American Politics Thread: Orange is the new POTUS

[FlameOn]

Originally Posted by nfotiu

Oh yeah, for sure. I don't understand why neither party is willing to try to tackle the absurd malpractice costs. There is probably enough money in that pot to make for good health care options for everyone and reduce taxes.

Well funded insurance lobbyists contributing to political campaigns because of Citizens United.

[ernie]

Originally Posted by nfotiu

I think the problem is that it didn't help enough people. If you are in the narrow income range that gets full subsidies for premiums and also subsidies that keep the out of pocket expense low, then it is fantastic. The next income group up who get subsidized premiums, but not subsidized deductibles would be fairly happy I assume. People who benefited from expanded medicaid in some states are probably in favor as well.

But that's just not enough people who benefited to have enough impact on elections. People who buy their own insurance and don't qualify from any subsidies probably don't feel any better off now, and may feel worse off. People on employer plans weren't affected much, but like to unfairly blame Obamacare for rising premiums.

Obamacare would have probably been much more popular if the subsidies went up to higher income levels. Obamacare's biggest flaw is that it did nothing to lower overall health care costs. If they could have figured out some kind of tort reform to reduce malpractice costs and then it could have been very popular.

There is no doubt that it didn't go far enough or help enough people but those it did help do not want it to go away. I disagree that there aren't enough people it helped to turn an election...the margins were slim.

The problem is people never understood what it actually was. They fall into their political camp and therefore it is good or it is bad no matter what it said. However, from the very beginning study after study and poll after poll showed if you stripped away the name (Obamacare) there was significant support for each item. Right now you have people connecting "Obamacare" with those items they liked. And they don't want to lose it.

You say it's not enough to turn an election...I'd say it is clear that those thoughts are very much influencing the moderate republicans and those from states that greatly benefited from it. It's why a party in complete control of congress, the senate and the presidency can't get anything done. There are still some non-ideologue republicans that are actually listening even if it's for job preservation.

The ACA is getting more popular everyday. Last poll I saw had 50% approval of the law and only about one third support repeal. The bulk of Americans want to see improvements on the law using the existing law as the backbone for those improvements. Perhaps the GOP will start listening after this embarrassing set back. Well clearly not but when repeal and replace later fails maybe then. It isn't going to take long for the immediate repeal be colored for what it is....tax break for the rich on the backs of everyone else. Tax breaks for the rich is the only thing the GOP cares about and what their entire agenda from taxation to healthcare is based on.

It doesn't absolve the Dems. Now is the time to reach across the aisle to moderate republicans and start making fixes.

[dash_pinched]

AP Politics‏@AP_Politics
Hurricane center calls Tropical Storm Don “small” and ″not particularly well organized.”

[Lanny_McDonald]

Originally Posted by nfotiu

Obamacare's biggest flaw is that it did nothing to lower overall health care costs.

Obamacare was not a healthcare bill. It was a health insurance mandate. Healthcare outcomes are not mentioned in any of the "healthcare" bills because lobbyists don't care about making people well, they care about generating profits for their benefactors.

If they could have figured out some kind of tort reform to reduce malpractice costs and then it could have been very popular.

Tort reform is irrelevant to healthcare outcomes as well. Tort reform is nothing more than insurance for doctors who have a propensity to #### up a lot. If you are a good physician and responsible in your actions you have no worries that your general insurance can cover. Where the problem is found is with doctors who are incompetent, perform risky procedures, or do not properly explain the risks of procedures they are performing on their patients. There are just too many physicians who have a God complex and over-promise to their patients. When things go sideways, they leave themselves open to malpractice suits, most because they practice medicine in irresponsible ways.

Healthcare and the healthcare laws should be driven by healthcare outcomes and the services required to meet and maintain those outcomes. A healthcare law should be like project charter and explicitly state the requirements that the healthcare system is to meet or exceed. Based on those requirements, the essential services can be identified and codified as mandates for all systems to provide as bare minimums. The behaviors of doctors and insurers are controlled through the identified mandates, and as a result costs should be controlled.

If you truly want cost controlled healthcare, the answer is single payer. Having a single insurer who is responsible for meeting the mandates as stipulated by law would allow that insurer to have suppliers bid to provide equipment and services. This is true competition that controls costs. At the same time you still allow insurance carriers to compete for supplemental services (dental, vision, discretionary services, etc.) providing for those with money to get upscale or private services where available. Basic healthcare should be available to all, and at a reasonable cost. Single payer provides for that.

