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Letters to the Editor

Be selective

January 11, 2011

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To the editor:

The House Republicans don’t like some parts of the Affordable (health) Care Act (ACA), so they’re trying to repeal all of it, all at once. Well and good. Elections have consequences.

However some overwhelmingly popular parts of the ACA are already in effect. Here are just a few of the new rules for insurance companies:

• no pre-existing condition exclusions for children

• must-insure rules for family members up to age 26

• no lifetime caps on benefits

• must spend at least 80 percent or 85 percent of your money on benefits on average or else give you a refund.

The ACA is already addressing some other issues as well, such as:

• There’s a new tax credit for small businesses.

• The “doughnut hole” in Medicare prescription coverage is being phased out.

• The new Elder Justice Act is being phased in to prevent abuse of the elderly, e.g. in nursing homes.

The Republicans want to make this all go away. Instead they should do the hard work to decide exactly which parts of the ACA they do and don’t like, and just repeal the bad parts.

By voting it all down at once, they’re telling us they want to go back to the bad old days. That’s good for insurance companies that invested heavily in their election. It’s bad for the rest of us.

Comments

cato_the_elder 3 years, 11 months ago

Actually, many Republicans supported a good deal of what the letter writer supports. If Obama and the Democrats had been interested in compromise and had not shut Republicans out of the process, much of this could have been enacted. However, that wasn't what the Dems wanted on their planned road toward government-run, single-payer national health insurance, of which Obamacare is Step One. That's why Republicans want to start over and enact a more sensible, affordable approach.

jafs 3 years, 11 months ago

Without the mandate, though, costs would undoubtedly skyrocket if one enacted the above provisions.

I'm not saying I think it's a good bill, just pointing out if you don't have the mandate, you don't have any mechanism that helps keep costs reasonable.

cato_the_elder 3 years, 11 months ago

The mandate was needed to drive what Obama wanted, but isn't necessary for a more modest bipartisan solution that Republicans and some Democrats could support.

jafs 3 years, 11 months ago

If they included the proposals in the lte, then costs would rise drastically without expanding the risk pool, which is what the mandate does.

cato_the_elder 3 years, 11 months ago

I didn't say that all of the proposals would fly, but many Republicans would have supported, by way of example only, banning exclusions for pre-existing conditions, allowing companies to compete across state lines, and correcting the donut hole oversight. The reason Obama needs the mandate is that instead of improving what we already have, his goal is one of wholesale lobotomization designed ultimately to drive private insurers out of business and force everyone, especially employers, into government-run health care straitjackets.

mbulicz 3 years, 11 months ago

We pay more than the rest of the world for our health care, and receive worse quality care than about half of the world. I don't know what this "affordable health care" is you're talking about, but the 55 million uninsured Americans and 700,000 who went bankrupt in 2009 from healthcare related expenses sure would love to know. Especially the nearly 400,000 of those bankrupt homes who carried major medical insurance.

We have never had good, affordable health care. The status quo just means your insurer determines whether they can treat your condition while keeping their executive retreat in the Hamptons. If there ever was a "death panel", well, this is it.

One can actually disapprove Obamacare AND the status quo, you know. There's no dichotomy that says there is a better system than both of these things. Dismantling Obamacare just leaves us with our overpriced, underinsured, ineffective health care system that we started with in 2008.

mbulicz 3 years, 11 months ago

Neocon attack 101:

1) Reject above point 2) Insert irrelevant board term (socialism, propaganda, 9/11) 3) Ramble long enough to distract from zero supporting evidence in counterargument 4) Re-assert that rebuttal's burden of proof is, in fact, on the original commenter 5) Revise until smarmy

notajayhawk 3 years, 11 months ago

"We pay more than the rest of the world for our health care, and receive worse quality care than about half of the world."

Just keep buying thew propaganda like a good little sheep.

There is no objective measure of health care system outcomes. The whole line of BS that we "receive worse quality care than about half of the world" is a fallacy. But don't let little things like facts interrupt your fantasies.

mbulicz 3 years, 11 months ago

Neocon attack 101:

1) Reject above point 2) Insert irrelevant board term (socialism, propaganda, 9/11) 3) Ramble long enough to distract from zero supporting evidence in counterargument 4) Re-assert that rebuttal's burden of proof is, in fact, on the original commenter 5) Revise until smarmy

notajayhawk 3 years, 11 months ago

Well, let's see:

Didn't mention socialism or 9/11 - and the BS you posted about how we "receive worse quality care than about half of the world" IS, in fact, propaganda. Sorry if you can't handle that.

As far as rambling: Well, my post was shorter than yours. 'Nuf said.

