Good news Obamacare gets even better!

I was not the one who brought up the word Liberty into the conversation about ACA.

And no I do not defend the NSA's actions.

But are you really saying that the same people who claim Liberty as their excuse for being against the ACA were protesting just as vigorously and publicly when the Patriot Act passed? or when it was renewed? or when the NSA spy scandal broke?
Not to mention when Romneycare passed in Massachusetts. So, where's the proof?

Again, my point is that if Liberty was the true concern, these earlier events would have provoked the public outrage that they are now showing about the ACA. So that cannot be the real reason.

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Originally Posted by Lainey

I was not the one who brought up the word Liberty into the conversation about ACA.

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That's correct. I brought it up as a one word response to the question "Which side do you think the right falls on?". Since then, I've simply responded to those who either tell me that I'm wrong in my opinion or imply that I am a hypocrite based upon their interpretation of my beliefs.

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But are you really saying that the same people who claim Liberty as their excuse for being against the ACA were protesting just as vigorously and publicly when the Patriot Act passed? or when it was renewed? or when the NSA spy scandal broke?

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No, I can't speak for what other people think. I can repeat what I've previously posted that I'm not aware of anyone with views similar to mine who don't think either of those examples were an assault on their liberty. The only exception possibly being elements of the Patriot Act since it was such a far reaching piece of legislation. When it is broken down into it's individual parts, some enjoy bipartisan support, and others, not so much.

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Again, my point is that if Liberty was the true concern, these earlier events would have provoked the public outrage that they are now showing about the ACA. So that cannot be the real reason.

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I'm afraid I don't find that conclusion convincing. How do you measure public outrage? Is it only public outrage if you disagree, while any agreement with your concerns is simply ignored?

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But are you really saying that the same people who claim Liberty as their excuse for being against the ACA were protesting just as vigorously and publicly when the Patriot Act passed? or when it was renewed? or when the NSA spy scandal broke?
Not to mention when Romneycare passed in Massachusetts. So, where's the proof?

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I'm not sure how one would know. How likely people one sees on social media are to be protesting something? (all the tea party members one presumably has on their social media? :) ) Whether it trends on twitter? (twitter trending seems straight out manipulated btw) Or something like media coverage? But does most of the media tend to cover protests or black them out? How many protests go uncovered everyday? What determines if the media covers a protest? Size of the protest? Or something else?

They only group I was aware of trying to protest the NSA was the "restore the 4th" movement, and I don't think it went anywhere (but again, since I wasn't there, would I know if it did? If several hundred people were out protesting it would the "revolution be televised"?)

If you are just talking Republican politicians and the like of course they aren't against the NSA. Actually the Dems in the house vote significantly better on civil libs overall (Senate and Prez are throughly corrupt - nothing more needs to be said about them).

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Again, my point is that if Liberty was the true concern, these earlier events would have provoked the public outrage that they are now showing about the ACA. So that cannot be the real reason.

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Yes I suspect you're right and liberty is often not the prime concern. I'm merely pointing out public outrage is being reflected to us through fun house mirrors at this point, and then we look through them trying to get an accurate picture of the (social-political) world and our place in it! I don't think we live in a culture with massive amounts of political protest or activity (or everyone you know would be going to a protest this weekend :) ), but exactly what *is* going on I suspect is utterly distorted. I do suspect that it's easier to build a protest on things people *perceive* as affecting them immediately and economically (rather than on civil libs, the environment etc. - even though that stuff is extremely important in the big picture), but I'm not entirely sure about that one either.

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Originally Posted by Alan

Peggy, Peggy, Peggy....sigh..I think we've gotten off into the weeds from the original path which dealt with liberty. In an effort to get it back on-track, let me again point out that I have the choice of whether or not I drive a car or use it on public roads. If I choose not to, there is no punitive tax associated with my choice. Under the ACA I do not have a choice to forego the purchase of a specific commercial product, nor do I have the choice to tailor that commercial product to suit my needs without bearing the brunt of a punitive tax, levied by the federal government. Under that scheme, I no longer have the freedom of choice, association or conscience for my own healthcare needs, nor would I have under any form of universal healthcare as the government has decided what I want, what I need, what I must have, and what I must pay for it. That is the opposite of liberty.

