Obamacare: So much for 'bending the cost curve'

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Politically incorrect debates should not be done in public. You win.

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medical students shouldn't be allowed to post here jesus christ
 
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Politically incorrect debates should not be done in public. You win. ;)

Just an FYI: most legal immigrants become citizens within 5-7 years after immigration, hence would not qualify as immigrant non-citizens. So the proportion of legal immigrants who suddenly cannot support themselves,after getting their green card less than 5 years ago, is probably much lower than you think.

For one, I'd like to see some data that shows most legal immigrants become citizens within 5-7 years.

Beyond that, you clearly didn't even read the very first line of the quote. Maybe you saw so much text and just skipped the whole thing. Here, I'll copy and paste just the first line so that you're not scared of the full explanation and might actually read it this time:


"Immigrants (legal and illegal) are referred to by the Census Bureau as the foreign-born. The foreign-born are individuals who were not U.S. citizens at birth. This includes naturalized citizens"
 
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If it'll mean financial bust for many families and sub-standard care, we'll know soon enough. Too many anecdotes on both sides so far. Time will tell.
 
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You are right, I missed that phrase.
 
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Why? "Immigrants" includes recent immigrants as well as people who have been here for decades. It's simply everyone who wasn't born here. Immigrants don't have permanent sponsorship deals.
Actually family-based permanent residents do. And it expires only when the sponsor dies or the sponsee becomes a citizen.
 
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Look at the graph above. The ACA/Obamacare has been a success or has it? The Uninsured rate dropped mostly due to Medicaid Expansion (free healthcare) and subsidies on the exchanges (paid for by the taxpayer). This Trillion dollar expansion of the welfare state will lead to either higher taxes and larger deficits or both. The Medicare tax on the "rich" ( many of you) won't cover the cost of the ACA.

The middle class voter, who buys insurance on the exchanges, is facing higher deductibles and large premium increases in 2016. Obama must be quite pleased with his transitional plan to a single payer health care system.
 
When the rest of the States expand Medicaid Enrollment the cost of the ACA will sky-rocket. Of course, the % uninsured will drop some more but can we afford this cost? How will the already broke USA pay for the ACA/Medicaid expansion/Subsidized exchanges? HIGHER TAXES which leads to lower economic growth and stagnation like most of Europe.
 
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FYI, I am "pro" Medicaid expansion in my State. I know taxpayers will need to come up with the money. I am not "pro" ACA because this is a State/Local issue and not a Federal one. Unfortunately, the Constitution has been ignored by Congress and SCOTUS and the ACA is the law of the land.

When you add up the real costs of the ACA to the States and the Federal govt it is well over 1.5 Trillion in the next decade. Since Obama doesn't care about deficits why should he care about another Trillion in spending to the already 18 Trillion we already owe.
 
Recent US Federal Deficit Numbers
Obama Deficits
FY 2016*: $474 bln
FY 2015*: $583 bln
FY 2014: $483 bln
FY 2013: $680 bln
FY 2012: $1,087 bln
FY 2011: $1,300 bln
FY 2010: $1,294 bln
Bush Deficits
FY 2009†: $1,413 bln
FY 2008: $458 bln
FY 2007: $161 bln
FY 2006: $248 bln
FY 2005: $318 bln
 
Look at the graph above. The ACA/Obamacare has been a success or has it? The Uninsured rate dropped mostly due to Medicaid Expansion (free healthcare) and subsidies on the exchanges (paid for by the taxpayer). This Trillion dollar expansion of the welfare state will lead to either higher taxes and larger deficits or both. The Medicare tax on the "rich" ( many of you) won't cover the cost of the ACA.

The middle class voter, who buys insurance on the exchanges, is facing higher deductibles and large premium increases in 2016. Obama must be quite pleased with his transitional plan to a single payer health care system.

The transition is just part of the plan and has been the whole time.

For the people out there who think that's just right wing conspiracy talk I say this.

Either the democrats are incredibly stupid (and so is anyone who actually bought into it) to think something like the ACA would actually work and be successful;

OR

The plan the whole time was to create a debacle, collapse the system and leave no other choice but for the government to swoop in and save everybody by giving Medicare to everyone, aka a single payer system. The beauty is most will be thankful for the government coming to rescue them.

I can see how people got caught up in wanting to be humanistic and give everyone medical care but anyone who objectively looked at the ACA, considered its financial impact AND though it was a good idea is stupid.

I sincerely hope most people got swept up by emotion and aren't that dumb, but I'm not so sure.
 