I didn't imply or say the burden of proof was on you. Sorry if you're feeling inadequate. It would be amusing to see what you would come up with for proof of your baseless claims, though. (Let me guess: Infant mortality rates, right?)

Liberal weaseling 101: If you can't defend your post, attack the criticism (without, of course, backing up the original claim).

Just

frikkin'

brilliant.

lucky_guy 3 years, 11 months ago

Again, when was it ever affordable? The 1950's maybe but then the life expectancy was 64 not 78. Is that what you are longing for?

just_another_bozo_on_this_bus 3 years, 11 months ago

We spend as much as twice as much on healthcare as other developed democracies, but don't get any better healthcare for all that extra money. That's what's meant by "affordable."

funkdog1 3 years, 11 months ago

No, health care was affordable before the private insurance industry took over. That's really basic knowledge.

just_another_bozo_on_this_bus 3 years, 11 months ago

The major reason laptops are so inexpensive is that they are almost all manufactured by cheap labor in third-world countries under conditions which few Americans would tolerate-- not even hardcore libertarians.

But healthcare can't be exported the same way manufacturing jobs can. And even if it could, the surge of unemployed healthcare workers would just contribute to the race to the bottom that global capitalism has created.

scott3460 3 years, 11 months ago

Is it government that restricts, or the AMA?

Doctors, it seems to me, produce and protect their monopolies.

SnakeFist 3 years, 11 months ago

Laptops and healthcare are two very different things. If laptops cost more than I want to spend, I can delay buying one until prices drop. If heart surgery costs more than I want to spend, I can't delay having it until prices drop or quality improves. The free market system simply doesn't work for all goods and services.

I also assume that, by free market, you want to eliminate ALL government regulation and let profit-maximization guide healthcare provider decisions. A great deal of regulation was a reaction to provider abuses under "freer" markets.

funkdog1 3 years, 11 months ago

Right. the market also becomes flooded with laptops which brings the price down. But people will ALWAYS need health care.

just_another_bozo_on_this_bus 3 years, 11 months ago

"It was a reaction to the problems created by previous manipulations of the market."

True. But most of the time the manipulation isn't by government, but rather by one of the market participants. You know, one of the self-described capitalists who would really like to get government out of his business. But he'll also do whatever is necessary to maintain his ability to manipulate government for his own narrow interests, in addition manipulation of the markets.

mbulicz 3 years, 11 months ago

"Health care was affordable before the government started controlling it. Ever since then, prices have gone up faster than the rate of inflation. "

And, like all good critical thinkers, you assert that correlation must equal causation.

madameX 3 years, 11 months ago

I'm aware of this, but if they wanted to drive that point home they probably should have marketed their big "vote to reapeal the healthcare bill" differently. If people don't know that their intent is to only repeal some parts of the bill and leave others it's their own damn fault for, you know, crowing about how they were going to repeal it.

just_another_bozo_on_this_bus 3 years, 11 months ago

The Republicans didn't do anything but distort the debate on healthcare with scare tactics, both during its passage in the last session and in the last election.

They offered no solutions then, and they offer none now. Big Health couldn't care less which way it goes. From their perspective, Obamacare is better than real reforms that would actually fix anything, so they can live with it. And returning the old status quo, which is what Republicans propose, would be even better for them, and even worse for the majority of Americans. But it would ensure generous campaign contributions for Republicans. (and certain Democrats, as well.)

purplesage 3 years, 11 months ago

Remember the days when insurance was insurance and not an alternative, preferred payor system? People bought it like they buy car insurance - in case of damage or liability. What we have is a system, that if moved to auto insurance, would artificially jackup the price of gasoline and oil (OK, maybe not the best analogy), double the price of tires, etc. and then call it insurance when those who could afford criminally expensive premiums could get a discount of 50% or so on the stated price.

Just about anything that can be financed over time or insured is artificially high priced. Real insurance, to protect us from calamities, might help moderate the ridiculous prices charged by anything medical. If no one could pay, the prices would have to come down. The current system, before, and especially after "reform" is just plain nuts.

notajayhawk 3 years, 11 months ago

That would be a good start. There's no reason why people can't budget for and pay out-of-pocket for the day-to-day, routine costs of medical care (like the annual checkups and that trip to the doctor when you have the sniffles). That would both make insurance more affordable (if it was major-medical only), and help drive down the cost of routine care through market forces.

madameX 3 years, 11 months ago

Actually, there is a reason for that, but it's wrapped into the problems with health insurance. It can be difficult to budget for routine visits to the doctor because it can be effin' impossible to find out how much a visit will cost if you don't have insurance. Some doctors won't see you at all, many of them are paid different rated by different insurance providers so it's not like they can simply charge you what they charge the insurance company. So yes, I agree that major-medical only coverage is a good option for some, this is still a problem that should be addressed.

jafs 3 years, 11 months ago

Also, there is the issue of prescription medication, which is extremely expensive.