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Oh baloney! I think you have that flag wrapped a little too tight around your head!:~)
Tell you what, the day we become Somalia, you can have complete freedom to not buy health insurance, and the hospitals will have complete freedom to let you die in the parking lot! And they will, cause, that's the way it is in an Ayn Rand utopia such as that!:0!

Whatever...it is the law of the land, like it or not, and it won't be repealed, cause the majority of American citizens fall on the side of compassion and decency. This country isn't, nor was it built on, every man for himself, despite the tea party taliban trying to convince people otherwise. Why the so called party of responsibility would be against what is essentially a set of regulations on the insurance industry is beyond me. I guess it's that whole black guy in the white house thing, cause, you know, they were for it before they were against it.
I'm glad our country did this. It's not perfect, god knows we really need universal health care, but it's a step in the right direction. And it IS helping people Lots of people, and not just poor, indigent people. I know that really pisses off the right but, there it is.

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Originally Posted by peggy

... And it IS helping people Lots of people, and not just poor, indigent people...

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oh peggy, I am so with you there. One of these days I'll be joining the ranks of people who are helped by Obamacare and I'm not indigent. I'll be jumping on Alan's back for the ride. Thing is, I'm not sure what happens when Alan throws in the towel and stops working and paying taxes. But tra-la, tr-la, guess I don't really need to think about that, Nanny G will take care o' me!

Thanks Peg, I should have known I couldn't get anything past you. Your ability to see through the murk and find the true rationale of racism, greed & mean-spiritedness, which is the true cause of all differences of opinion, is truly phenomenal. I stand in humble awe of your insight.

Alan's federal tax burden is historically the lowest it's been in decades, so don't worry about him going broke, Iris Lily. And if we could just stop getting involved in endless, pointless foreign wars, just think how much we'd have to spend or save!

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Originally Posted by JaneV2.0

... if we could just stop getting involved in endless, pointless foreign wars, just think how much we'd have to spend or save!

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This... definitely this. What we could do with that money to fix our own space. Imagine!

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Originally Posted by CeciliaW

This... definitely this. What we could do with that money to fix our own space. Imagine!

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+1

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Originally Posted by JaneV2.0

Alan's federal tax burden is historically the lowest it's been in decades, so don't worry about him going broke, Iris Lily. And if we could just stop getting involved in endless, pointless foreign wars, just think how much we'd have to spend or save!

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Agreed 100% about the pointless foreign wars! Rob

It must be great, that's why your forced to buy it.

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Originally Posted by iris lilies

oh peggy, I am so with you there. One of these days I'll be joining the ranks of people who are helped by Obamacare and I'm not indigent. I'll be jumping on Alan's back for the ride. Thing is, I'm not sure what happens when Alan throws in the towel and stops working and paying taxes. But tra-la, tr-la, guess I don't really need to think about that, Nanny G will take care o' me!

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Yep, we can always just keep adding to the debt. What could go wrong. Just keep putting things off till after the next election.

Its not going to affect me anymore, I already quit working years ago. I was one of those evil 1% who got tired of putting in all those hours to pay more in taxes than I was spending. I need to look into what other freebies I am entitled to. I am unemployed after all.

Or it just keeps getting worse and worse.
I teach nursing students in SC, many of whom work at doctor's offices already. One of them said today that their obgyn office is turning away any new patient with "Medicare or Obamacare plans" (her words) because they cannot make any money on them. They are told sorry, go find another doctor.

So how good are these plans, if you can't get treatment?

It has always been an issue with Medicare and doctors have always been selective in insurance plans they accept. Nothing really new here when it is a one off comment. The issue of Medicare is critical in some states, like Alaska, with few doctors to begin with. Obgyn's are said to be in short supply all over due in part to malpractice insurance issues. Add other issues on top and some will cherry pick if they can.

