Health care policy is an area that is as divisive and polarized as anything between liberals and conservatives. I recently offended regular commenter J. Ewing, by asserting conservative leaders and the voters who elect them lack compassion for the uninsured. I also commented that opposites sides tend to operate from completely different sets of facts and suggested that he would dismiss whatever facts I presented out of hand. So my goal / experiment is to see if there is any common ground to be found on the facts related to the American health care system. I am also curious what facts people use to support their opinions about the benefits or drawbacks of the ACA act. Lastly, I'd really like to understand the values of conservative Christians who seem to advocate for health care policies that make absolutely no sense to my value system, but I am not too hopeful on this last one.
So to start off the discussion I would like to posit what I consider fact. The U.S. spends the Most On Health Care, Yet Gets Least. The linked study rates the US low on access, efficiency (cost), equity, life expectancy, infant mortality and even quality. I was going to argue that the USA has high quality care for the majority, but according to this study we are 6 out of 7 here as well. For further discussion the linked article ends with the following opinion, "About the only good news for America,.... is that the new health law could put the U.S. on a path towards improvement," which sounds about right to me. As the ACA act will not be fully implemented for a few more years, comments on it will necessarily stay in the realm of opinion. I suspect opposite sides will rely on very different sources of expert opinion of its likely impact.
Thoughts?
Contradictory information?
Explanation of why affordable access to a full range of health care services in a country as rich as ours should not be considered a basic human right?
29 comments:
Let me take the last question first, but even before that let me say I come at this from a compassionate Christian viewpoint, well grounded in reality, and I take offense when someone knowingly says otherwise. Let's stick to facts, logic and opinions rather than imputing motivations to others.
The question of why health care is not a right is very simple. It cannot be. You exercise your right to free speech, for example, and my right to free speech, as well as all of my other civil rights, remains firmly intact and protected. Your right to a fair trial is no skin off my nose, either. But for you to get health care, some doctor must forgo their right to be paid for their services. They work for your benefit, and that is slavery, not your right. Just because the doctors are paid something (though less than they want), only says that these government programs are half-measures of slavery. The ACA reduces those payments and is therefore slavery-enhancing. Simple logic. Sorry.
J. Ewing
J,
It is probably better to steer clear from that last question, though thanks for taking a stab at it. I apologize for implying you lack compassion, as this really shouldn't be judged. In a world with thousands of kids dying from hunger each day, there's ceretainly much more I could do. I am a far cry from living up to my own values.
about ACA reducing payments to doctors, perhaps this is/ could be a good thing. I know I have had three different insurance companies and all have negotiated reduced fees for services, according to explanations of benefits I receive. I get most of my information on the ACA from Ezra Klein, who happens to have written on this recently, We’re having the wrong argument on health-care costs
I believe he is arguing that using the size and neg. power of govt to bring down costs/payments to doctors is a worthy goal. This could be done fairly by treating people less with better outcomes.
J,
It is probably better to steer clear from that last values related question, though thanks for taking a stab at it. I apologize for implying you lack compassion, as this really shouldn't be judged. In a world with thousands of kids dying from hunger each day, there's ceretainly much more I could do. I am a far cry from living up to my own values.
About ACA reducing payments to doctors, perhaps this is/ could be a good thing. I know I have had three different insurance companies and all have negotiated reduced fees for services, according to explanations of benefits I receive. I get most of my information on the ACA from Ezra Klein, who happens to have written on this recently, We’re having the wrong argument on health-care costs
Maybe the one of the goals of ACA
should be to reduce payments to doctors, in a fair way because they are providing fewer services with better health outcomes.
J,
It is probably better to steer clear from that last values related question, though thanks for taking a stab at it. I apologize for implying you lack compassion, as this really shouldn't be judged. In a world with thousands of kids dying from hunger each day, there's certainly much more I could do. I'm a far cry from living up to my own values.
about ACA reducing payments to doctors, perhaps this is/ could be a good thing. I know I have had three different insurance companies and all have negotiated reduced/discounted fees for services, according to explanations of benefits I receive. I get most of my information on the ACA from Ezra Klein, who happens to have written on this recently, We’re having the wrong argument on health-care costs
Sorry for not replying sooner, I am putting a garage door in the back of my third garage stall... The joys of being a 3 car/driver + multiple toys family...
As for this interesting discussion, it reminds me of a discussion I had with a very Conservative Christian person that I know very well. We were discussing what to do with Mexicans and Illegal Immigrants, and I said the best way to solve the problem is to improve things in Mexico so folks don't want to come to the USA.
