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If Obamacare goes down

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If Obamacare goes down

Postby Huckleby » Sat Mar 24, 2012 9:46 am

I think the most likely outcome of the Supreme Court review is that the mandate will be struck down, and with it the health insurance exchanges and the regulation of the insurance industry. The other half of Obamacare, the addition of 20M to medicaid rolls, will stand.

But lets say the Supremes strike down the whole thing. I expect the Dems will rally around "Medicare for all." The Republicans have already crossed the rubicon and supported Paul Ryan's radical budget. There is no middle ground left. We'd be heading for a more polarized, more hostile, more definitive struggle than we saw over Obamacare.
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Re: If Obamacare goes down

Postby ArturoBandini » Sat Mar 24, 2012 10:04 am

I disagree. I think the SCOTUS will say that the ACA is Constitutional and the U.S. will go forward with it :? I don't get a "limited government" vibe from the SCOTUS, but more of a "keep your executive-branch hands off our judicial power" vibe, when they rule against the administration (as in the recent Sackett vs. EPA case).
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Re: If Obamacare goes down

Postby Huckleby » Sat Mar 24, 2012 10:17 am

ArturoBandini wrote:I think the SCOTUS will say that the ACA is Constitutional and the U.S. will go forward with it :?

So what is your preference? Do you want Obamacare, or ACA as you respectfully call it, to get aborted?

(I hope we don't get lost in debating what the court will do. Opinions & evidence are all over map, that debate comes down to reading chicken entrails. Please endulge me and stick with hypothetical that Obamacare gets axed.)
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Re: If Obamacare goes down

Postby ArturoBandini » Sat Mar 24, 2012 10:36 am

My preference is that the ACA is ruled unconstitutional and implementation is halted immediately. Ideally this would be followed by an effectively complete deregulation of the medical services and pharmaceuticals industries.

However, I recognize that in reality this is extremely unlikely to happen. We'll probably just end up with an incomplete set of dysfunctional policies (instead of a complete set of dysfunctional policies under the ACA), so we may be worse off without the ACA. Price controls will result in shortages of doctors, drugs, insurance products, and other medical goods. Government-run insurance pools will be overwhelmed by the high costs of just the first wave of enrollees, and the whole fight will begin anew.
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Re: If Obamacare goes down

Postby snoqueen » Sat Mar 24, 2012 11:21 am

If the whole healthcare act went down and deregulation was implemented, how would you propose a (say) 55 year old man making $25,000/year with (say) one dependent get healthcare?

I'm serious here. The very poor will continue to get healthcare by showing up at emergency rooms and basically being subsidized by the insured (though their healthcare is then expensive and spotty) and the wealthy will continue to pay for full coverage. It's the inbetweeners, like the example above, who fall through a very large crack. If they receive healthcare, can't pay, go through collections procedures and get garnished, and/or declare bankruptcy they will likely be unable to get another job or an apartment -- so they've got something to lose, unlike the very poor who have nothing to lose. But they clearly can't pay, as the numbers don't work. (Make up some plausible numbers for this person's monthly budget and prove it to yourself if you like: food, rent and utilities, transit, other necessities including various copays, insurance premiums, etc.)
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Re: If Obamacare goes down

Postby Henry Vilas » Sat Mar 24, 2012 11:39 am

Uncovered catastrophic medical bills are the number one reason for personal bankruptcy in the U.S. The rest of the world is astonished by this simple fact.

Around 50 million Americans have no health insurance.
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Re: If Obamacare goes down

Postby Huckleby » Sat Mar 24, 2012 12:30 pm

snoqueen wrote:If the whole healthcare act went down and deregulation was implemented, how would you propose a (say) 55 year old man making $25,000/year with (say) one dependent get healthcare?


Right. And fiscal conservatives on both sides of aisle are in agreement that the age of medicare eligibility needs to be raised. How the F are people from 50-70 range going to get health insurance without Obamacare? Health insurance is going to get more expensive and selective without Obamacare, the spiral of healthy people opting out of insurance pools is already underway.

"Medicare for all" would be a drastic move. It would require a national VAT tax to fund it.

