D.C. Circuit guts ObamaCare

[kramerfan86]

Agreed. Let's just vote in single payer already.

Yea the government is doing such a great job on everything these days giving them even more power seems like a solid idea.

 

[hobbsyoyo]

And the private healthcare market is such a working wonder!

 

[Farm Boy]

Though at this moment in time it's probably the more sensible of the two.

"Uhm, guise? Could we not burn the system down for half the country? Ploxxy plz?"

 

[sophie]

Yea the government is doing such a great job on everything these days giving them even more power seems like a solid idea.

And having the worst ranked health care service for twice the cost among developed nations is working SO well for us right now.

 

[Ajidica]

Yea the government is doing such a great job on everything these days giving them even more power seems like a solid idea.

We just need to resurrect Bevan and everything will be fine.

 

[hobbsyoyo]

@FarmBoy - Really? The private healthcare market was 'burned down'?

Not even close.

And for those who didn't have healthcare before the law, ACA is a godsend. Maybe not the best of all possible options, but definitely a huge improvement. Which is something that those without healthcare never seem to grasp.


And the other improvements that ACA brought to those who already have healthcare (no more lifetime limits, maximum overhead allowances on providers, can keep kids on insurance until 26, etc), well they just get brushed under the rug because if you hate Obamacare for political reasons than there can obviously be nothing good about it.


After all, the ACA did 'burn down' the private healthcare market.

Statements like that are why we can't have a rational discussion about the current state of healthcare in the US and our politicians do nothing but spin their wheels without fixing anything.

 

[kramerfan86]

I know far more people in my personal life whose coverage got worse or more expensive than I do whose situation improved.

And the mindset of "oh well the current system is bad" as an argument for why an idea is good is never a good argument because things getting even worse is always an option. Look at the VA system, look at medicare, look at ACA, the US government is not a competent government, especially at healthcare. Now Im not delusional, we need changes, but dumping all the power in the federal government's lap just seems like an exceptionally bad idea considering their history on the subject.

 

[hobbsyoyo]

My anecdote beats up your anecdote. Plus, there are millions of people who were uninsured who now have insurance in addition to millions of young healthy people paying into a previously unaccesable system and bringing down costs for everyone. But your friends obviously outweigh any statistics.

The VA was chronically underfunded by congress and additionally, a lot of the problems they are facing are due to two factors that everyone forgets:

A) A huge increase in the number of veterans due to our wars
B) A big change in the attitude of the VA wherein they actually have been trying to clean up their mess and start clearing there backlog of vets in need

A) isn't the fault of the VA, neither is the underfunding by congress. B) has had massive ramifications in that because of A) and underfunding, there arose situations where managers felt pressured into lying to make their problems go away. Do you really think that doesn't happen in private markets (of any kind - not just healthcare)?

And the VA does provide a ton of good to veterans and is making huge strides to improve. Plus, they are publicly accountable in a way that private companies never will be when the only people they report to are shareholders.


And what exactly is wrong with medicare?

 

[kramerfan86]

Funding for one, its already riding the struggle bus for funding and it only covers one portion of the population. Secondly, people do not realize how cut rate medicare is with patient care. To save costs they really hack away at patient service and in fact a lot of private insurance companies just follow medicare's lead when they do that. Now that could probably be resolved with funding, but where is the money going to come from if pretty much joins into medicare rather than just the 65 and older population?

 

[Farm Boy]

@FarmBoy - Really? The private healthcare market was 'burned down'?

Not even close.

And for those who didn't have healthcare before the law, ACA is a godsend. Maybe not the best of all possible options, but definitely a huge improvement. Which is something that those without healthcare never seem to grasp.


And the other improvements that ACA brought to those who already have healthcare (no more lifetime limits, maximum overhead allowances on providers, can keep kids on insurance until 26, etc), well they just get brushed under the rug because if you hate Obamacare for political reasons than there can obviously be nothing good about it.


After all, the ACA did 'burn down' the private healthcare market.

Statements like that are why we can't have a rational discussion about the current state of healthcare in the US and our politicians do nothing but spin their wheels without fixing anything.

Nono, not that at all. The private healthcare lobby came out against the ACA hard the first time it was challenged in court. This time, their silence is deafening. They know full well what pulling subsidies from ~37 states will do at this point. It's the government that's currently trying to burn down the healthcare system in place without any game plan to ameliorate harms.

 

[kramerfan86]

Yea I am not sure what the end game is here, I guess the naive hope republicans are going with is if the court does this, the law will be so gutted they'll be able to overturn it, but does anyone think the democrats would actually go for that? Even if the burnt out remains of ACA are all that remain and its a system worse than the old system sheer ego alone means they wont get rid of it. it is very possible for pure reasons of ego something far worse than either ACA or the old system will sit around and fester.

 

[El_Machinae]

Well, prices were rising at what? 8%? The idea is mostly a one-time hit that slows the increase. It's like amortizing insulation to tamp down your heating bills. To be a Cassandra again, it's discovered cures that bring down real prices. Any specific system becomes less costly with discovered cures. It's worth some personal effort. Especially compared to the looming medical bills.

 

[hobbsyoyo]

Nono, not that at all. The private healthcare lobby came out against the ACA hard the first time it was challenged in court. This time, their silence is deafening. They know full well what pulling subsidies from ~37 states will do at this point. It's the government that's currently trying to burn down the healthcare system in place without any game plan to ameliorate harms.

Oh, sorry for the misunderstanding.

