Making a Case for the Affordable Care Act

[GatorAbe7]

Caller Paul make an on-air case for the Affordable Care Act. He meanders for a full ten minutes but hits well on the "Low Information" points to build the typical entitlement case.

- Affordable Care act doesn’t change anything because some employees had a pattern of cutting employees hours to avoid paying benefits. (:30)

- People who didn’t have health coverage before will now have health coverage (2:10)

- Supporters/Voters of ACA deserve health coverage no matter the cost to the employer. (6:40)

- The ACA enormously raising rates on business should be seen as the new cost of doing business, equivalent to other costs of business such as advertising. (8:10)

- Companies shouldn’t cut hours due to ACA. The raised cost of full time employment should be offset by a satisfaction that they are providing healthcare, even if ACA costs risk putting the business out of business. (9:20)

http://www.youtube.com/watch?v=9zBXsXPl1oU&list=UUqnUZeOZgRe7z6ahOhELrjA&index=1

[secgator]

Caller Paul sounds exactly what I envision Fred sounds like. Voice--content--you name it.

That is not Paul...that IS Fred.

[gatorev12]

...which is exactly what Republicans and many independents have been saying for years: the "Affordable Care Act" has absolutely nothing to do with affordable care and will only increase costs across-the-board for businesses and healthcare--AND act as an anchor to wage appreciation.

Amazing how quickly the proponents of Obamacare have transitioned from "we need to address rising healthcare costs" to "forget healthcare costs, this was really about insuring the uninsured."

[fredsanford]

...which is exactly what Republicans and many independents have been saying for years: the "Affordable Care Act" has absolutely nothing to do with affordable care and will only increase costs across-the-board for businesses and healthcare--AND act as an anchor to wage appreciation.

Amazing how quickly the proponents of Obamacare have transitioned from "we need to address rising healthcare costs" to "forget healthcare costs, this was really about insuring the uninsured."

Pubs said that because they are reflexively against any government solution before they even know what it is.

[gatorman_07732]

Pubs said that because they are reflexively against any government solution before they even know what it is.

Well thanks for admitting that they passed an enormous legislation that will be like an elephant on our backs without them explaining it to us.

[mocgator]

I just got back from DC. I was at a large Healthcare Executives round table. Several aids of prominent Senators were there.

The net if the meeting...

The bill is a disaster...

Ron Wyden's aide (a supposed health care expert) was reduced to a stammering mess.

I'll give you all the details when I have some time.

[surfn1080]

Cost of doing business.... Omg entitlement at a new level!

[austingtr]

If anyone wants to get real depressed and understand Obamacare, how we got to this health care crisis, the implications of the ACA, how it will fail to contain costs, and the true goals of it you got to read

OPEN WIDE AND SAY MOO! Is only $5 on kindle, is a good read by someone who actually knows what he is talking about, and if you don't want to spend the $5, you can read it online on his blog. Here is the link.

http://covertrationingblog.com/rebuilding/open-wide-and-say-moo-the-up-to-date-archive

I started yesterday and have not been able to put it down. For the liberals here, please plow throw the chapter in which he explains progressivism, and continue soldiering on because everyone is going to be affected by this atrocity of law. Bottom line is, we don't live in a free country unless something radical changes. The fact is our law makers excepted themselves from this law. That right there should be cause for great alarm.

[g8orbill]

Pubs said that because they are reflexively against any government solution before they even know what it is.

so tell us shab- just what is this aca going to accomplish and how much is it going to cost

[Pablo]

Comparing Obamacare expenses to advertising expenses under a "cost-of-doing-business" umbrella is bad logic. Are all businesses now required to advertise? No. Are all businesses now required to pay these increases in rates? You tell me.

[Pablo]

Saw this on Twitter, thought I'd pass it on...

"I love Obama because now I can get health care even though I'm unemployed."

"why are you unemployed?"

"I got laid off because my employer can't afford to pay for Obamacare."

[rivergator]

The point is that we need some kind of system to get people health insurance. More companies have been switching to contract work and part time work without benefits well before the ACA came in. Even if you do have employee insurance, if you get laid off and have an existing condition, it could cost a lot more than you can afford to get health insurance.
Then you have an incident, say a mild heart attack, you then owe hundreds of thousands.
It's way too easy for health costs to financially destroy someone who has done things generally right in life, but didn't happen to save up $1 million or so.