Even Liberals should understand that deficits don't matter until they DO MATTER. Will our debt/bonds still be bought by the Chinese and other investors when we exceed 100% of GDP? Is it possible that these large deficits could cause devaluation of our currency and thus our way of life circa 2025? Finally, why would any intelligent person allow the deficit to reach these astronomical levels when sound fiscal policy is much better for our economy? The easy road has consequences down the line.
 
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The whole ACA to single-payer debate is a rhetorical tool used equally by both sides (excite vs incite).

The problem is that the current system, pre or post-ACA, sucks. And it sucks because, like most industries in the US, it has been systematically co-opted by large businesses to serve their interests, and those interests are advanced by the government in exchange for campaign contributions.

We have the highest administrative burden of any healthcare economy in the world. Look at this:

https://magic.piktochart.com/output/2353598-admin-cost

Admin Cost.png
 
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The whole ACA to single-payer debate is a rhetorical tool used equally by both sides (excite vs incite).

The problem is that the current system, pre or post-ACA, sucks. And it sucks because, like most industries in the US, it has been systematically co-opted by large businesses to serve their interests, and those interests are advanced by the government in exchange for campaign contributions.

We have the highest administrative burden of any healthcare economy in the world. Look at this:

https://magic.piktochart.com/output/2353598-admin-cost

View attachment 193884
The problem with that argument is by correctly pointing out administrative costs it implies that other countries with single payer systems are completely efficient with their cost structure. As if the government that administers healthcare has no waste and and is entirely efficient.
 
How do they define "waste"? Although, it does seem like an awful lot of overhead with all the different insurance companies, hospital systems, billing companies, EMR systems, exchanges, etc etc.
 
I'm reading the article they cited for the claim "In the US system, nearly 15% of all spending is administrative waste."

I can't figure out what in this article would justify that claim. It doesn't even use the term "waste" at all. This seems to be the closest thing I could find:
"In the United States, administrative tasks consumed 13.5 percent of physicians' time"


It does, however, contain these excerpts:

"In 1999 U.S. .. [private insurers'] average overhead (11.7 percent) exceeded that of Medicare (3.6 percent) and Medicaid (6.8 percent)"

"The overhead costs of Canada's provincial insurance plans totaled $311 million (1.3 percent) of the $23.5 billion they spent for physicians and hospital services."

"U.S. employers spent $12.2 billion on internal administrative costs related to health care benefits and $3.7 billion on health care benefits consultants — a total of $15.9 billion, or $57 per capita (Table 1). Canadian employers spent $3.6 billion for private health insurance and $252 million to manage health benefits, or $8 per capita."

"The average U.S. hospital devoted 24.3 percent of spending to administration. Hospital administration consumed $87.6 billion, or $315 per capita (Table 1). In Canada, hospital administration cost $3.1 billion — 12.9 percent of hospital spending, or $103 per capita."

"A system with multiple insurers is also intrinsically costlier than a single-payer system. For insurers it means multiple duplicative claims-processing facilities and smaller insured groups, both of which increase overhead.41,42 Fragmentation also raises costs for providers who must deal with multiple insurance products — at least 755 in Seattle alone43 — forcing them to determine applicants' eligibility and to keep track of the various copayments, referral networks, and approval requirements. Canadian physicians send virtually all bills to a single insurer. "

And also, the article is from 2003.
 
We have reached the first part but all that means is we are at a point of no return - i.e. we'll never get a government that will try to stop these costs from accelerating because if they tried, they'd get deselected at the voting booth.

"A democracy cannot exist as a permanent form of government. It can only exist until the majority discovers it can vote itself largess out of the public treasury. After that, the majority always votes for the candidate promising the most benefits with the result the democracy collapses because of the loose fiscal policy ensuing, always to be followed by a dictatorship, then a monarchy." unsourced attribution to Alexander Fraser Tytler

I have an easy fix for that. Only people who pay income taxes should be allowed to vote. The rest of the people are dependents of the state just like children.
 
I'm reading the article they cited for the claim "In the US system, nearly 15% of all spending is administrative waste."

I can't figure out what in this article would justify that claim. It doesn't even use the term "waste" at all. This seems to be the closest thing I could find:
"In the United States, administrative tasks consumed 13.5 percent of physicians' time"

Yes, the (seminal) Woolhandler and Himmelstein article on this topic is from 2003. Nobody thinks that US HC administration has become MORE efficient since then.
 
The problem with that argument is by correctly pointing out administrative costs it implies that other countries with single payer systems are completely efficient with their cost structure. As if the government that administers healthcare has no waste and and is entirely efficient.

Not true. It defines waste as the delta between what other countries with similar levels of economic development spend on a per-cap basis and what we spend on a per-cap basis.