Yea I am not sure what the end game is here, I guess the naive hope republicans are going with is if the court does this, the law will be so gutted they'll be able to overturn it, but does anyone think the democrats would actually go for that? Even if the burnt out remains of ACA are all that remain and its a system worse than the old system sheer ego alone means they wont get rid of it. it is very possible for pure reasons of ego something far worse than either ACA or the old system will sit around and fester.

Yeah, it's all just sheer lunacy at this point. The Administration has been firm in stating that they don't have a game plan to deal with a loss of subsidies and the speculation is that they are saying/doing this to put pressure on the court to not gut the subsidies.

Which is a piece of asinine brinkmanship. That said, I don't know realistically what the Administration could do to ameliorate a loss of subsidies. The Republicans won't pass a fix, the democrats won't pass a repeal and we'll just be stuck with a hobbled system.

Well, prices were rising at what? 8%? The idea is mostly a one-time hit that slows the increase. It's like amortizing insulation to tamp down your heating bills. To be a Cassandra again, it's discovered cures that bring down real prices. Any specific system becomes less costly with discovered cures. It's worth some personal effort. Especially compared to the looming medical bills.

On rising prices - it's very easy for someone to point out that they know someone who's rates went up (see above) and even easier to then blame that increase on the law (with or without any proof).
But one thing we do know is the case is that for once, the rate of growth of prices is slowing. Granted, that's not a downturn in prices but realistically that's not possible. But a slowdown in the rate of growth is a huge achievement and there is a lot of evidence to point out that this was because of the ACA, not in spite of it.

 

[Timsup2nothin]

Yea I am not sure what the end game is here, I guess the naive hope republicans are going with is if the court does this, the law will be so gutted they'll be able to overturn it, but does anyone think the democrats would actually go for that? Even if the burnt out remains of ACA are all that remain and its a system worse than the old system sheer ego alone means they wont get rid of it. it is very possible for pure reasons of ego something far worse than either ACA or the old system will sit around and fester.

Does anyone think the Republicans have thought one second beyond this mythical 'overturning'? While the previous system wasn't "burned down", the laws governing it did cease to apply and grudgingly or not the entire industry has shifted into compliance with the new laws...at a substantial cost in aggravation and dollars. The Republicans have run for years on promises to 'undo' the ACA with not a single breath given to how this magical reversal of time is supposed to be accomplished.

That's putting aside that the previous system of 'free market medical services' generated a rapid and continuing spiral in health care services price...and the single largest buyer of healthcare service was in fact the US government. Twenty years from now there will be three times as many octogenarians in the US as there are now, unless we find some convenient justification for killing off the elderly. So the consequences of allowing prices to spiral for another couple decades are entirely predictable, and as the largest consumer our collectively held entity 'the government' cannot survive that. Again, this is putting aside that we can't get back to that anyway.

The ACA was a thousand pages of transition. This old law goes out, this takes effect. That goes out, that takes effect. Decades of planning went into how to make such a transition in the regulation of what is generally considered a vital industry without causing some sort of disastrous collapse. So the Republicans in the house stamp out a one page 'bill' effectively saying 'we don't like it so make it magically disappear' on a weekly basis and then claim they are legislating. Now they have the senate on board, so I assume the entire legislative branch is hopelessly borked.

 

[El_Machinae]

No, I mean before ACA. Prices were rising way above inflation. Now, part of this is because healthcare is a superior good, but also because the entire system is primed for a market failure.

 

[Timsup2nothin]

No, I mean before ACA. Prices were rising way above inflation. Now, part of this is because healthcare is a superior good, but also because the entire system is primed for a market failure.

Healthcare isn't a superior good, it just benefits from superior marketing.

The most powerful marketing tool in the world is forcing an intermediary payment system...by putting the burden of payment on an intermediary you take the purchase decision out of the hands of the actual buyer. "Is this test really necessary?" "Don't worry, your insurance will pay for it." "Oh, okay then."

Creation of the glaringly false perception that to be healthy one must see a doctor, which provides the background of the marketplace.

Outright predation on the fearful customer. In the car business we had a saying; "work the customer 'til they buy or die." We knew, and the customer knew, that there was no reason to expect any result other than 'buy', from either us or someone else. Medical services are routinely sold as 'buy or die' when it is not necessarily true. Had I been allowed to threaten my customers with imminent death my closing rate would have markedly improved.

 

[onejayhawk]

Given comments by Alito and Scalia, they postpone implementation for Congress to fix it or the States to form exchanges.

This Congress? The Democrats will filibuster every move.

Where do the states come in? They already opted out.

No, I mean before ACA. Prices were rising way above inflation. Now, part of this is because healthcare is a superior good, but also because the entire system is primed for a market failure.

As apposed to now, when they are rising much faster than inflation?

I see nothing that has stabilized the market. An inept competitor has entered, with a captive market share. That is not a huge change.

J

 

[JollyRoger]

This Congress? The Democrats will filibuster every move.

Where do the states come in? They already opted out.

J

As to "this Congress", that is exactly what the government lawyer shot back at Scalia belief that Congress would fix it and he received laughter from the audience, including from members of Congress from both parties. In addition to filibuster concerns, you have to get the House to do something - ask the Speaker the likelihood of doing that.

As to the States, they can still opt in.

All pretty moot given that the Government is going to win this case.

 

[Timsup2nothin]

This Congress? The Democrats will filibuster every move.

J

You say this as if any Republican, anywhere, has demonstrated that they have given a single thought to 'fixing' anything. The magic time machine to wind the clock back to 2010 ain't parked in some Republican garage somewhere, is it?

 

[JollyRoger]

They only have to add a couple of words to the statute to fix it. They could have done it already if they wanted to. No filibuster would be expected from the Dems for adding those couple of words.