[GatorAbe7]

The point is that we need some kind of system to get people health insurance. More companies have been switching to contract work and part time work without benefits well before the ACA came in. Even if you do have employee insurance, if you get laid off and have an existing condition, it could cost a lot more than you can afford to get health insurance.
Then you have an incident, say a mild heart attack, you then owe hundreds of thousands.
It's way too easy for health costs to financially destroy someone who has done things generally right in life, but didn't happen to save up $1 million or so.

We needed some kind of system, because apparently we had no system, and the government's solution, ACA, is turning out to be far worse than not having a system at all. You have a mild heart attack under ACA, you're still financially screwed. :halloween:

[rivergator]

We needed some kind of system, because apparently we had no system, and the government's solution, ACA, is turning out to be far worse than not having a system at all. You have a mild heart attack under ACA, you're still financially screwed. :halloween:

why is that?

[gatorman_07732]

Having a system that forces people to purchase a service or be penalized is completely unAmerican.

[gatorev12]

The point is that we need some kind of system to get people health insurance.

The point is--that's moving the goalposts.

Obama came into office saying we needed to "do something about the rising cost of healthcare."

...and his finalized plan does absolutely nothing to address the rising costs of healthcare...and, if anything, have caused the cost of healthcare to rise even further.

There was an old maxim in world history classes when discussing the "Holy Roman Empire": it was neither Holy, nor Roman, nor an Empire.

I sort-of see the "Affordable Care Act" being laughed about in the future along those lines.

[rivergator]

The point is--that's moving the goalposts.

Obama came into office saying we needed to "do something about the rising cost of healthcare."

...and his finalized plan does absolutely nothing to address the rising costs of healthcare...and, if anything, have caused the cost of healthcare to rise even further.

There was an old maxim in world history classes when discussing the "Holy Roman Empire": it was neither Holy, nor Roman, nor an Empire.

I sort-of see the "Affordable Care Act" being laughed about in the future along those lines.

You're really going to claim that part of Obama's 2008 campaign was not to get insurance for the uninsured?

[fredsanford]

The point is--that's moving the goalposts.

Obama came into office saying we needed to "do something about the rising cost of healthcare."

...and his finalized plan does absolutely nothing to address the rising costs of healthcare...and, if anything, have caused the cost of healthcare to rise even further.

There was an old maxim in world history classes when discussing the "Holy Roman Empire": it was neither Holy, nor Roman, nor an Empire.

I sort-of see the "Affordable Care Act" being laughed about in the future along those lines.

The CBO differs with your Limbaugh-esque analysis.

Again, you will have to wait a few years until all aspects of the law are in place to judge its cost effectiveness.

[gatorev12]

You're really going to claim that part of Obama's 2008 campaign was not to get insurance for the uninsured?

No--Obama very clearly spoke of finding a way to insure the uninsured in his campaign.

But you're once again trying to conflate two separate issues. The impetus for Obamacare and how it was sold to the American people was as a means to "do something about rising healthcare costs."

[fredsanford]

No--Obama very clearly spoke of finding a way to insure the uninsured in his campaign.

But you're once again trying to conflate two separate issues. The impetus for Obamacare and how it was sold to the American people was as a means to "do something about rising healthcare costs."

The right has no business talking about conflation of issues.

Remember how the 9/11 attacks were conflated with the need to go into Iraq?

[rivergator]

No--Obama very clearly spoke of finding a way to insure the uninsured in his campaign.

But you're once again trying to conflate two separate issues. The impetus for Obamacare and how it was sold to the American people was as a means to "do something about rising healthcare costs."

Read any of Obama's support for the bill and you will see there was always discussion of getting people insured. It's simply ridiculous to claim it wasn't always a part of it.

[gatorev12]

The CBO differs with your Limbaugh-esque analysis.


...spoken like a person who has precious little idea of what the CBO does and does not do.

Let me give you a simple hypo here to de-bunk your complete faith in the CBO report: say your salary is 50K right now. You've already figured out this year's taxes and expect to get an $1K refund. Now, based on your employer promising a $1K a year raise for the next decade...AND keeping the tax rates the same as they are over the next decade...you budget yourself $12K in tax refunds over the course of the next decade.

Of course, practical realities mean that your employer could fire you at any time; the company may force you to take a paycut--a new job could result in a low salary, etc.