The other countries need not be perfectly efficient, nor are they assumed to be in this analysis.
 
I have an easy fix for that. Only people who pay income taxes should be allowed to vote. The rest of the people are dependents of the state just like children.

So if I'm a college student I get no say? You didn't enjoy the minute you could vote for a presidential candidate after you turned 18? Stay at home dad can't vote? 70 year old retired anesthesiologists?
 
So if I'm a college student I get no say? You didn't enjoy the minute you could vote for a presidential candidate after you turned 18? Stay at home dad can't vote? 70 year old retired anesthesiologists?

SCOTUS would never allow it. So, it would take a Constitutional amendment to make any changes to who can not vote in the USA.

It makes for good discussion but that's about as far as it goes.
 
Not true. It defines waste as the delta between what other countries with similar levels of economic development spend on a per-cap basis and what we spend on a per-cap basis.

The other countries need not be perfectly efficient, nor are they assumed to be in this analysis.
No doubt that we don't get the return for our money that other countries seem to. It's unfortunate that our politicians are to dysfunctional to make a dent in per capita spending anytime in the forseable future.
 
So if I'm a college student I get no say? You didn't enjoy the minute you could vote for a presidential candidate after you turned 18? Stay at home dad can't vote? 70 year old retired anesthesiologists?
No because at age age 18 we are idiots, too easily persuaded by rhetoric. Yes, I got a thrill when I voted after I turned 18 and soon after I realized the folly of my vote and got buyer's remorse the summer I got my first good paying job and saw my pay check assaulted with all the B.S. deductions. Stay at home Dad usually has a spouse who pays income taxes to the system. 70 year old anesthesiologist has paid way way way more than he will ever take back from the system - he should get 2 votes for all the $ he has paid in over the years.
 
I'm happy to see you guys really believe in the founding principles of the Constitution.
Tell me what you think the founding principles are. This should be interesting.
 
I'm happy to see you guys really believe in the founding principles of the Constitution.
You do realize that when our nation was founded, only property-owning male individuals (plus property-owning females in NJ) had the right to vote? That was less than 5% of the population back then. Check out the history of voting rights.

Remember that democracy is not inherently good or bad. If the majority vote to infringe on the rights of the few, whether it be to institute slavery, commit genocide, or require those who've chosen to work to surrender the fruits of their labor to those who've chosen to be idle... you get the idea. People have free will, and a lot of freedom in this country, and quite a few use that freedom to wreck their health (smoking, excessive drinking, excessive eating, drugs, risky sexual behavior). I don't care what bad choices others make, but I don't think that those who intentionally choose healthier lifestyles should be made to bear the burden of those that don't. Medicine is a commodity. It's time and resources. You could throw the entire GDP at healthcare, but unless you can lower healthcare costs by lowering the unnecessary demand on the system (ex: abuse of emergency room visits, excessive/unnecessary tests to CYA), you might not win that fight.
 
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So if I'm a college student I get no say? You didn't enjoy the minute you could vote for a presidential candidate after you turned 18? Stay at home dad can't vote? 70 year old retired anesthesiologists?

We would have the tightest fiscal policy ever.

The college student should get a job that makes him/her pay at least 1 dollar in taxes. Otherwise wait for the next election when they are done with college. I don't see the hurry when they have been unable to vote the prior 18 yrs.

The retired anesthesiologist might get a vote if his 401k plus SS place him above the tax bracket. I suspect that would be the majority.

The spouse of the stay at home dad will vote for whatever makes more sense for her. She is already the boss of the house.

Only self sustaining individuals should be allowed to vote. Otherwise people will ruin the country voting for their handouts.
 
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Look at the graph above. The ACA/Obamacare has been a success or has it? The Uninsured rate dropped mostly due to Medicaid Expansion (free healthcare) and subsidies on the exchanges (paid for by the taxpayer). This Trillion dollar expansion of the welfare state will lead to either higher taxes and larger deficits or both. The Medicare tax on the "rich" ( many of you) won't cover the cost of the ACA.

The middle class voter, who buys insurance on the exchanges, is facing higher deductibles and large premium increases in 2016. Obama must be quite pleased with his transitional plan to a single payer health care system.
Actually. To add.

According to the rand report. 8-10million "newly insured" really have nothing to do with the ACA.
8-10 million newly insured simply by gaining jobs and thus employer health coverage.

Just love how liberal group people gaining health insurance coverage and saying it's due to the ACA when it has nothing to do with it.

Kinda of like saying bill clinton's policies worked during the 1990s to achieve the"surplus". Just baloney. We all know the real reason. The Internet boom. Most tax revenues generated from soaring incomes because of tech bubble and capital gains.
 
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