It is going to get worse, before it gets better.. health care act

[Peacetrain]

We all love easy things.. but the assumption that something this large (the Affordable Care Act) was not going to have gigantic growing pains.. is just not dealing with how things work in the world.. nothing and I mean nothing nada.. rolls out smoothly without major hiccups and bumps and starts because things crop up..

I do not have this sense of it was all doomed from the start.

Oh my GOD is this great news copy and they (media types of all political persuasions) will ride this horse till it drops.. and then you begin to hear the positive things that were going on all the time.


I have never ever ever been disappointed by this President in the long run. He lets things get messy.. but then they tend to sort out so much quicker than anyone ever had a concept that they would.. because he lets it all out at once..

The thing that frustrates me no end is the whole concept that is being promoted that there is no way to understand this bill it is so big.. yadda yadda yadda.. we need to get rid of it and start again .. yadda yadda yadda..

All it is is a risk pool.. when you don't need the services you keep paying in and those who need the services take what they need.. some day everyone draws water from that well.

Just like social security and its health component medicare. we are all in it together.. and this time we are doing it with the private sector..but even with medicare.. you have a private sector group who covers Part D and supplemental... so those beloved programs of medicare have their private sector pieces

Everybody in me media take a breath.. breathe deep..

[JoePhilly]

1. ... now if we could get the media to HOLD that deep breath, longer, longer ...

... then things would get better.

[Peacetrain]

2. Just think how everyone is tuning in to

the media outlets.. and ta dah.. the corporations are making a killing in their commericals.. just life..

[Lifelong Dem]

3. If the Republicans would STFU

Then the media would STFU. And 45 million uninsured would be insured and the majority of people would be paying less in premiums.

[Peacetrain]

4. Here you go..

(_)O cup of coffee for you and (_)O one for me.. ain't it the truth!!

[TheKentuckian]

5. The current issues were all foreseen and ignored. We haven't even got to the structural flaws and

traps laid by foolishly accepting scores of TeaPubliKlan amendments and wrongheaded perceptions baked into the cake here.

Your point would be valid under virtually any outcome but it becomes a lame excuse when it is used to paper over any and everything

[Peacetrain]

7. Totally disagree with you..

no one is papering over anything.. I am sort of shocked that so many did not see there would be major issues with something this large and this big a change oh how we do things.. literally telling people you either get insurance or you get some meaningless penalty.. but penalty in name only .. but you have to do it.

its huge.

There are all kinds of kinks in the works kentuckian.. no one is denying that.. and some of them of a very suspicious nature.. that will probably play out in some future book..

But even that aside.. it such a major change in how we do things.. so I am not seeing the sky fall

Complain all you want to.. and I will join you .. I have a brother who lives in SD below the poverty level.. can get nothing.. nada..he will not be penalized because the SD republican governor is a complete dufus.. but he has no insurance either..


That still does not mean this will not work out in the long run.. as these issues pop up they have to be addressed. And trust me hindsight is always 20-20

just saying..

[TheKentuckian]

15. Pretty thin complete disagreement here, based not off facts but rather perception.

I'm really just saying that the current hubbub was easily predictable and therefore should have been avoided, knowing that unforeseeable issues would come as a reasonable consequence of the scale of the undertaking but instead problem after problem was filed under "we'll fix it later" with little to no concern about how we'd even have the ability to do so and when or how the things that need fixing would put the brakes on having and/or acquiring such power.

I'm here to tell you that the current problems are small potatoes compared to the time bombs ticking away.

I think that many believe good intentions will make even the most wayward and flawed law eventually work out in the end but ignore that dragging all the systemic entropy and propping up "stakeholders" is too much to just "fix".

Unfortunately, sometimes in this world the best you can do just isn't good enough and sometimes good intentions pave the road to hell. The meat is deeply flawed and it is the last minute trimmings that are expected to carry the day here. The things that proponents identify as being the seeds that will flip this thing from GingrichCare are last moment add ons in the legislative process like the poorly thought out MLR that will bite us yet and likely cause overall costs to rise rather than act as containment and the state waivers.

I don't folks get or are willing to admit this effort is flawed not just compared to other systems but in its own context because it is feeble even for a strictly market based reform, this isn't in practical reality the government instituting regulations on a market but rather it turns out to be substantially an idea out of right wing think tanks written by the insurance cartel and the pharmaceutical corporations with over a hundred TeaPubliKlan amendments all with no other intent but to be gremlins in the works and cause hardships for those we are supposed to be helping with a few pay to play sweeteners to make the muck palatable enough to go down.

Look there is no way to accept this as even an honest effort to rein in the cartel because for all the supposed reform we still have a fucking cartel with an antitrust exemption which means they don't actually even compete which means all the market force talk is pure jive and so on a fundamental level we after all of this dust up have the exact same system in place as before with a few pay to play features that make up the bulk of the "change" and an obligation of 5 he people to the profits of 5 he same predatory cartel we were supposed to be fixing.

The thing doesn't even start off with consistent logic, though it seems to lean toward the assumption of over utilization and insufficient cost sharing as the reason for the worst abuses of the cartel and a genuine desire to expand the safety net but with an underlying desire to string it together based on personal responsibility as well as identifying a societal need but framed as an individual obligation.