The problem, though, isn't with the idea that people should have affordable access to healthcare regardless of their financial means. I haven't seen anyone stand up and say, "Poor people should die of cancer at a higher rate than rich people, on the basis of the relative lack of affordable access to treatment and other financial barriers to preventive and remedial care." Until people can stand up and state that that is their intention, without equivocating, then the efforts to apply perspectives that would tend to promulgate that very result are reasonably disparaged and repudiated, and the issue that remains is what can we do right now to work against that kind of end-result.

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Originally Posted by sweetana3

It has always been an issue with Medicare and doctors have always been selective in insurance plans they accept. Nothing really new here when it is a one off comment. The issue of Medicare is critical in some states, like Alaska, with few doctors to begin with. Obgyn's are said to be in short supply all over due in part to malpractice insurance issues. Add other issues on top and some will cherry pick if they can.

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So, would it be safe to say that governmental intrusion into markets results in less choice, and in many instances lower availability of services?

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Originally Posted by Alan

So, would it be safe to say that governmental intrusion into markets results in less choice, and in many instances lower availability of services?

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Before we could say that we would need to assess whether those with Obamacare had previously had other insurance that made higher payments for doctor's services.

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Originally Posted by jp1

Before we could say that we would need to assess whether those with Obamacare had previously had other insurance that made higher payments for doctor's services.

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Is "higher payment" the only measure? I would guess that bae would be willing to make a higher payment than the plan Alan is funding if he could continue to see the physician of his choosing.

For Pete's sake--bae can see any physician he likes. Within reason, so can I--if I pay for the privilege.

The idea is to make affordable health care available to people who would otherwise be shut out of our third-world two-tier system, not to prohibit people of means paying for concierge service.

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Originally Posted by JaneV2.0

For Pete's sake--bae can see any physician he likes. Within reason, so can I--if I pay for the privilege.

The idea is to make affordable health care available to people who would otherwise be shut out of our third-world two-tier system, not to prohibit people of means paying for concierge service.

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Sure, anyone can pay for treatment, they've always been able to. The point made up-thread was that many people are having a hard time receiving services due to the way Medicare reimburses, as well as the ridiculous malpractice insurance required of any practitioner (how long has it been since any meaningful discussion of tort reform?). I think we forget that the ACA's promise of "affordable health care" is mis-leading. What they're actually promising is "affordable health insurance" and neglecting the barriers it places in front of actual health care.

It appears to me that the government's forced intrusion into the medical marketplace has dis-incentivized practitioner's willingness to practice. Especially when it results in a break-even or loss to the service provider. Concierge service may become the new norm as a result.

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One of them said today that their obgyn office is turning away any new patient with "Medicare or Obamacare plans" (her words) because they cannot make any money on them. They are told sorry, go find another doctor.

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Pretty extreme if they are actually turning away all Obamacare plans, even silver plans and up? Those aren't great plans (deductibles tend to be high etc.) but most doctors can hardly afford to turn them away and most here aren't I'm sure (look it's not like everyone has a great top fo the line soon to be Cadillac insurance plan via work, most don't - I do and it costs me - but most doctors don't want to turn away so much of the population). The issue with doctors not seeing *Medicaid* patients has long been an issue though - Medicaid really doesn't reimburse the doctors enough to want to see Medicaid patients, especially in this state, which is particularly bad.

Oh and I doubt the obgyns are actually losing business from the ACA, they must have seen a spike in business with the promise to cover birth control (think long lasting birth control with an initial up front cost).

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The point made up-thread was that many people are having a hard time receiving services due to the way Medicare reimburses, as well as the ridiculous malpractice insurance required of any practitioner (how long has it been since any meaningful discussion of tort reform?).

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Isn't this an issue doctors can bypass anyway? I mean the last doctor I went to I HAD to sign an agreement agreeing all disputes would go to arbitration (not court) to even get treatment. So isn't that in some sense legally (I have to assume they are operating legally) bypassing the whole tort issue anyway, making it kind of a non-issue (ok even arbitration isn't free but it isn't actually a tort!). Do I have any great desire to sue a doctor? No, but how does not having access to courts and having to sign an arbitration agreement make you feel? Um actually in some sense like I may as well be seeking care in Mexico!!! 3rd world America. Kind of like what kind of shady practitioners am I seeing .... sigh. Ok I saw them anyway (and crossed those fingers hard).