I assumed this Christian person would agree that this would be the benevolant thing to do. I was somewhat surprised to hear them say that it would not work because of all of Mexico's corruption problems. This was then followed up by them stating their belief that "we can't save everyone".
Now is this person cruel and uncaring, or just being pragmatic?
Now let's take this concept to Africa. Should the developed world really work to save every life in Africa? Knowing full well that those countries and their citizens continue to stupidly fight/kill, and have not learned to slow their birth rate? (ie every sperm is sacred)
Where would the Earth be in 10 yrs if their death rate plummetted quickly and they did not slow their birth rate?
China had to implement some Draconian efforts to slow their growth rate and change their culture, I don't see that control improving in Africa and India.
Therefore death is the natural consequence of bearing more children than that family, group of people or region can afford to support. Just like when there are too many pheasants or deer in MN during a hard Winter, death comes and returns things to its sustainable level.
Should we really support a non-sustainable growth rate within a population or should we let natural consequences correct and teach? (ie God's will...)
Now how does that rambling comment relate to American Healthcare. In my opinion, Universal Healthcare and other Socialistic systems usually seek to protect people from the natural consequences of their decisions. (a very bad thing...)
There are many reasons why poor folk are poor, some is bad luck but many are because they made bad choices. Here is a partial list of some of those bad choices:
- had too many children
- drank too much
- smoked too much
- bought too much
- gambled too much
- broke laws
- too fussy about jobs/hours
- didn't learn enough
- didn't work hard enough
- didn't work enough hours
- didn't behave appropriately
Now what happens when we reward these folks by giving them Pay Checks and Free Healthcare Access?
Don't we remove the natural consequence that they have brought upon themselves?
Don't we encourage more people to take up that lifestyle? (ie more takers and fewer providers)
How long before the providers can not support the takers?
Unfortunately, since free loaders are a natural part of every group, team and society. There have to be some severe consequences in place to force them to contribute, learn and improve, otherwise they will not...
The the cruel reality is that "We can not save everyone, especially those that do not want to work for it".
By the way, I have poor friends and family members and they have had no problem getting access. And when it was bad enough, they took on boat loads of debt and then declared bankruptcy. So as I made a point on MN Publius the other day, everyone has access and we already pay for this via our insurance premiums... Why would we want the government involved and making sure the consequences are further reduced?
This may be why our costs are higher... However, I think it is because we put too much money into trying to save people that they would just let die. Doesn't cost too much to give them $50,000 and say that they should enjoy their last 3 mths. Whereas we would spend a $1,000,000 to get them 4 mths...
I forgot to mention that you are correct that the truly Unlucky may get screwed by this philosophy of natural consequences.
To this I say: I guess no system is perfect and maybe it is God's Will... (ie just had to throw that in)
Whereas J would say this is where the "real/non-govt charities" come in to help them all. If someone asks, they will try to help.
I'm a bit more pragmatic, life is a lot about luck. And it does suck to be unlucky. All I can do is give to charities often, help the folks I know that are facing challenges and remember to be very very thankful for my great luck so far. I will simply never support Socialistic programs because though they may help/save some, they come with too many negative consequences that could simk the USA. I thus accept that some will not be saved, and sincerely thank them for their scarifice.
Laurie,
Hopefully that helps you understand why I am happy that people have to work hard to get ahead and obtain proper medical care. If we scored number one on all of those measures, I would be truly worried.
Anything that is simple to attain, is soon taken for granted and abused. One truly appreciates and cares for that which has to be worked for.
John,
Thanks for the responses. You sure don't shy away from that values part of my question. Makes me tempted to quote scripture (Matthew 25:31-46) and I left the Lutheran church of my childhood over thirty years ago. Right now I am off to my Unitarian church where last night I joined a discussion on economic justice and tonight's topic will be on Keith Ellison's recent speech on inclusion. The values part of the issue is interesting, if very unlikely to lead to agreement or even much understanding. Though I plan to reread and contemplate later.
I'm surprised to have gotten no disagreement yet to my "fact" that American healthcare system is not only much more costly, but also inferior to many other countries' health care systems.