Republicans complain that Obamacare is "european socialism." Ironically, by killing Obamacare and going for their brass ring (that would be the fanstical Paul Ryan budget) the Republicans are pushing the country into being a european country.
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Re: If Obamacare goes down

Postby Henry Vilas » Sat Mar 24, 2012 12:50 pm

ArturoBandini wrote: Price controls will result in shortages of doctors, drugs, insurance products, and other medical goods.

Is that a problem in the rest of the industrial world, where some type of universal care is the rule?

For example single payer for drugs in Canada results in much lower cost. It works in the U.S. for the V.A. medical system. Why can't to be expanded for all Americans?
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Re: If Obamacare goes down

Postby pjbogart » Sat Mar 24, 2012 7:00 pm

If Obamacare is ruled unconstitutional then Republicans will have to explain why health insurance premiums continue to go up. Right now they'd have us believe it's because of Obamacare, so I expect a big reduction any day now.
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Re: If Obamacare goes down

Postby Comrade » Sat Mar 24, 2012 7:48 pm

Henry Vilas wrote:
ArturoBandini wrote: Price controls will result in shortages of doctors, drugs, insurance products, and other medical goods.

Is that a problem in the rest of the industrial world, where some type of universal care is the rule?

For example single payer for drugs in Canada results in much lower cost. It works in the U.S. for the V.A. medical system. Why can't to be expanded for all Americans?


It is indeed a problem where it has been implemented. There is rationing and shortages in the UK. Have you ever watched Prime Ministers Questions? It is often the topic of loud complaints.
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Re: If Obamacare goes down

Postby Henry Vilas » Sat Mar 24, 2012 8:09 pm

We don't need to have the majority of physicians employed by an American national health service, as in the U.K. There are many successful models throughout the industrial world where we call learn from their best practices. A single payer system would be a great start. The economy of scale would save billions and Americans would have better health outcomes. For all the money the U.S. spends on health care, we lag behind many other nations. And ~50 million Americans do without.
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Re: If Obamacare goes down

Postby Huckleby » Sat Mar 24, 2012 9:12 pm

Comrade wrote:It is indeed a problem where it has been implemented. There is rationing and shortages in the UK. Have you ever watched Prime Ministers Questions? It is often the topic of loud complaints.


Overall, satisfaction with the British system remains high. But they have arguably the most fully socialized health system in the world. Its not just single payer, the government operates the hospitals too. "Universal health care" doesn't mean a health care system must or should look like Great Britian's.

The rock-ribbed conservative Heritage Foundage maintains an index of economic freedom. "According to Heritage, the creators of the Index took an approach similar to Adam Smith's The Wealth of Nations that "basic institutions that protect the liberty of individuals to pursue their own economic interests result in greater prosperity for the larger society."
http://en.wikipedia.org/wiki/List_of_freedom_indices

Only five countries in the entire world are rated as "free" given Heritage's stringent equirements for unobstructed capitalism: Austrailia, Hong Kong, Singapore, New Zealand and Switzerland. Every one of these countries offers government-guaranteed universal healthcare. Evidently, insuring that all citizens have good access to healthcare is not incompatible with a vibrant economy, in fact it appears to be critical to a healthy business climate. :idea:
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Re: If Obamacare goes down

Postby Huckleby » Sat Mar 24, 2012 9:21 pm

Henry Vilas wrote: A single payer system would be a great start. The economy of scale would save billions and Americans would have better health outcomes.

Single payer works OK. It saves on administrative costs, but countries that use regulated insurance companies can achieve greater efficiencies overall.

I barely care what kind of system we choose. I could live with the gov controling EVERYTHING like in England, all the way to a free market system where the gov role is limited to providing vouchers for poorer people. There are many ways to get everybody access to health care.

If the Republicans blow-up Obamacare, then it is time to settle-in for "Medicare for All" struggle.
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Re: If Obamacare goes down

Postby Huckleby » Sat Mar 24, 2012 9:26 pm

pjbogart wrote:If Obamacare is ruled unconstitutional then Republicans will have to explain why health insurance premiums continue to go up.

Yes. The Republicans have no answers at all. Well, they have some decent ideas that could be part of a plan, if they were willing to yield on the fundametal issue of universality.

The Dems are going to win this war, it's inevitable.
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Re: If Obamacare goes down

Postby Comrade » Sat Mar 24, 2012 9:28 pm

How did this mess that is healthcare come to be in the UK? Do you know when and how it started and what the people were promised?
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