BUT...using those metrics and assuming nothing changes, sure, you can claim that over the course of the next decade, you'll get $12K in refunds.

Again, you will have to wait a few years until all aspects of the law are in place to judge its cost effectiveness.


Sounds like Pelosi's "we have to pass the bill to see what's in it." Which has rightly been lampooned for its utter ridiculousness. You saying it, reworded, is no less ridiculous.

[rivergator]

Here's some excerpts from Obama's speech to Congress in support of the bill. Still want t claim insurance for the uninsured had nothing to do with it?

Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are not primarily people on welfare. These are middle-class Americans. Some can’t get insurance on the job.

Others are self-employed, and can’t afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer. Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.

There are now more than 30 million American citizens who cannot get coverage. In just a two-year period, one in every three Americans goes without healthcare coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone.

More and more Americans worry that if you move, lose your job, or change your job, you’ll lose your health insurance too. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won’t pay the full cost of care. It happens every day.

link (http://usliberals.about.com/od/healthcare/a/ObamaHealthInsSpeech.htm)

[108]

the big elephant in the room is that nothing short of Single Payer or extreme cost controls is going to bring down the cost of insured health care

so you guys can bitch about the ACA, but your elected officials really don't have a plan B for what used to be their plan A....premiums have been skyrocketing for years

[gatorman_07732]

the big elephant in the room is that nothing short of Single Payer or extreme cost controls is going to bring down the cost of insured health care

so you guys can bitch about the ACA, but your elected officials really don't have a plan B for what used to be their plan A....premiums have been skyrocketing for years

In your Amerika. We won't get any healthcare with a single payer system

[gatorev12]

Here's some excerpts from Obama's speech to Congress in support of the bill. Still want t claim insurance for the uninsured had nothing to do with it?


In addition to moving the goalposts, now you're trying to put words in my mouth.

Again, I'm not claiming Obama was never wanting to insure the uninsured. He said that was a priority in the campaign--and also while he was selling the legislation.

But to sit here and pretend that was the impetus for "getting something done" on healthcare is more than a bit dishonest considering the parts of the speech you're leaving out is Obama's diatribe on "rising healthcare costs crippling our economy and American families."

It's almost as dishonest as Obama's claims to have the entire congressional hearings placed on C-Span...and the reality of Obamacare being passed on midnight after closed-door backroom negotiations between a few holdouts.

[GatorAbe7]

why is that?

Because ACA passes the buck of rising healthcare costs to business. Business, in turn, will keep employee hours below 30 hours to stay in business. Who then pays for the mild heart attack of all the employees working less than 30 hours?

[108]

Because ACA passes the buck of rising healthcare costs to business. Business, in turn, will keep employee hours below 30 hours to stay in business. Who then pays for the mild heart attack of all the employees working less than 30 hours?

the overwhelming majority (90%) of small businesses are under 50 people, which is the max they can have before having to fork over some money if they are not going to provide health care to their employees....they make up 57% of the employed

after that, over 90% of businesses that employ more than 50 people, give health insurance to their employees

[g8orbill]

we still have to pay for you people who do not have coverage whether or not we have 50 employees

[fredsanford]

we still have to pay for you people who do not have coverage whether or not we have 50 employees

You've been paying--in the most expensive way there is.

[rivergator]

In addition to moving the goalposts, now you're trying to put words in my mouth.

Again, I'm not claiming Obama was never wanting to insure the uninsured. He said that was a priority in the campaign--and also while he was selling the legislation.

But to sit here and pretend that was the impetus for "getting something done" on healthcare is more than a bit dishonest considering the parts of the speech you're leaving out is Obama's diatribe on "rising healthcare costs crippling our economy and American families."

It's almost as dishonest as Obama's claims to have the entire congressional hearings placed on C-Span...and the reality of Obamacare being passed on midnight after closed-door backroom negotiations between a few holdouts.

So make up your mind. You started this particular conversation by claiming that by saying "we needed some system to get people insurance" was moving the goalposts. I pointed out that insuring the uninsured was part of the discussion from the beginning. You disagreed and said it was all about cutting costs. I provided quotes from Obama's speech to Congress in support of ACA in which he referred over and over to the need to get insurance for the uninsured.
And now you're saying exactly what? That part of the reason was getting insurance, that it wasn't it?
I mean, damn, guy.

[mocgator]

Saw this on Twitter, thought I'd pass it on...