John,
about the high cost of care, I think my dad cost Medicare near $1,000,000 in his final 9 months. While he was hospitalized we always hoped for the best, but if he had been able to look into a crystal ball I'm not sure my parents would have chosen all the treatments. I think end of life care is going to be rationed more in the future. I hope there will be a better plan than doing it strictly by wealth.
about your radical advocacy for the elimination of the health care safety net, there is something in your explanation that makes a tiny bit of sense to me. The cognitive dissonance bothers, me sort of like a loose tooth that I can't quite let alone. It doesn' fit at all with my long held value of universal health cate that is reinforced by my church and liberal blog reading.
That seems to describe me... Loose tooth, festering sore, chronic pain, etc... (haha) I'll try to cover the safety nets vs self reliance topic more in future posts.
By the way, here is a paradigm for you to consider. Which is more correct?
"John's radical advocacy for the elimination of the health care safety net" or "Laurie's radical advocacy for massive growth in the health care safety net."
My point: I thought the safety net was adequate a couple of years back, and have suggested no changes. The Progressives like yourself seem to be the one demanding change. Interesting....
By the way, sorry to hear about your Father.
I think his example explains why many still think the American healthcare system is the best system in the world, though your posted links would say otherwise. It is truly a difference in criteria, weighting and scoring... This is why it is hard to find one set of data that we all support.
Him and his Doctor's were free to pursue extensive and expensive care. Whereas the belief is that this freedom is limited in other countries. And you know how us Americans like our Freedoms.
Now is one $1,000,000 extensive treatment worth doing at the loss of 5,000 well checks? (ie $1,000,000/$200) I suppose that depends if you are the one needing the $1,000,000 treatment to stay alive...
"I'm surprised to have gotten no disagreement yet to my "fact" that American healthcare system is not only much more costly, but also inferior to many other countries' health care systems." -- Laurie
Sorry, but sometimes real life intrudes upon this cyber world. I kept trying to compose a short response to your request for facts, not wanting to span several posts with it as John did. I see two approaches, and I'll try to be brief with both.
The first is the notion that the US spends the most and gets the least. I acknowledge the fact that the US spends the most, but if the four strategies of the Mayo study were followed, all of which essentially move government out of the healthcare "business," our costs would be pretty much in line with the other developed countries. It is also true that our life expectancy and infant mortality are not as good as countries with more socialized medical care, but most of this is covered in a book called "How to Lie with Statistics." Some nations do not count as infant mortality those children who die before the age of seven days past normal gestation. The US counts every infant born alive, no matter how premature. On the other end of life, we have to acknowledge that we have a very diverse population, many of which make poor decisions about their health, like using illegal drugs or getting themselves shot in gang wars, or dying in tragic traffic accidents. None of these things have to do with the quality of our medical care nor, more importantly, with who pays for it. I will point out to you that 100% of people on Medicare die. Obviously, if we eliminated Medicare, these people would live forever. Okay, perhaps I am being a bit facetious.
I am not so much concerned about the set of "facts" you use as I am about your conclusion from them, namely that the ACA is going to solve anything. It's just not logical in light of what I know to be true. Start with the notion that providing insurance to the "47 million uninsured" is going to suddenly result in their having healthcare, and at lower cost to all of us. since there will be not one doctor more as a result of ACA,the law of supply and demand says that costs will go UP, and since as many as 30% of doctors, in surveys, say they will leave the profession rather than accept the ridiculously low payments promised under the ACA, supply will go down even further. Having health insurance doesn't mean you can get health care.
Of course, that is not really going to be much of a problem because of the 47 million uninsured there are 52 million who are illegal aliens, already eligible for Medicaid but don't take it, those who can afford it but don't buy it, or who are only temporarily uninsured (i.e. unemployed). And every one of them can, by current law, be treated for any condition in the emergency room.
We are already seeing that it does not work. The additional mandated coverage is driving insurance premiums UP. The reductions in payment schedules have many doctors refusing to accept new Medicaid and Medicare patients. Far from making healthcare MORE available, the ACA is making it LESS available. Government cost controls lead to rationing, reduced availability and quality, or to costs going up in ways that aren't controlled. Congress can never repeal the Law of Supply and Demand (nor the Law of Unintended Consequences) no matter how often they try. The ACA is simply far-left good intentions run amok, in a brutal victory over good common sense.
J. Ewing
J,
Please, Please, Please provide a couple of sources for your numbers... Just copy and paste 2 web addresses in and you will help me to have an excellent day... Thanks
LTN 2 plus 3
LTN Follow the Logic
LTN Total is Whoops
LTN Stating the Obvious
No source requested for philosophical discussion, only if you imply it is a FACT...