[nfotiu]

Originally Posted by New Era

Obamacare was not a healthcare bill. It was a health insurance mandate. Healthcare outcomes are not mentioned in any of the "healthcare" bills because lobbyists don't care about making people well, they care about generating profits for their benefactors.



Tort reform is irrelevant to healthcare outcomes as well. Tort reform is nothing more than insurance for doctors who have a propensity to #### up a lot. If you are a good physician and responsible in your actions you have no worries that your general insurance can cover. Where the problem is found is with doctors who are incompetent, perform risky procedures, or do not properly explain the risks of procedures they are performing on their patients. There are just too many physicians who have a God complex and over-promise to their patients. When things go sideways, they leave themselves open to malpractice suits, most because they practice medicine in irresponsible ways.

I can't agree with any of that paragraph. OB/Gyns pay a fortune in malpractice insurance. Doctors spend over $200,000 per year in some places. Is that because they are all crappy doctors doing risky procedures? It's wasted money that should be spent on health care, not going to malpractice insurance companies and lawyers. Doing things like capping non-economic damages nationally, and limiting lawyers' cuts on medical claims could allow health care costs to be cut dramatically.

I have a very hard time believing that the threat of expensive malpractice suits does anything to improve health care. I think the studies out there support that position. If they don't, feel free to show some credible evidence.

The ACA should have found ways to reduce costs, and the lowest hanging fruits are malpractice costs, and administrative costs.

[nfotiu]

Originally Posted by ernie

There is no doubt that it didn't go far enough or help enough people but those it did help do not want it to go away. I disagree that there aren't enough people it helped to turn an election...the margins were slim.

The problem is people never understood what it actually was. They fall into their political camp and therefore it is good or it is bad no matter what it said. However, from the very beginning study after study and poll after poll showed if you stripped away the name (Obamacare) there was significant support for each item. Right now you have people connecting "Obamacare" with those items they liked. And they don't want to lose it.

You say it's not enough to turn an election...I'd say it is clear that those thoughts are very much influencing the moderate republicans and those from states that greatly benefited from it. It's why a party in complete control of congress, the senate and the presidency can't get anything done. There are still some non-ideologue republicans that are actually listening even if it's for job preservation.

The ACA is getting more popular everyday. Last poll I saw had 50% approval of the law and only about one third support repeal. The bulk of Americans want to see improvements on the law using the existing law as the backbone for those improvements. Perhaps the GOP will start listening after this embarrassing set back. Well clearly not but when repeal and replace later fails maybe then. It isn't going to take long for the immediate repeal be colored for what it is....tax break for the rich on the backs of everyone else. Tax breaks for the rich is the only thing the GOP cares about and what their entire agenda from taxation to healthcare is based on.

It doesn't absolve the Dems. Now is the time to reach across the aisle to moderate republicans and start making fixes.

I don't think we are too far off in how we view things. I do think that too many people ended up in the "make too much to qualify for subsidies, but now have to buy more insurance than they want or can afford" category, and their voices drowned out the people who were truly helped by it.

I agree that a lot of the opposition against Obamacare is not based on fact though.

[Bill Bumface]

Originally Posted by Senator Clay Davis

As I have always said....

"Do a great healthcare plan"


Ladies and Gentleman, the President of the United States of America.

[DuffMan]

Originally Posted by Bill Bumface

"Do a great healthcare plan"

Ladies and Gentleman, the President of the United States of America.

awhile ago it was "a beautiful picture"

Donald J. Trump ✔ @realDonaldTrump
Despite what you hear in the press, healthcare is coming along great. We are talking to many groups and it will end in a beautiful picture!
10:01 AM - 9 Mar 2017

[Lanny_McDonald]

Originally Posted by nfotiu

I can't agree with any of that paragraph. OB/Gyns pay a fortune in malpractice insurance. Doctors spend over $200,000 per year in some places. Is that because they are all crappy doctors doing risky procedures? It's wasted money that should be spent on health care, not going to malpractice insurance companies and lawyers. Doing things like capping non-economic damages nationally, and limiting lawyers' cuts on medical claims could allow health care costs to be cut dramatically.

Total cost of malpractice insurance in the United States in 2010 was 2.4% of all medical expenditures.

https://www.forbes.com/sites/rickung.../#6064b6f32ff5

https://www.hsph.harvard.edu/news/pr...lity-costs-us/

For doctors this is a definite cost they would like to see cut. That is pure profit right into their pockets. Any reductions would be minimal. That's a doctor's cost of doing business, not a "healthcare" cost. If the AMA really felt so strongly about this issue, there would be tort reform in place, and it would have happened a long time ago.