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Originally Posted by ApatheticNoMore

Pretty extreme if they are actually turning away all Obamacare plans, even silver plans and up? Those aren't great plans (deductibles tend to be high etc.) but most doctors can hardly afford to turn them away and most here aren't I'm sure ).

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Yes, in SC, this particular practice is turning away anyone with an "Obamacare" plan, along with anyone with Medicare. I don't know if they used to take Medicare patients.

We have had trouble finding any doctors who will see us up here in Michigan after our move--most seem closed to new patients, some bizarrely so--they wanted a health history before would agree to see us, and one asked my husband, first thing out their mouth-- Do you have medical marijuana card?

I am think WTF is this place we have moved to? We have Blue Cross Blue Shield employer provided plan.

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Originally Posted by Alan

...I think we forget that the ACA's promise of "affordable health care" is mis-leading. What they're actually promising is "affordable health insurance" and neglecting the barriers it places in front of actual health care. ...

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Good point. We should just institute single-payer, and remove the insurance middle man. We've experimented with insurance, and it hasn't served us well.

I agree, Jane!

Well, some doctors are turning away any patient that is not a retainer paid member of their group. Concienge medicine anyone?

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Originally Posted by JaneV2.0

Good point. We should just institute single-payer, and remove the insurance middle man. We've experimented with insurance, and it hasn't served us well.

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I'm not sure how single-payer would solve the problem. It would only replace a private sector bureaucracy with a government bureaucracy, while broadening the disincentives to practitioners. I suppose it would have to require the vast majority of health care providers become government employees (wage slaves), another disincentive to future practitioners.

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Well, some doctors are turning away any patient that is not a retainer paid member of their group. Concienge medicine anyone?

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So a few rich people will have conceirge medicine (and if you think you are one of them, well you are probably not, unless you really are rich - if the middle class wants to think they are rich they are badly deluded). And that will be of little concern whatsoever to most people, as they not being conceirge class, will still have to have whatever they are able to get if anything I guess (even if it's going to Mexico if it comes to that eventually I suppose, until then employer plans I guess).

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Originally Posted by jp1

Before we could say that we would need to assess whether those with Obamacare had previously had other insurance that made higher payments for doctor's services.

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Good point, and the inescapable fact is that some folks went from no options to some options. Given all the possible scenarios, that scenario is the one that all reasonable people would prefer to be removed from by such a change, if they began there.

If nothing else, getting rid of the insurance companies would reduce costs considerably. Or it should.

People try to avoid considering two aspects at the same time, but looking at this matter without holding both aspects in mind together at the same time is itself a corruption - the two aspects being cost efficiency AND universal access. The moral imperative recognizes that people shouldn't die, or suffer a second-class physical existence, because they're poor. The reality is that most of the benefit we gain from improving the efficiency aspect of this naturally will go towards remedying the moral failing of society with regard to the access aspect. That really frustrates those who just want to gain for themselves some marginal advantage in terms of cost of their own healthcare. So much change and they don't see how it benefits them personally, because they're actually not hurting as badly as others.

Single-payer itself won't overcome that. That would require UHC. Basic healthcare can be provided more efficiently when offered to all, like the US armed forces protects the nation efficiently, because it provides the same service predicated on everyone getting it. Economies of scale are real, but it requires acknowledging the value of building a system that doesn't need to police access, doesn't have to have a huge infrastructure to channel funding and payments, etc.

And remember that people who opt-out by securing their own service doesn't really degrade from that efficiency. By paying their own way for concierge services, they're actually relieving some pressure on the provision of basic service, and don't obviate the benefits of efficiency.

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Originally Posted by dmc

Yep, we can always just keep adding to the debt. What could go wrong. Just keep putting things off till after the next election.