I agree with whoever had trouble submitting a comment (J?) This happens to me so frequently on this blog I usually copy before I hit publish. In this case you will be spared my usual long winded thoughts and instead get a shorter paraphrase.
about what view is radical, I would argue this statement is:
(though John seems to have retracted a bit with his additional comments)
"I will simply never support Socialistic programs because though they may help/save some, they come with too many negative consequences that could simk the USA. I thus accept that some will not be saved, and sincerely thank them for their scarifice."
from it one can reasonably infer support for only private insurance (employer based or purchased on the indiviual market.) Without Medicare and Medicaid the ranks or the unisured would grow tremendously.
Universal health care, on the other hand, is not radical at all. Other developed countries provide it and expanding coverage here would not require massive growth. The ACA reduced the number of uninsured from 50 million people or 15% to 20 million or ~6% and a way was found to pay for it. Those remaining without health insurance could be brought more fully into the system at a reasonable cost. As I think John said we are all paying something already for the care of the uninsured (#'s not 100% accurate as they are off the top of my head)
about facts related to the the overall quality of our health care system, I don't have time to study the details today. I have paperwork to complete and there's Obama's speech to listen to and blog analysis to read)
I anticipate that the biggest disagreement will relate to whether people in countries with "socialize medicine" receive as high quality care as do Americans who have insurance. There seems to be some agreement already that our health care is high cost. I imagine there will be some disagreement as well re access and quality of care for the uninsured. I have not yet carefully read my own link with which I started this topic. I am open to its arguemnet that more tests and treatments (more typical of American care) does not automaticlaly lead to better outcomes.
well, I promised a brief commentary and it seems I just can't do it. I will keep trying though.
From Laurie
I agree with whoever had trouble submitting a comment (J?) This happens to me so frequently on this blog I usually copy before I hit publish. In this case you will be spared my usual long winded thoughts and instead get a shorter paraphrase.
About what view is radical, I would argue this statement is:
(though John seems to have retracted a bit with his additional comments)
"I will simply never support Socialistic programs because though they may help/save some, they come with too many negative consequences that could sink the USA. I thus accept that some will not be saved, and sincerely thank them for their scarifice."
From it one can reasonably infer support for only private insurance (employer based or purchased on the indiviual market.) Without Medicare and Medicaid the ranks or the unisured would grow tremendously.
Universal health care, on the other hand, is not radical at all. Other developed countries provide it and expanding coverage here would not require massive growth. The ACA reduced the number of uninsured from 50 million people or 15% to 20 million or ~6% and a way was found to pay for it. Those remaining without health insurance could be brought more fully into the system at a reasonable cost. As I think John said we are all paying something already for the care of the uninsured (#'s not 100% accurate as they are off the top of my head)
About facts related to the overall quality of our health care system, I don't have time to study the details today. I have paperwork to complete and there's Obama's speech to listen to and blog analysis to read.
I anticipate that the biggest disagreement will relate to whether people in countries with "socialize medicine" receive as high quality care as do Americans who have insurance. There seems to be some agreement already that our health care is high cost. I imagine there will be some disagreement as well re access and quality of care for the uninsured. I have not yet carefully read my own link with which I started this topic. I am open to its argument that more tests and treatments (more typical of American care) does not automaticlaly lead to better outcomes.
Well, I promised a brief commentary and it seems I just can't do it. I will keep trying though.
I am not terribly supportive of our Socialistic systems, but I am in no hurry to dismantle them. I just think they are more than adequate. And they are likely creating more freeloaders, and encouraging more citizens to make BAD decisions than are preferred.
Of course Universal Healthcare is radical... At least to the Conservative half of Americans. They see it slipping over to the dark side... (ie Socialism) You have got to read some Ayn Rand...
"The problem with socialism is that, sooner or later, you run out of somebody else's money." Dame Thatcher.
I don't understand how people can look around and observe that American free-market capitalism has given us "the greatest good for the greatest number" in every are of economic activity, and then think that the same cannot possibly be true of health care or education. I've SEEN it work, in both areas. I guess I'm inclined not to believe the socialists who say it doesn't, and instead believe my own lyin' eyes.
J. Ewing
"Without Medicare and Medicaid the ranks or the unisured would grow tremendously." -- Laurie
Actually, according to one of my (required, apparently) reference links, the number of uninsured is currently zero, so you are no doubt correct. However, without Medicare and Medicaid, the cost of health insurance would be half or less of what it currently is, to where more Medicaid-eligible people could afford to buy private insurance, and Medicare recipients could buy insurance for what they now pay, especially if you consider their lifetime payments to the "trust fund."
