rickyp wrote:fate

My concern is more about "Why?" Why did all Americans have to suffer some kind of disruption so that people like your friend could get covered. We know that a fraction of those the President is bellowing about are actually "new" to the system. Why is that? Why didn't we just target those without insurance to begin with?

Can you admit that the previous 25 years experience with health insurance costs and availability was disruptive, for many individuals and for society at large?

Can you admit that there was a problem of the un and under insured? That bankruptcies and poor and delayed medical care for the un and under insured? That run away health costs were damaging quality of life for middle class and lower?
And that there were no real answers provided in terms of public policy except in places like Massachussetts.?

And the point is that most will understand that there is some improvement, except in States that, for purely ideological reasons, denied the Medicaid expansion.

And then the question becomes how many people are fiercely ideological like you, and how many do their cost/benefit analysis and decide on something on purely practical application of the costs and benefits?

Time is on the side of the purely practical and as every bogey man diminishes in scale, against the ideologues.

And the point is that most will understand that there is some improvement, except in States that, for purely ideological reasons, denied the Medicaid expansion

So simple-minded, it's not worthy of refutation. That sentence is not only false, it's something you don't even try to prove.

With the June 2012 Supreme Court ruling, the Medicaid expansion became optional for states, and as of December 2013, Texas was not planning to implement the expansion. As a result, many uninsured adults in Texas who would have been newly-eligible for Medicaid will remain without a coverage option

1. That's not the issue.
2. The ACA is worse than doing nothing

danivon wrote:The Swiss system with refinements and tweaks? That seems to be what you are getting - mandatory insurance with set minimum benefits, provision for those who cannot afford it, fines for those who can but don't take it out...

But Obamacare rejects the best ideas the Swiss have to offer — and adopts the worst. Consequently, the president’s healthcare law will not yield the Swiss-style levels of coverage its cheerleaders lust after.

The chief similarity between Obamacare and Santésuisse is the individual coverage mandate. Both countries require all to obtain health insurance.

The mandate is reasonably popular in Switzerland. More than half the Swiss public supports the country’s healthcare system.

That’s partly a function of the country’s cultural aversion to risk. A study conducted by LGT Group and Johannes Kepler University earlier this year found that 77 percent of Swiss investors — a class probably more tolerant of chance than most — described themselves as “risk averse” or “risk neutral.”

Obamacare does not attract comparable support. Fifty-two percent of Americans would like to see it repealed. An even greater share has consistently opposed the law’s individual mandate.

Swiss citizens choose from a pool of 92 government-regulated insurers, all of which must provide a generous baseline package covering doctor’s visits, medication, in-home nursing care, physical therapy, and hospital stays. Remarkably, the Swiss government spends just 2.7 percent of GDP on health care — nearly two-thirds less than what the U.S. government spends.

Liberal health wonks cite the Swiss experience as evidence that Obamacare will work similar marvels. But Switzerland’s achievements are less noteworthy than advertised.

For starters, 96 percent of Swiss had insurance before the installation of Santésuisse in 1996. So the country’s healthcare overhaul upped the coverage rate by a whopping 3 percent.

Further, Switzerland has not yet figured out how to control healthcare costs — as a new paper published by researchers Ewout van Ginneken and Katherine Swartz in the New England Journal of Medicine points out.

Switzerland and Obamacare are both trying to change the way health care is purchased. Managed care is growing in popularity in Switzerland; U.S. officials are hoping Accountable Care Organizations will prove more popular than the last go-round at managed care, the dreaded HMOs. But according to van Ginnekin and Swartz, “[e]xperience from the Netherlands and Switzerland shows that such efforts are not enough.”

The two scholars also contend that Switzerland has had trouble enforcing its mandate. It’s tried to fight noncompliance by levying penalties of up to 50 percent on top of the premium on the uninsured. Swiss folks who lie about their health coverage can actually go to prison.

The United States will face even more difficulty enforcing its mandate — and therefore won’t come close to matching Switzerland’s rate of coverage. At its peak, the fine for failing to comply with the mandate will represent just a fraction of the cost of insurance coverage. According to the Congressional Budget Office, 30 million Americans — or about 8 percent of the population — will be uninsured in violation of the mandate by 2022.

If there’s one aspect of Switzerland’s healthcare system that Obamacare should’ve borrowed, it’s the decoupling of health insurance from employment. The Swiss are free to pursue whatever line of work best suits their talents and interests — rather than settling for a job simply because of the health benefits.