Beyond the most basic premise of providing access to those locked out there is no consistent world view here to the point that one might actually believe that the two parties actually did cleave a some babies in half and hammered out a compromise except we did all the compromise internally and got exactly one vote in the house from a bit player with no juice to demand (with no apparent influence on the legislation which was totally what the Senate produced) so we get 100% of the blame and the opposition has zero incentive to make bad better and ever motivation to make it fail or morph into a nightmare.

The party has walked away from better plans in the past because we used to understand that you can't spin straw into gold and shit works even more poorly. You have to have something to build on even if you are making a purely incremental effort. Our foundation is made of sand and we need major systemic reform just as much now as we did in 2008 and will be in even more desperate shape with less resources in say 2034.

[Thinkingabout]

6. ACA has been in a battle from the time President Obama brought up the subject and

Continues to be a battle. In the years to come when all the benefits of ACA have rolled out and citizens start reaping the rewards of healthcare the battle will start seeing a light at the end of a very long tunnel. The US has dragged its feet for years on health care. The same ones who fight so hard against ACA are some of the same who say we have the best health care in the world and it is not true unless all have access to health care.

[Peacetrain]

8. Yep

Heard a very interesting conversation today when I took my Mom to get her hair cut.. one of the stylists was asked by a customer if she had her Obamacare.. and the stylist said no I am still on my parents insurance.. Oh said the customer that is good.. well duh.. they have already forgotten who put that through for them.. Obama..

[Thinkingabout]

11. Big K & R

[Savannahmann]

9. Here is the real problem.

Elections are won and lost when a few percentage points of voters shift one way, or the other. When they are with us, we win, when they are not, we lose. So five million people are affected right now, and I think that is low, because I heard on NPR that up to a million in California alone were losing their health plans. Five million votes that are probably going to the other guys in the next election, perhaps as many as ten million votes going to the other guys.

Tell me how we can win with that? Because I'm going to tell you we can't. Doubt me? Democratic Senators are jumping ship and offering all sorts of legislation to try and fix it. They know they can't wait, because they can't win re-election next year if they are seen as the big bad meanies who took away the people's insurance.

Then we're going to hear more about the stories we've already heard whispers about. How many of these plans have limited doctor choices, and then we'll hear how they can't make appointments. My wife had to call six offices before she could find an OB/GYN, and that was three years ago. Imagine how it's going to be when more are in the marketplace. Appointments? Nope, not taking new patients, but thanks for calling.

So the next round of news stories, assuming we ever get past the President Lied meme, will be how expensive these policies are and how you're paying for NOTHING because the legislation did not increase supply, only demand.

That is what we're going to be running on in 2014, and that is what we're going to be fighting against. What do we do? Blame the insurance companies for not having enough doctors? Blame them for being greedy bastards, which they are, and blame students for opting for law school instead of medical school? Blame the Doctors for not choosing general practice and OB/GYN as a field?

In the meantime, the Republicans will be running on this. "We told you there was a problem, we tried to tell you for years that there were real problems with this law, and now our predictions are coming true." Who wins the election? You tell me?

An analogy I used in another thread. If your mechanic screws up your oil change and destroys your engine, do you take the car back to him to get the motor rebuilt? No, you never take anything back to that mechanic. If Democrats are perceived as destroying the Health Care system, even if we are only slightly to blame, it's perception remember, do we really expect the people to continue backing us in the elections?

[Peacetrain]

10. I am not worried.

It is going to be messy.. but I am not worried.. and if besides.. I kind of like where President Clinton started taking us with this assurance of insurance for those who will be off the rolls) and the President is taking those steps.. but that assurance.. is the first step to medicare for all.. big old risk pool that can have a private sector.. just like medicare does with its supplemental s and its part D..but everyone will pay in the same amount.. I am all good with how this is starting to shape up..

[Thinkingabout]

12. Was your wife's difficulty locating an OB-GYN a result of ACA? I wonder why so many

Vote with the 1% when they are not a part of the 1%. Far too many apparently want to keep the 1% happy and don't realize they are hurting themselves, this is not the smart thing to do.

[haele]

13. I've always had problems finding an OB/GYN.

Seems unless you're pregnant, they don't want you to be their patient.
Took me 2 1/2 years to find one in the network with an opening for new patients that weren't pregnant, and she decided to retire last year. I'm 54, so it looks like I'm going to have to depend on my GP to find anything wrong for the next few years until I find another OB/GYN.

That's not an ACA issue.

GPs aren't much easier to find, either, unless you're with an HMO, and then you have to deal with all the HMO hoops and games to see a specialist if you need one.

Haele

[Savannahmann]

14. I didn't say it was an ACA issue.

It isn't. It's been a problem for years before now. Decades perhaps. However, the problem isn't going to get any better. My point was that when people start getting their insurance, and try to make the appointments, they are likely to run into the same problems, and it will likely get worse. So they will blame who? Insurance companies? The insurance companies isn't responsible for the shortage of doctors is it? We increased demand with the ACA, and did not to address the supply. The blame for that will be placed squarely on us, by the voters.

Then the year after, the employer mandate will finally kick in, and then more people will be shopping for insurance in the exchanges, while the prices go up, they may blame the insurance companies for that, but too many will blame us. 2014 is in trouble, 2016 is in doubt. We are liable to be in the minority for a decade over this.