J. Ewing
"I am open to its argument that more tests and treatments (more typical of American care) does not automaticlaly lead to better outcomes." -- Laurie
But it is Medicare and Medicaid (and defensive medicine), the principal drivers of health care costs in this country, which CAUSE these unnecessary tests. Explanation on request.
J. Ewing
Thanks for the thoughts and links related to our health care system.
What I have learned so far is that I may be quite close minded on this topic, as I have low motivation to read them. I will get to them this weekend and will be surprised if they change my views much.
Not surprisingly, opinions of the likely impact of the ACA vary greatly I will very likely continue to get most of my facts and analysis from Ezra Klein, who writes frequently and favorably of the ACA, linking to a variety of his own expert sources. Today he talks about the cost saving potential of The high-deductible plans in the Affordable Care Act and links to this brief article by the Kaiser Family Foundation What Conservatives Won In Health Reform (And Don’t Seem to Know It.)
I am curious to follow a link that claims the number of uninsured is zero. This differs more than slightly from the 50 million uninsured people counted by the Census Bureau USA Today
Not sure you will be satisfied, though I could be wrong, just getting your opinions from one-sided sources (even mine). At some point I've always found that you have to think the thing through for yourself, and compare what is claimed for the thing with what it does or is likely to do. On that score we already know enough about the ACA to say it is a miserable failure and cannot possibly do what is claimed for it. Details on request.
J. Ewing
J,
Health care policy is complex so I guess we all have to pick our sources of information and our experts. I do base my opinions on my experience. I have been unemployed and uninsured in the past, as have my kids (junk, high deductable insurance in their case.) My concerns about health care are access, cost and quality, in that order. (I do take the high quality for granted.)
Okay, I'll bite, about this:
"we already know enough about the ACA to say it is a miserable failure and cannot possibly do what is claimed for it"
How can this be when it won't be fully implemented for several yrs?
And how can one argue about the provisions that have already taken effect, such as ending rescissions and no discrimination against kids with preexisting conditions?
Finally, perhaps I missed it, but where is the evidence that you are more open minded on this topic than me? What opinions of yours have changed?
I don't believe I said I was more open-minded than anybody. It would have been a conceit if I had, because I have a mind like a steel trap-- firmly shut once triggered with what I consider enough information. I can change my mind if you can persuade me I'm wrong, but it doesn't happen very often. I'm also getting to where I can understand how people come to different conclusions.
I'll try to provide the "evidence" requested in the next few days.
J. Ewing
J,
Thanks for your ongoing participation in my experiment, can people of basically opposite viewpoints agree on facts. How it looks to me is not much. We do seem to agree that American healthcare is comparitively costly, and perhaps agree that other countries offer greater access (universal coverage.) I have learned (and I am sure you disagree) that that other countries are also superior in quality (though I personally have no complaints about the quality of care my family has received.)
When it comes to fact based analysis of the ACA, there seems to be huge differences on all aspects. I did follow your links and was slightly amused to see that they were to more of your own comments. Perhaps you have credentials/ experience as an expert, I know nothing about you beyond a blog name. As I've mentioned I rely on people with letters behind their names who work for think tanks and universities etc. I did pop over to Cato Institute and Heritage Foundation sites and saw they have experts quoting fact based opinions on how terrible the ACA act will be.
If my job was working as a health care policy analyist or reporter, I might read competing white papers to compare claims. Instead I am going to go with our health care system was clearly in need of major reform (due to cost, access, and quality) and the ACA is the result of over a years efforts in congress (make that 20 or 40 years if we go back to Clinton or Nixon administrations.) The ACA is surely not perfect, but needs to be given a chance and improved as we go forward.
I did especially relate this recent comment you made:
"I have a mind like a steel trap-- firmly shut once triggered with what I consider enough information. I can change my mind if you can persuade me I'm wrong, but it doesn't happen very often. I'm also getting to where I can understand how people come to different conclusions."
I am finding I can make small adjustments in my thinking with a bit of conscious effort.
Laurie, you asked for evidence that the ACA is not all that was promised. Let me try to address that. In no particular order:
We were promised that "if you like your health insurance you can keep it." So far, the Obama administration has granted over 1000 waivers for companies, unions, and even the whole state of Maine who would have dropped health coverage for their employees without the waiver. Other companies have already dropped coverage, and health insurance premiums have gone up in many places, pricing some people out of health insurance.