I have a very hard time believing that the threat of expensive malpractice suits does anything to improve health care. I think the studies out there support that position. If they don't, feel free to show some credible evidence.

From the Harvard article.

”While some elements of medical liability costs — such as the high amount spent on legal expenses —represent inefficiencies and could be trimmed, Mello counters claims that money spent on medical liability is waste. “We shouldn’t forget that despite all its dysfunctions and inefficiencies, the medical liability system does produce social benefits,” she said. “It makes injured patients whole by providing compensation; it provides other forms of ‘corrective justice’ for injured persons, producing psychological benefits; and it may deter future injuries by signaling to health care providers that they will suffer sanctions if they practice negligently and cause injury.# The question is, can we reform the system to enhance these benefits and get them at lower cost?”

The ACA should have found ways to reduce costs, and the lowest hanging fruits are malpractice costs, and administrative costs.

As pointed out, malpractice costs are all a part of doing business. Let me ask you a question about malpractice costs. Do you think malpractice insurance costs would be lower if doctors put some skin in the game by operating as an individual rather than as a shielded corporation? Because they are so shielded the insurance carrier is assuming a massive amount of risk on behalf of their customer. I'm sure premiums would come down if the doctor assumed more risk, meaning the carrier assumed less risk? If I'm a ####ty driver and I want a zero deductible policy, I can get it, I'm just going to play through the nose. If I'm a good driver and take a higher deductible, putting some of my skin in the game, my insurance rates are much lower. Think these are contributing factors to this cost?

Again, the ACA was not about healthcare or reducing costs, it was about providing insurance to people and guaranteeing 40 million new customers to the medical insurance industry. Nothing more, nothing less. I would love to see a discussion about a healthcare law, but the politicians are too busy talking about how they are going to carve up the pie of all the money in that part of the economy.

[direwolf]

Looks like plan C is also dead.

https://www.nytimes.com/2017/07/18/u...722706&ref=cta

With their bill to repeal and replace the Affordable Care Act in tatters, Senate leaders on Tuesday pushed to vote on a different measure that would repeal major parts of President Barack Obama’s health law without a replacement — but that plan appeared also to collapse.

Senators Susan Collins of Maine, Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska, all Republicans, immediately declared they could not vote to repeal the Affordable Care Act without a replacement — enough to doom the effort before it could get any momentum.

“I did not come to Washington to hurt people,” Ms. Capito said in a statement. “I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.”

Senator Rob Portman of Ohio hinted strongly that he too would oppose it.

It was unclear whether Mr. McConnell would even be able to clear a procedural hurdle to get to a vote on the repeal-only measure. He faced the same math problem as with his own bill: He can afford to lose only two Republican senators, with Vice President Mike Pence breaking the tie.

Not only has he apparently lost three, Senators Collins, Murkowski and Capito, but he must wait for the return of an ailing Senator John McCain, Republican of Arizona.

Ms. Collins said she would vote against the procedural step.

“I do not think that it’s constructive to repeal a law that is so interwoven within our health care system without having a replacement plan in place,” she said. “We can’t just hope that we will pass a replacement within the next two years. Repealing without a replacement would create great uncertainty for individuals who rely on the ACA and cause further turmoil in the insurance markets.”

Mr. Portman all but joined her.

“If it is a bill that simply repeals,” Mr. Portman said, “I believe that will add to more uncertainty, and the potential for Ohioans to pay even higher premiums, higher deductibles.”

[Senator Clay Davis]

Shockingly Trump is being proven to be a garbage negotiator. Just out of curiosity to his cultists, is the non-stop winning getting tiring yet?

[nfotiu]

Originally Posted by New Era

Total cost of malpractice insurance in the United States in 2010 was 2.4% of all medical expenditures.

https://www.forbes.com/sites/rickung.../#6064b6f32ff5

https://www.hsph.harvard.edu/news/pr...lity-costs-us/

For doctors this is a definite cost they would like to see cut. That is pure profit right into their pockets. Any reductions would be minimal. That's a doctor's cost of doing business, not a "healthcare" cost. If the AMA really felt so strongly about this issue, there would be tort reform in place, and it would have happened a long time ago.

It's ridiculous to say that cost of business does not factor in to the cost of service. That 2.4% translates to 54 billion dollars per year, and would be more than enough to pay for all obamacare subsidies. It also translates to saying that every household pays $450/year on fighting/insuring/preventing malpractice claims. As your article points out, a lot of that money goes towards healthcare insurance paying for unnecessary tests used solely to defend against malpractice claims and very little of that goes to patients who've been wronged.

