Sunday, May 7, 2017

AHCA is Inadequate

Jerry and I have been going at it regarding ACA, AHCA, pre-ACA and Medicare. Then I saw this piece's Title and just had to start laughing... I mean the irony that the Left thinks AHCA is inadequate for one set of reasons and the Conservatives think it is inadequate for a totally different set of reasons is humorous... Well at least for me it is. :-)

CNN Kasich Says AHCA is Inadequate
TP AHCA is Inadequate
Kaiser Health News

I especially like this title...
How A Bill That Nearly All Opposed Managed To Pass The House

MP AHCA Links for my convenience. Even though my latest comments have not been showing up...
MP AHCA - Eric
MP AHCA - Sam

24 comments:

jerrye92002 said...

Too bad there isn't coverage for dyslexia in the AHCA. Though perhaps in the ACHA there is....

My take is that it is inadequate because ACA should have been repealed as it was passed, as one great, "comprehensive" disaster-waiting-to-happen. Once that was done, the temptation to "fix" the unfixable would be passed, and true health care reform could move forward. Kasich was concerned about the transition, and rightly so, but the first rule of medicine is to stop the bleeding.

Anonymous said...

The reason we don't have universal health care is not because it's not needed, it's because we can't agree on what it should be. That, to me, is powerful argument for fixing Obamacare rather than starting over.

Republicans are in a tough spot. Obamcare is essentially a Republican program, and the standards they have repeatedly set for it, are standards any Republican program would find hard to meet. Under Trump Care, can you keep your current policy? No. Under Trump Care will you be able to keep your doctor? No. Under Trump Care, will your premiums stay the same? No. Under Trump Care, will you have more than one insurance company to choose from? Not necessarily. These are the answers you get when you are in favor of a free market system with respect to health care. I have never been quite sure of what the advantages are, I am sure there will be some, but I will leave that to others to explain.

Donald Trump is an old man, and he tires easily. When he is, he tends to let his guard down. As a businessman he is intensely aware of things like efficiency and economy of scale. When that happens, he starts talking about single payer, and the wonders of the Austrailian health care system. I think it's entertaining how nervous that makes Republicans.

--Hiram

Anonymous said...

As a Democrat, one of the most embarrassing things about the politics of Obamacare is the claim that we made, that you will be able to keep your policy. When you think about it, that claim is remarkably outlandish. How could we possibly make such a guarantee about something as complex and unsure as health insurance policy? In fairness to my Republican friends, it isn't a claim that would dream of making for any iteration of any of their health care proposals. It's something they were absolutely right about, and that we were absolutely wrong about. How did we get it so wrong?

I blame intellectual laziness. We thought we solved this problem when we grandfathered in existing health care plans. Existing plans under Obamacare were not subject to the assorted regulatory requirements, for the most part. Policy holders could keep those non conforming plans. What we overlooked was that the insurance companies themselves would cancel those plans, and that this would be seen, not unfairly, as a failure to keep our promise. We blew that one. What I would say is that our failure to keep this promise didn't make things worse. There has never been a guarantee that your current policy would exist indefinitely into the future. That would be an impossible promise to keep, and it's one Republicans never make. In an Obamacare environment, the fact that poor policies go away, isn't a bad thing; it in fact represents an inevitable market response to the fact that they weren't competitive, either for insurance companies to offer or consumers to buy. But those arguments are difficult to explain, and we made no effort to explain them, and so we lost the argument. Oh well.

--Hiram

John said...

Jerry,
Thank you for the ACHA / AHCA correction. I think I got them all fixed.

John said...

Healthcare in Australia

Sanders Supports Trump regarding Australia has a better system

VOX Australia System

jerrye92002 said...

Here is a question: IF everybody can either buy an insurance policy, have one through their employer, or go on Medicaid or Medicare, isn't that "universal health coverage"? What difference does it make if it is a public-private "partnership" like Australia's rather than an entirely government-run system like Sanders wants?

Anonymous said...

IF everybody can either buy an insurance policy, have one through their employer, or go on Medicaid or Medicare, isn't that "universal health coverage"?

No. If people don't have health coverage, health coverage isn't universal.

"What difference does it make if it is a public-private "partnership" like Australia's rather than an entirely government-run system like Sanders wants?"

There are a lot of differences between public and private insurance. Private insurance must show a profit. Private insurance is accountable to it's shareholders, not to taxpayers. While I am not a big fan of private insurance participation, there are many ways to improve the way private participation contributes to universal coverage.

--Hiram

John said...

Wiki Universal Healthcare

jerrye92002 said...

According to the definition, UHC is when everybody "has access to" health care. I claim everybody has access to it now, and did before Obamacare. That many chose not to avail themselves of the insurance side of it (Medicaid, employer or a low-cost policy of their own), and that 6.5 million people even now refuse to do so, does not mean they do not have the opportunity. The biggest problem with UHC is what happens when government starts giving away free stuff.

Anonymous said...

UHC is when everybody "has access to" health care

That's the pertinent quibble. Republicans want to argue people have health care if they have access to health care. Sort of like saying one owns a Mercedes just as long as they don't throw you out of the showroom.