Further, by assigning individuals responsibility for securing their own health insurance, the Swiss system demands that its citizens be cost-conscious.

Many Swiss opt for plans with high deductibles in order to save on monthly premiums. Indeed, the Swiss pay for nearly a third of their health care out of pocket, according to the Organization for Economic Cooperation and Development (OECD). That’s double the share that Americans spend.

The United States could disentangle insurance from employment — à la the Swiss system — by offering individuals the same opportunity to purchase coverage with pre-tax dollars that businesses currently enjoy. Such a move would inject more competition into the insurance marketplace — and force consumers to be more judicious with their healthcare dollars.

Unfortunately, Obamacare takes America in the opposite direction. The law’s mandate that all employers cover their workers cements the employer-sponsored system in place — and exacerbates the cost problems it creates.

Some elements of Santésuisse would prove beneficial if implemented in the United States. But Obamacare chose the wrong ones. Indeed, it appears that the lessons from Switzerland’s healthcare system have thus far been lost in translation.

rickyp wrote:Rickyp

And the point is that most will understand that there is some improvement, except in States that, for purely ideological reasons, denied the Medicaid expansion

.

fate

So simple-minded, it's not worthy of refutation. That sentence is not only false, it's something you don't even try to prove.

Oh come on ....

http://kff.org/state-profiles-uninsured-under-aca/

With the June 2012 Supreme Court ruling, the Medicaid expansion became optional for states, and as of December 2013, Texas was not planning to implement the expansion. As a result, many uninsured adults in Texas who would have been newly-eligible for Medicaid will remain without a coverage option

Similarly you'll find this in all 25 States that have not implemented the Medicaid expansion. Have a look. Or refute with a source like the Kaiser Foundation. You can't.

Actually, that's exactly the issue.
Whether the half assed attempt that is the ACA will net out better than what was the status quo.
Which is all that was, for all intents and purposes, on offer as an alternative...
And be better at:
1) Lowering numbers of uninsured.

2) Improving quality of health insurance offerings to avoid "under insured" running into debt and bankruptcy or finding themselves unable to afford necessary care...

3) bending the curve of health care cost inflation.

Or do you have other metrics in mind?

Governors refused Medicaid expansion because of the curtailing Federal support, which will leave States on the hook for more costs in outlying years

Furthermore, the CBO says 30 million Americans will be uninsured in 2020. That's pretty sad, given all the tumult and cost in the ACA

rickyp wrote:fate

Governors refused Medicaid expansion because of the curtailing Federal support, which will leave States on the hook for more costs in outlying years

.

So, you aren't refuting the claim as you said you could ...you're offering the mealy rationale that the Governors provide as to why they've turned down free money.

And the point is that most will understand that there is some improvement, except in States that, for purely ideological reasons, denied the Medicaid expansion

The question is, what are the States who are turning down medicare doing for the people affected?
The answer is, nothing really.

So how are the uninsured in places like Texas and Loiusiana getting their health care and why is that better and cheaper than Medicaid at 10% of the cost of medicaid?

Comparing the two alternatives is a cost analysis that might fly. Turning down Medicaid that's free today, and costs 10% of the actual cost somewhere down the road without doing the analysis is ideological.

fate

Furthermore, the CBO says 30 million Americans will be uninsured in 2020. That's pretty sad, given all the tumult and cost in the ACA

.
Because of the governors who've turned down the free medicaid expansion.

Complaining that there remain uninsured because some States won't accept Medicaid and laying this at the ACA's door is ridiculous.

That there will be uninsured is not because of the ACA but because of the failure of ideologiically rigid governors turning down the ACA
Its akin to the Man who murdered his parents begging for clemency from the courts because he's an orphan
....