From the Harvard article.

”While some elements of medical liability costs — such as the high amount spent on legal expenses —represent inefficiencies and could be trimmed, Mello counters claims that money spent on medical liability is waste. “We shouldn’t forget that despite all its dysfunctions and inefficiencies, the medical liability system does produce social benefits,” she said. “It makes injured patients whole by providing compensation; it provides other forms of ‘corrective justice’ for injured persons, producing psychological benefits; and it may deter future injuries by signaling to health care providers that they will suffer sanctions if they practice negligently and cause injury.# The question is, can we reform the system to enhance these benefits and get them at lower cost?”

There's a lot of opinion in that statement, but it isn't really contradicting anything I am saying. I wasn't arguing to get rid of malpractice altogether, just to limit them like Canada and some states do.

You seem to have a strong bias against doctors, which I don't share.

[Lanny_McDonald]

Originally Posted by nfotiu

You seem to have a strong bias against doctors, which I don't share.

What? Where the hell does that come from? Just because I think that some doctors crying foul over the cost of the insurance they have to carry is disingenuous makes me biased against doctors? That's like suggesting that because I think teenagers who complain about high insurance premiums for bad driving should just shut up and deal it, that I have a bias against all teenagers, or worse, all drivers. Crazy.

You'll have to excuse me if I believe that there are better ways to control the costs of healthcare in the United States by examining the other 97.6% of costs, rather than those insurance costs that protect the public from the transgressions of those entrusted in providing positive healthcare advice and life saving procedures. Frankly, if a doctor cuts off the wrong leg, he deserves every punitive damage that is headed his way. That ain't bias, that's just believing in what is right. If you #### up someone else's life because of your intentional actions, you deserve to have your life ####ed up.

[GirlySports]

The ACA definitely made a number of improvements but health care still is prohibitively expensive for way too many people. Having private insurance doesn't help much if the deductibles are too much for you to afford. At a minimum, expanded Medicaid/Medicare eligibility is essential. But the Democratic Party should be pushing for at least a public option, if not single payer. Hopefully that will be part of their platform in 2018 and beyond.

I don't think the Dems would even want that. Its not like they're historic rivals of the insurance industry or something.

[Thor]

Originally Posted by Senator Clay Davis

Shockingly Trump is being proven to be a garbage negotiator. Just out of curiosity to his cultists, is the non-stop winning getting tiring yet?

On facebook I've noticed the "big quiet" from those vocal Trump fans I have been used to seeing trying to excuse, support and laugh at libtards.

Its glorious.

[MissTeeks]

[MissTeeks]

Double post

[Leeman4Gilmour]

If I were running the Democratic Party, I'd pick now to acknowledge a couple of flaws in the ACA as it stands, and offer up some amendments to the ACA to fix these flaws. I think Obama had already acknowledged it wasn't perfect and needed some kinks worked out so maybe they've already tabled something. Anyway, it would be a wonderful coups if the Democrats absolutely killed "repeal and replace" by coming forward with a bi-partisan "fix" instead which was accepted.

[ResAlien]

Originally Posted by Leeman4Gilmour

If I were running the Democratic Party, I'd pick now to acknowledge a couple of flaws in the ACA as it stands, and offer up some amendments to the ACA to fix these flaws. I think Obama had already acknowledged it wasn't perfect and needed some kinks worked out so maybe they've already tabled something. Anyway, it would be a wonderful coups if the Democrats absolutely killed "repeal and replace" by coming forward with a bi-partisan "fix" instead which was accepted.

I feel that in the current political climate the Republicans will at best not change anything. They can afford to buck their own party by not playing ball and sell it as protecting their constituents but working with Democrats? They'll get decimated in their reelection campaigns by a conservative opponent.

I could be proven wrong but a bipartisan health care bill? No I imagine any fix to the ACA would have to come with a legislative shift to Democrats but even then whichever Republican is in office (Don, Pence, Ryan) will veto it.

No I think the way this plays out is the Republicans will actively sabotage ACA markets until the situation is so untenable that a fix must be passed. They'll force a change by hurting their base who will blame Democrats anyway.

[CorsiHockeyLeague]

I do think that if they can get control in 2018, put forward an "Obamacare Plus" that addresses the major deficiencies in the old system, and then the President vetoes it, well, if the current administration isn't sunk by then that might do it. People would be pissed.