Its not going to affect me anymore, I already quit working years ago. I was one of those evil 1% who got tired of putting in all those hours to pay more in taxes than I was spending. I need to look into what other freebies I am entitled to. I am unemployed after all.

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I just love how the whole republican meme of the poor, hard working 1% (who are makers, after all, and not takers), the job creators who really really just need some more tax breaks/perks, that meme is so handily crushed by...the 1%. (completely clueless I might add)
Exhibit 1.

You know, I'm guessing if you dress in rags and maybe rub a little dirt on yourself, the church down the street would give you some nice clothes and a hot meal. Perhaps you can work that angle. You know, free stuff.

I just plan on doing what the Democrat's want. I'll keep my income around 60k and get on the goverment dole. Why worry about the grandkids, they can figure out how to pay for our debt. I'm just another unemployed 56 year old after all.

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Originally Posted by dmc

I just plan on doing what the Democrat's want. I'll keep my income around 60k and get on the goverment dole. Why worry about the grandkids, they can figure out how to pay for our debt. I'm just another unemployed 56 year old after all.

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You know, a long time ago we were asked on this forum to not engage in stereotyping.
I think your statement may be meant to be funny, but it's pretty tiresome to continually hear that Democrats want everyone to be unemployed and live off of government benefits. Really? Because I don't know a single one who doesn't have the same behavioral values that every normal person - Democrat, Republican, Independent, or none of the above - would applaud, including getting a good education, making something of yourself, working hard, saving money for emergencies and retirement, helping your neighbor, etc. etc.

So I would like to see us get back to discussing real solutions to real problems, and stop the silly stereotyping.

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Originally Posted by Lainey

You know, a long time ago we were asked on this forum to not engage in stereotyping.
I think your statement may be meant to be funny, but it's pretty tiresome to continually hear that Democrats want everyone to be unemployed and live off of government benefits. Really? Because I don't know a single one who doesn't have the same behavioral values that every normal person - Democrat, Republican, Independent, or none of the above - would applaud, including getting a good education, making something of yourself, working hard, saving money for emergencies and retirement, helping your neighbor, etc. etc.


So I would like to see us get back to discussing real solutions to real problems, and stop the silly stereotyping.

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I'm just responding to Peggy's comments, I get tired of it also.

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Originally Posted by Alan

. I suppose it would have to require the vast majority of health care providers become government employees (wage slaves), another disincentive to future practitioners.

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Other countries seem to have overcome that hurdle. I know that some Americans hate the idea that other countries have something to teach us, but maybe we could look at how other countries have continued to get people to go into the medical profession despite the horror of being a [gasp] government employee.

Well any 'taking advantage of the system' probably just stems from the flaw of the system not being universal really, it's built in. Whatever you can live with yourself with at any given time I guess, just don't complain when others also game systems, taking out student loans for non-student expenses is one I heard recently (but if one was broke and unable to find work it could be a means of survival and I don't knock survival).

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Really? Because I don't know a single one who doesn't have the same behavioral values that every normal person - Democrat, Republican, Independent, or none of the above - would applaud, including getting a good education

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or don't. I value learning. Just much of "education" is just job training rather than much else. So yes do job training if you need or want the additional income and have reason to believe it is likely to pay off and don't if you don't. It still does statistically pay off in many cases, if you don't go crazy with the debt, just less and less so.

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making something of yourself

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What is something? Career success, parenting, something more esoteric, self-actualization?

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working hard

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work as much as you must to survive if you don't have any better options, but no point in glorifying it. :)

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saving money for emergencies and retirement

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someone posted that the poor don't and instead give their money to the friends and family in need. I could find nothing wrong with that value system, the gift economy existed long before all this (and it's about a network of obligations). It's just perceived as a risky strategy by the middle class (and it probably would be for them if the support structures aren't there!). But is it risky? No the fact they may be poor doesn't prove it's risky, whether it helps in times of financial need or not compared to saving would be some proof (although the benefits of living that way may be greater than that - it's pretty stressful to be poor, maybe that helps).