half of my point.

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

The rate of increase in healthcare costs has been declining since the recession, and people who work on such things for a living are arguing about how much of that decline (not an absolute decline, but a decline in the rate of increase) is attributable to there recession and how much is attributable to the ACA.

I know you know all of this because you referred to it in your prior post and because you've carefully implied the recession is the key cause. So I suspect you also know that people give some credit to the ACA and some to the recession.

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

I don't think of Sebby as a Trump voter. But he did adamantly profess indifference to the choice between Trump and Hillary.

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

I do. I can't prove it, or how much is attributable to it, but I think the ACA has had a positive impact in that regard.

My chief gripe with it is, savings weren't and aren't paramount, but it was sold like they were. And while some of its failing is attributable to states' non-cooperation, the ACA is not working. And where it is working, it's screwing a lot of people of modest means who had fine coverage before which is non-compliant now.

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

Not exactly what you were discussing, but I think it's pretty clear that the low unemployment rate is as much of a function of a decrease in the denominator as an increase in the numerator, which is to say that people who in other years were part of the workforce are not looking for work. I haven't seen a good explanation of this. It could be that some of these people have given up hope of finding work, but if that were the case you would they would come back into the work force as measured unemployment drops.

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

I have. Repeatedly.

Like I said, I'm about the last person you want to compare with. I've spent a year with negative income because of health care costs. I have dealt with health insurance costs for three different operations over a period of 20 some odd years.

That $5000 deductible wonk dealt with - we've gone out of pocket three times to deal with it for people who helped us out with parents and their issues, and we've also helped them with significant uncovered expenses. My wife has one little girl named after her - it was a very tough uncovered pregnancy - and that is a very rewarding thing, even though it was very difficult for us financially at the time.

Among the many things I've dealt with is my wife struggling to come up with $500,000 in a certified check to cover a life saving drug I was denied coverage for, at a point when I had hours to live. I've lost most of my net worth and gone deep into debt dealing with my own cancer.

Believe me, you don't want to compare life dealing with health care costs and bureaucracies with me.

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

Yes, this is one of the big issues of our time, and it's clear there are a lot of things going on, some of which are positive and some negative. They're not all people who have given up on finding work, and some are in a shadow economy that has a lot of its own problems, but some are doing things like spending more time in school. But I also have yet to see that brilliant piece that bring order to the problem.

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

I still don't understand what you mean by paramount. As a political matter, Obama and the Democrats wanted to cover more people without blowing up the budget. So they devised a plan that both spent and saved money. I find it completely bizarre that you think this was selling it as something it wasn't. Yes, there are costs to HCR, but there were also cost savings, and a lot of people spent a lot of time making sure the two were balanced.

When you say the ACA is not working, I'm not sure what you mean. Again, it's a big law with a lot of pieces, and some of them are working better than others. If you talk to someone who was deeply involved in designing it, they will have a long list of things they would fix about it now. No one pretends otherwise. The reason those fixes haven't been adopted is Republicans.

Some people may have had coverage before, but it wasn't "fine." It was crappy coverage, and they didn't know it yet because they hadn't had to try to use it.

Note that what you and Hank are making opposite complaints about the ACA. Hank says it has made care worse. Your complaint is that it requires coverage that is too good -- that it has forced people to raise the level of their care. If you guys were more interested in getting healthcare policy right, you'd be arguing with each other. Instead you're both looking to bury the ACA, and it doesn't really matter why.

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

Fuck. I just hit some button and lost a long reply.

Here's the cliff's notes. The bourgeoisie aren't complaining about the ACA. It's the middle and working class people losing policies and waiting for care.

We should simply expand medicaid, let private equity open unique clinics for the people who can't afford to pay for any coverage, and tax the top 20% to pay for it. But let the middle class and working class folks stay in the private system. Don't throw them into the public side of the two tiered system we all know is coming.

I'm sorry you've acquired those bona fides re: HC.

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

The only people complaining about the ACA are Republicans, and they're doing it for partisan reasons. Normal people care about their healthcare, not about the ACA, and they have all sorts of complaints. They want the government to make the healthcare system work better. Unfortunately for them, Paul Ryan and Republicans on the Hill are more interested in cutting taxes for the wealthy, and have an ideological opposition to using the government to make the healthcare system work better.

If I did this kind of politics for a living, I would be appealing to Trump to protect ordinary people from Paul Ryan and the House Republicans.

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

Exactly.

Yup

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

What part of "Medicaid Expansion" and "insurance subsidies" was not explicit enough for you?

You know that many of them were young and healthy and thus a net positive to the system's cash flow, right? (To the extent they signed up)

I do not know how you missed that in the Obamacare debates.

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

I have three siblings who started solo consulting businesses in the last three years. The two single siblings rely on the exchanges for their health insurance, and both say they would have had to found a job with a company for insurance had the ACA not passed.

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

I think we should be clear about something: everyone in their right mind complains about health care costs.

And in the ACA there is one provision or another that will touch a nerve with almost anyone, and there are some structural features that need to be fixed. Those of us who are fans (at least speaking for myself) don't look at it and say, hey it solved everything, we say, hey, it is the beginning of a solution to a complex set of problems, and the things we're less happy with are more than outweighed by the things we're more happy.

All of which makes it ripe for partisan attack, even though there are, indeed, a huge number of people, mostly middle-income and lower-middle income people but also many people in poverty or in transition, who are very happy with the added benefits now.

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

That's part of it, but it's also a declining part of it.

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

I see from a good source on Twitter that the Republicans' plans for the ACA threaten:

12 million new Medicaid recipients
9 million on subsidies
52 million with pre-existing conditions

Odd that our conversation focuses so much on the 9 million, and so little on the other 64 million. It's almost as if the conversation is not animating by the actual effects on real people, but on the notion that someone without money is getting something they don't deserve.

Re: Ever wonder why the Nihilists were Russian
 

That's total BS. It's folks like you, bourgeoisie, nihilists, partisans, trying to speak on behalf of the working class.

Screw that, we all know what Dude speaks on behalf of the working class.

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

Hmmmmmmmmm.