"I love Obama because now I can get health care even though I'm unemployed."

"why are you unemployed?"

"I got laid off because my employer can't afford to pay for Obamacare."

Wait until they discover that Universal Coverage doesn't mean Universal Treatment...

It will be a laugh riot...

[gatorev12]

So make up your mind. You started this particular conversation by claiming that by saying "we needed some system to get people insurance" was moving the goalposts. I pointed out that insuring the uninsured was part of the discussion from the beginning. You disagreed and said it was all about cutting costs. I provided quotes from Obama's speech to Congress in support of ACA in which he referred over and over to the need to get insurance for the uninsured.
And now you're saying exactly what? That part of the reason was getting insurance, that it wasn't it?
I mean, damn, guy.

I'll make this simple: at any point in time, was Obamacare sold to the public as a means of cutting "rising healthcare costs?"

Yes or no.

Since no reasonable person could argue "no"--then it's a valid critique to observe that continued supporters of Obamacare are trying to ignore the obvious and focus on what, initially, was a very small part of the impetus to "do something" about healthcare reform.

And let's not forget--in order to be upheld by the SC, the Obama Administration claimed in hours of oral arguments that this was a valid exercise of the Commerce Clause..and spent about 10 minutes saying "well, even if it's not valid under the Commerce Clause, it's also valid use of the taxing/spending provisions..." ---and, in the end, that's the only reason it wasn't overturned: the SC ruled it was a tax.

[rivergator]

I'll make this simple: at any point in time, was Obamacare sold to the public as a means of cutting "rising healthcare costs?"

Yes or no.

Since no reasonable person could argue "no"--then it's a valid critique to observe that continued supporters of Obamacare are trying to ignore the obvious and focus on what, initially, was a very small part of the impetus to "do something" about healthcare reform.

And let's not forget--in order to be upheld by the SC, the Obama Administration claimed in hours of oral arguments that this was a valid exercise of the Commerce Clause..and spent about 10 minutes saying "well, even if it's not valid under the Commerce Clause, it's also valid use of the taxing/spending provisions..." ---and, in the end, that's the only reason it wasn't overturned: the SC ruled it was a tax.

When I said that part of the reason for the bill was to get insurance for the uninsured, you disagreed. Now, you're going back and claiming "Gosh, I never said that ...."
Like I said, make up your mind and get back to me.

[ArtDeco]

The only real way to lower healthcare costs is to limit utilization to cases that are necessary.
There's posters on here that mention single-payer as the solution. Bull. All single payer accomplishes is (1) paying less to doctors and professionals b/c single payer is a monopoly and (2)putting decisions in the hands of bureaucrats who can sit back and selectively cut out what they consider to be "costly" procedures without regard to case or medical necessity.
Item (1) is a product of envy. Paying less to struggling doctors who are already cutting back services may make the left feel better, but it does not lower costs. Doctor fees do not drive this engine, utilization does. Single payer does nothing to address overutilization for non-urgent problems. Item (2) addresses utilization, but not from a medical necessity point. I'd rather my insurance not pay for the million hypochondriacs that flood doctors' offices than not pay for someone's organ transplant.
We as Americans have to be honest to each other and admit that we run to the doctor too much, and the guiltiest are those with little or no cost share involved.
I already see single payer in my practice, it's called Tricare, the military insurance. Active duty personnel and their young wives and kids have no cost share or copays to worry about, i.e. literal, free healthcare. They are the biggest abusers of the system. They demand to see GI doctors for a tummyache, strep tests for kids who barely complain, vascular surgeons for the wife's spider vein. There is actually a reimbursement code in the system used by Medicare and all insurances called a "Well Worried" exam. It basically is a way of charging an insurance for a person who thought they had an issue, but realy didn't. I would wager that a third of all doctor visits, whether GI or Family Practice or Ortho or what have you, are needless and unnecessary. But if you give a person free and unfettered access to the system, overuse inevitably will happen.
THIS is what is costing the system. Ask Mastoid the anestesiologist how many of his surgeries are "elective", in other words, not entirely necessary. Gallbladders, knee replacements, tonsillectomies. I'm not advocating doing away with these, just make the patient have some skin in the game i.e. cost shares, significant co-pays. That's how you lower the overall cost of healthcare, not by adding more consumers, but by making consumers smarter about their utilization and actually paying a percentage of their own income to see if a visit or a lab is truly worth it to them.