We were promised that prices would drop, but as noted prices have only gone up in response to the additional federal mandates on what constitutes "basic" coverage. For example, a 64-year-old never-married man could be required to buy coverage for pregnancy and mammograms.
We were promised that children could remain on their parents policies until age 26. This has caused some insurers to simply quit offering child-only policies. Far from being universal coverage, Obamacare is already causing FEWER people to have health insurance coverage, and remember that having health insurance does not guarantee you health CARE.
At least one third of all doctors have said, in surveys, that they will leave the profession rather than practice under the patient-harming constraints of the ACA. Other doctors and providers continue the trend of not accepting Medicaid or Medicare patients because of the low reimbursement rates. Those rates would have been even lower, and MORE people would have lost their access to health care, had Congress not passed the separate $500 million "doc fix" that restored Medicare payment rates to what they had been before the ACA cut them.
And of course we were promised that the ACA would reduce the deficit, but just passing the "doc fix" means that the ACA adds some $500 billion to the deficit, and the more accurate accounting suggests that the real cost approaches $2 trillion over the first 10 years of the program, and that ignore secondary effects like having doctors leave the system and insurers dramatically raising rates to compensate for all of the mandates. Even at the most fundamental level, we ought to recognize that it is impossible to give health care to 47 million more people and spend less than we do now, in total.
of course, Obamacare will make an effort to control costs, and we have already seen how that will be done. The administration has already decided that some women under the age of 50, even with a family history of breast cancer, do not need mammograms, or at least that the government won't pay for them. The government has also decided that it won't pay for expensive breast cancer treatments, either, therefore offering an incentive for pharmaceutical companies to never develop such drugs. It is a great way to reduce costs, and so what if thousands of women die? Is what socialized medicine gets you. In one week, in Canada, I contributed to two private fundraisers so that Canadians could be sent to US for healthcare that the Canadian system denied them. That is not "better" by any stretch of my imagination.
There is obviously a great deal of interplay between these various failure modes, but the overarching one is that socialized medicine is only better than no medicine at all and that it has no place in a free economy, where competition provides the greatest good for the greatest number. Even now, before the ACA, 86% of us were happy with our healthcare. Why would we screw that up trying to make the other 14% happy?
J. Ewing
J,
Thanks for taking the time for writing the lengthy critique of the ACA. This "fact" (among many) doesn't sound believable to me:
"At least one third of all doctors have said, in surveys, that they will leave the profession rather than practice under the patient-harming constraints of the ACA,"
The AMA had this on their website:
"The Affordable Care Act* (ACA) is a comprehensive health system reform law that will increase health insurance coverage substantially for the uninsured and implement long overdue reforms to the health insurance market. The new law includes many major provisions that are consistent with AMA policy and hold the potential for a stronger, better performing health care system. While the new law represents a tremendous step forward on the path toward meaningful health system reform, it is not the last step, but rather the beginning."
It seems to me the AMA position on the ACA would be fairly representative of most doctors opinion. You never have said what sources you rely on for health care information.
Does your strong negative opinion of socialized medicine apply to being a Medicare recipient at some time. The past few days I have been reading how poorly the Ryan plan of vouchers for seniors to get private health care insurance will work, as the plans will be very costly or nonexistant.
For the number of doctors who will quit practicing under Obamacare, I rely upon established polling firms like Gallup. I'm sure you can Google one up.
I have long found it strange that the AMA does NOT seem to represent the views of doctors any better than the AARP represents the views of seniors. Both organizations seem to have bought into the notion that the promises of Obamacare are in fact realizable in the real world in which their members live, despite the simple common sense knowledge that it cannot. I suspect it is similar to the support offered by the insurance industry, anticipating huge new profits because of the individual mandate requirement, or the AARP support, based on the elimination of "Medicare Advantage," a private insurance competitor to AARP's Medicare supplemental insurance product.
my strong negative opinion of socialized medicine is informed from study, from simple logic, and from experience. You can perhaps understand my deep anger towards Obama demanding that the ACA eliminate annual and lifetime payment caps from private insurance, if you know that my own father died when he hit the lifetime Medicare cap. I could have readily accepted such a limit except that, when the family offered to pay the remaining bills rather than let him die, we were refused, because Medicare doesn't "allow" that! if Obama had eliminated the lifetime cap on Medicare before demanding it of private insurance, Dad would not have to have died so soon.
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