Anybody with even one or two monthly drugs they need to take may find it hard to pay for them out of pocket.

But I agree in principle that insurance should be used for large, unexpected expenses rather than routine predictable ones.

notajayhawk 3 years, 11 months ago

"The House Republicans don’t like some parts of the Affordable (health) Care Act (ACA), so they’re trying to repeal all of it, all at once."

Um, that's because 1) all the parts you mentioned don't work without the mandate, and it's the mandate that the people of this country do not want; and 2) the legislation as passed will drive up the cost of health care for everyone.

just_another_bozo_on_this_bus 3 years, 11 months ago

"the legislation as passed will drive up the cost of health care for everyone."

There are many reasons to dislike the current plan, but it isn't going to drive up costs, although it won't significantly reduce them either.

notajayhawk 3 years, 11 months ago

Really, boohoozo?

Just what do you think the effect of the loss-ratio mandate, in the absence of a premium cap, will be?

[Hint: Try looking at the states that have tried that.]

Hopefully you can find someone to explain the question to you.

just_another_bozo_on_this_bus 3 years, 11 months ago

Insurance premiums might go up. But those have very little to do with the actual cost of healthcare.

funkdog1 3 years, 11 months ago

You're the one in intentional denial in this instance. The HMO act of 1973 didn't require any business to provide health care. And wage controls? That's a pretty loose corollary to health care. Wage controls drive all sorts of waves through the economy; any effect on health care is going to be fairly far removed.

But health insurance has had a direct effect on the health care industry; it's a straight line from point A to point B, from when it got to the point that patients virtually had to have health care to be seen by a doctor or given a fair price, to doctors having to carry their own expensive insurance to guard against being sued into the ground, which has further driven up prices. And people wouldn't be suing so often if there wasn't so much money at stake. Maybe if these were still the days when you paid for your own health care out of pocket, doctors would look you in the eye and say, “I'm sorry. I kind of screwed up. Why don't I lower this bill for you?” But that can't and doesn't happen anymore and it’s because of insurance and lawyers.

I am all for the free market when it works. But for one thing, large businesses almost never act as good citizens unless they're forced to and unfortunately, government is the only entity large enough to even begin to force businesses to not pollute, not discriminate, pay a decent wage and compensate their customers when their customers are harmed by their actions or products. People who insist that the free market is always right are stubbornly, totally unwilling to admit that the free market has created a money making, out-of-control monster when it comes to insurance and the health care industry. It's become a system about money as opposed to the best care for the patient. But we can't abolish insurance companies, because that would be real government involvement, so we're forced to put these ridiculous band aids on the system.

These aren’t the days of mashing up some willow bark for a malaria patient and praying they get better. We have a moral and economic obligation to provide health care, because these days, we can actually save lives. America needs a strong, healthy work force if we’re to survive in a global economy. We can barely even staff our police, fire and military forces.

As far as "wage controls" go, every time the minimum wage goes up, there's this huge outcry from conservatives that businesses will go under and inflation will go up. Only that never happens. It's not like inflation stalls every decade that it takes for govt. to finally raise the minimum wage. If minimum wage hadn't gone up when it did around 1990, I would never have been able to pay for rent and college. And don't tell me that it drove prices up considerably because all the sudden I could afford an apartment. And food. And books for school.

jafs 3 years, 11 months ago

I generally agree.

But LO is right about the way that employer sponsored health coverage got started - it had to do with the fact that employers couldn't offer higher wages due to wage controls around WWII, and so they started offering benefits instead, like health insurance, to attract and keep good employees.

The fact that we generally take it for granted that employers should offer that is sort of funny, given that there's been no requirement to do so for quite a while.

funkdog1 3 years, 11 months ago

I'll tell you why Wal-Mart refunded your money for your laptop. So that hopefully you won't notice that they pay their employees crap wages and crap benefits so that many of them are forced to utilize public benefits. They don't want you to get up in arms about the fact that they've almost singlehandedly shifted the production of small goods to China. That's why they smile at your face and refund your money.

In the years that I worked crap jobs the minimum wage went up twice. Nobody got fired. Maybe the boss went to Vegas one fewer time that year.

handley 3 years, 11 months ago

Don't repeal the health care law. I wonder how many members of congress own stock in the big insurance industry. If they pass any laws that puts money in the insurance company profits, and puts money in their own pockets that is a conflict of interest. Improve the health care laws.

jafs 3 years, 11 months ago

That would be federal income taxes you refer to, I'm guessing.

Carol Bowen 3 years, 11 months ago

Doesn't this legislation tweak Medicare? More benefits and more savings.

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