In fact, the CBO projects that under Obamacare over the next decade, the number of uninsured will never fall below 30 million. Here are the year-by-year projections from the report:

2013 - 55,000,000
2014 - 44,000,000
2015 - 37,000,000
2016 - 31,000,000
2017 - 30,000,000
2018 - 30,000,000
2019 - 30,000,000
2020 - 30,000,000
2021 - 31,000,000
2022 - 31,000,000
2023 - 31,000,000

Doctor Fate wrote:

danivon wrote:The Swiss system with refinements and tweaks? That seems to be what you are getting - mandatory insurance with set minimum benefits, provision for those who cannot afford it, fines for those who can but don't take it out...

http://www.forbes.com/sites/sallypipes/ ... -the-best/

Hospital stay and outpatient care in any general ward of the canton of residency;
Nursing care, of up to 60 hours per week at home or in a nursing home;
Examination, treatment and nursing in a patient’s home by a physician or chiropractor;
Rehabilitation ordered by a physician, including health resorts;
Physiotherapy and ergotherapy (max. 9 sessions)*;
Nutritionist/diabetic consultation (max. 6 sessions)*;
Emergency treatment abroad;
Transportation and rescue costs (50% of emergency transport costs up to CHF 5,000 per year and 50% of non-life threatening transport up to CHF 500 per year);
Legal abortion;
Maternity costs, including 7 routine examinations, post-natal examination, childbirth and 3 breast-feeding consultations;
Serious and inevitable dental treatment;
Contribution to spectacles and contact lenses of CHF180 per year for children and CHF180 over 5 years for adults.
Complementary medicines (alternative and homeopathic remedies)
*After physician referral.

danivon wrote:But the point is you claimed that it would have been better if Obamacare had been the Swiss system with refinements and tweaks when that is exactly what it is. It's just that you disagree on the value of those tweaks and refinements.

Anyway, I thought this was a thread about polling and predictions?

Not my job. You said "nothing" is being done for them. Prove it.

Texas Medicaid will only cover certain adults, specifically some disabled people, pregnant women, and, only if they make no more than 15 percent of the federal poverty level, parents. To put that into perspective: A single adult raising one child in Texas who makes more than about $2,400 per year makes too much money to qualify for Medicaid in the state. That person’s child is covered through the Medicaid Children’s Health Insurance Program, but the parent is not.

So if a single-parent Texan making $2,500 per year seeks health insurance in the new marketplace, her yearly insurance premium is estimated to be $1,250, because she is not eligible for a government subsidy to purchase insurance. That’s almost exactly half of that person’s entire yearly income. And if that same single parent works full-time for minimum wage, she’ll make $15,080, but her premium will still be $1,250, for which she would receive no federal subsidy to purchase the same insurance that her single counterpart gets for free.

rickyp wrote:fate

Not my job. You said "nothing" is being done for them. Prove it.

33% of Texans have no health insurance ... And those covered by texan medicaid?

Texas Medicaid will only cover certain adults, specifically some disabled people, pregnant women, and, only if they make no more than 15 percent of the federal poverty level, parents. To put that into perspective: A single adult raising one child in Texas who makes more than about $2,400 per year makes too much money to qualify for Medicaid in the state. That person’s child is covered through the Medicaid Children’s Health Insurance Program, but the parent is not.

So if a single-parent Texan making $2,500 per year seeks health insurance in the new marketplace, her yearly insurance premium is estimated to be $1,250, because she is not eligible for a government subsidy to purchase insurance. That’s almost exactly half of that person’s entire yearly income. And if that same single parent works full-time for minimum wage, she’ll make $15,080, but her premium will still be $1,250, for which she would receive no federal subsidy to purchase the same insurance that her single counterpart gets for free.

So the Texas poor end up going to emergency wards... Which ends up being paid for by Texan taxpayers, anyway. But Perry passed on Medicaid because in 2020 Texas would foot 10% of the cost.... If you factor the cost of emergency room care for the uninsured.... it sure doesn't make "numbers sense" to pass on the $7 billion that Medicaid would have brought the State...

http://rhrealitycheck.org/article/2013/ ... -in-sight/

Regional Commissioner Stanley W. Suchman noted that the 452,000 workers earning the federal minimum wage or less made up 7.5 percent of hourly-paid workers in the state. Nationwide, those earning the federal minimum or less accounted for 4.7 percent of the hourly-paid workforce.

bbauska wrote:RE: Senate midterm elections

GOP gains 8 seats and controls the Senate
IA, AK, AR, LA, MI, NC, MT, SD, WV go GOP
KY goes Dem (Maybe!)

The rest retain the same party.

Since this was supposed to be about polling et. al, does any others wish to partake?

So our forecast might be thought of as a Republican gain of six seats — plus or minus five. The balance has shifted slightly toward the GOP. But it wouldn’t take much for it to revert to the Democrats, nor for this year to develop into a Republican rout along the lines of 2010.

danivon wrote:. . . on the 'no toss ups' table they break them down as Dems hold NC and gain KY, . . . .