That many chose not to avail themselves of the insurance side of it (Medicaid, employer or a low-cost policy of their own), and that 6.5 million people even now refuse to do so

But then people did. The numbers of uninsured went way down. And according to the OMB, if the Republican "access" quibble is enacted, the number of uninsured will go up by 24 million.

What's driving the Republicans linquistic exercise, isn't a love for language it turns out. Rather their it's the fact that their quibble will save roughly a trillion dollars, which they will proceed to distribute to their wealthy (and health insured) contributors. Words matter of course, but who knew their price tag was so high?

--Hiram

Anonymous said...

Republican use of language is fascinating. They are at their cleverest and at their most intricate when they affect folksiness. Republicans like to use broken sentences, sentences that seem to be missing or misusing important words creating ambiguity. This isn't accidental, it's quite intentional. The missing words are usually the ones that are controversial.

--Hiram

Anonymous said...

Here is a discussion of what I am talking about:

https://www.washingtonpost.com/news/fact-checker/wp/2017/05/08/decoding-hhs-secretary-prices-spin-on-the-american-health-care-act/?utm_term=.9ffdb1850de4

it's interesting to me that there are people, pixel stained wretches I think of them as, who construct such incrate sentences, so carefully designed to combine truthfulness with deception. The truth is pretty obvious. Under the Republican plan, spending won't keep pace with the need for care, and so we have to find people to exclude. People who are unhealthy, maybe or who can't afford lobbyists. Why not just say it?

--Hiram

John said...

WP Decoding HHS Secretary

John said...

Choices, Choices... Food, Rent, Health Insurance, House Payment, Utilities, Kid's activities, car payment, other... What is a low income person to do?

"That many chose not to avail themselves of the insurance side of it (Medicaid, employer or a low-cost policy of their own)), and that 6.5 million people even now refuse to do so, does not mean they do not have the opportunity."

I sure am happy that I actually have disposable cash with which to make choices with... Or well... That I did until I had 2 kids go off to college... :-)

jerrye92002 said...

Of course you are happy. You should also be very happy that government allows you to make those choices. Imagine if there was a government mandate that you HAD to buy a health insurance policy, and that it had to include a lot of things that you did not need or want, and couldn't afford? Oh, wait...

jerrye92002 said...

Here's another tidbit, if I remember correctly: 70% of people covered under the ACA were actually people who were eligible for Medicaid, but did not choose to get it. We had "universal" health care and people did not take it. What do you want to do, force them to take it? That was Hillarycare, by the way.

John said...

Jerry,
Maybe you should research some before writing. KFF ACA and Medicaid

As for choice, I had a good full featured insurance policy so ACA did not impact me significantly. Just some premium increases to cover kids to 26 and to cover those with pre-existing conditions...

Anonymous said...

What is a low income person to do?

One logical choice is not to buy health insurance because, as Republicans take ever opportunity to point out, health insurance is different from health care. They know they will receive health care anyway so why not let someone else pay for it? Why not let it be free?

Republicans, and indeed all of us, now that given the chance, people will pay for their health insurance. We know that because the number of uninsured has gone down under Obamacare. We also know because Republican show guilty knowledge by running away from facts. That was why, despite their years of complaints about how Obamacare was enacted, they were under such immnse political pressure from their leaders to pass their bill before the CBO scoring. Facts can be frightening things.

--Hiram

jerrye92002 said...

I did the research years ago, and your cite seems to confirm it. The SMALL reduction in the number of uninsured was largely due to people signing up for Medicaid. The other number I am not going to look up for you is that, of the 11 million "newly insured" under the ACA, only about 1 million are truly new. The rest were those already (or newly) eligible for Medicaid, and those who LOST their insurance because of the ACA.

And look at what you wrote: "As for choice, I had a good full featured insurance policy so ACA did not impact me significantly. Just some premium increases to cover kids to 26 and to cover those with pre-existing conditions..." So, if you liked your plan (just as it was), you got to keep it? And your costs went down $2500/year? Was it your choice to pay more? How is that silk purse looking?

John said...

Jerry look at that source again... Most of the new medicare policies were due to expansion...

As for slightly higher premiums... I got more value, so that is fine. (ie insurance for kids until 26 and assurance that I can always get reasonable insurance premiums in the future. (ie pre-existing condition rules and 3X time rule for older people)

As for "choice to pay more", as consumers we have little choice... Other than to buy no frills plans that may burn one later... Like many things in life, one gets what they pay for.

Anonymous said...

Congressman Paulsen in his op ed this morning seems to suggest that under the bill he voted for, premiums will be reduced, insurance contracts will be irrevocable, and once in, insurance companies will not be able to leave the market. Apparently, Erik has become a Democrat, and I somehow missed the email.

--Hiram

jerrye92002 said...

"I got more value, so that is fine." Oh, so the administrators of that ACA-compliant plan offered you the option for a "higher value plan" and you voluntarily took it? At least when my company offered an alternate, much cheaper plan (with equivalent benefits), I still had the option of the more expensive one.

John said...

I have the choice of ~5 variations...

John said...

Paulsen Op Ed