[gatordowneast]

You've been paying--in the most expensive way there is.

And Massachusetts passed Romney care and the proponents claimed that hospital emergency rooms would no longer be overrun with those seeking "primary care" and costs would go down. I just saw a gentleman on the news from Massachusetts say their emergency rooms are more packed than before, the wait for docs is much longer and health care costs have sky rocketed...in Massachusetts who only had approximately 8% of their citizens uninsured prior to Romney care.

Cluster___k.

[GatorAbe7]

so you guys can bitch about the ACA, but your elected officials really don't have a plan B for what used to be their plan A....premiums have been skyrocketing for years

108, the ACA absolutely wont lower healthcare costs...http://www.gatorcountry.com/swampgas/showthread.php?t=255851

[G8trGr8t]

The only real way to lower healthcare costs is to limit utilization to cases that are necessary.
There's posters on here that mention single-payer as the solution. Bull. All single payer accomplishes is (1) paying less to doctors and professionals b/c single payer is a monopoly and (2)putting decisions in the hands of bureaucrats who can sit back and selectively cut out what they consider to be "costly" procedures without regard to case or medical necessity.
Item (1) is a product of envy. Paying less to struggling doctors who are already cutting back services may make the left feel better, but it does not lower costs. Doctor fees do not drive this engine, utilization does. Single payer does nothing to address overutilization for non-urgent problems. Item (2) addresses utilization, but not from a medical necessity point. I'd rather my insurance not pay for the million hypochondriacs that flood doctors' offices than not pay for someone's organ transplant.
We as Americans have to be honest to each other and admit that we run to the doctor too much, and the guiltiest are those with little or no cost share involved.
I already see single payer in my practice, it's called Tricare, the military insurance. Active duty personnel and their young wives and kids have no cost share or copays to worry about, i.e. literal, free healthcare. They are the biggest abusers of the system. They demand to see GI doctors for a tummyache, strep tests for kids who barely complain, vascular surgeons for the wife's spider vein. There is actually a reimbursement code in the system used by Medicare and all insurances called a "Well Worried" exam. It basically is a way of charging an insurance for a person who thought they had an issue, but realy didn't. I would wager that a third of all doctor visits, whether GI or Family Practice or Ortho or what have you, are needless and unnecessary. But if you give a person free and unfettered access to the system, overuse inevitably will happen.
THIS is what is costing the system. Ask Mastoid the anestesiologist how many of his surgeries are "elective", in other words, not entirely necessary. Gallbladders, knee replacements, tonsillectomies. I'm not advocating doing away with these, just make the patient have some skin in the game i.e. cost shares, significant co-pays. That's how you lower the overall cost of healthcare, not by adding more consumers, but by making consumers smarter about their utilization and actually paying a percentage of their own income to see if a visit or a lab is truly worth it to them.

Agree

[The_Graygator]

Obamacare is the biggest fraud ever passed over on the American People, or, in better terms, forced down their throats.

In a few years after this abomination of a bill is officially enacted, you're going to hear and see the millions of Americans wailing and crying to the govt. about all the high costs of this system when they thought it was going to be free.

I for one have already lost my health insurance because of what Obama has done to this economy which has directly affected my livliehood, and I sure as hell wouldn't be able to afford an Obamacare policy which will cost consdierably more than the priovate sector policy I had, not to mention it won't cover near as much as my previous one did either.

Wait until all the welfare leeches and bums who've never held a job all their lives because they've sponged off the govt. have to actually pay for a HC policy. That's going to be a sight!

[MastaG8r]

In addition to moving the goalposts, now you're trying to put words in my mouth.LOL. That's his trademark M.O.

http://www.chicagostagereview.com/wp-content/uploads/2009/03/riverdance-pic.jpg
...a journey to absurdity.

[austingtr]

the big elephant in the room is that nothing short of Single Payer or extreme cost controls is going to bring down the cost of insured health care

so you guys can bitch about the ACA, but your elected officials really don't have a plan B for what used to be their plan A....premiums have been skyrocketing for years

Said like a true progressive.

Read the book and deny anything in it, and still claim progressives are still compatible with the great American experiment.

Open wide and say moo!

[austingtr]

Wait until they discover that Universal Coverage doesn't mean Universal Treatment...

It will be a laugh riot...

So true, I get the sarcasm, but this really keeps me up at night. And I'm a doc.