Paul Ryan proposes scam as Obamacare replacement

[shira]

Link to LA Times article.

Cliff's notes:

• Ryan says 10% of Americans have preexisting conditions that would make them ineligible for health insurance absent Obamacare.
• So Ryan (and Republican politicians in general) advocate replacing Obamacare with a voluntary system that includes state-subsidized "high risk pools."
• Unfortunately, the percentage of Americans with pre-existing conditions is much, much higher than 10%:

• Double-unfortunately, high-risk pools were widely implemented by states prior to Obamacare, and were a colossal failure.

Health economist Austin Frakt observed in 2009, that by 2000, high-risk pool enrollment came to only 8% of the uninsurable population nationally, ranging by state from 1% to 54%. The problem was inadequate funding, which prompted states either to place caps on enrollments or saddle members with sky-high premiums. "We estimated that high-risk pool premiums were above 25% of family income for 29% of the medically uninsurable population," Frakt wrote. "That is, even when high-risk pool enrollment was possible, for a large minority of medically uninsurable individuals, it was unaffordable."

California's pool, the Major Risk Medical Insurance Program, or "MR. MIP," illustrated the problem. In 1990, when the program began with a $30-million budget funded by tobacco taxes, that was sufficient to enroll only 10,000 of the estimated 300,000 Californians who qualified. By 2009, as my colleague David Lazarus reported, enrollment was capped at 7,100. Premiums were set as much as 37% higher than market rates for individual policies. The plans came with annual caps of $75,000 in benefits, not enough to cover treatments for some major diseases.

Nationwide, enrollment in state pools was so meager that "you could almost invite some of these pools over for dinner," Georgetown University health policy expert Karen Pollitz told PBS Newshour. "They're really dinky. There are only six that have more than 10,000 enrollees."

Keep in mind that conservative economist James Capretta estimated in 2010 that a high-risk program would need $15 billion to $20 billion a year to cover 4 million enroll -- and he was in favor of the idea. And that as recently as last year Ryan, as House Budget Committee chairman, was pushing to cut $12.5 billion a year from the food stamp program, in part by turning it over to the states as a block-grant program. There lies the future of protection for those with preexisting conditions under Ryan's scheme. It's all about cost-cutting, pure and simple. As an alternative to Obamacare's flat outlawing of such exclusions, it won't wash.

Obamacare is about making real health insurance available to everyone. The Republican party is about shell games and pretending that a discredited system is the answer to our health-care prayers.

 

[master_shake_]

why do they hate aca so much?

do they hate that people have health care?

or is it something to do with their healthcare friends getting less money?

 

[Indus]

why do they hate aca so much?

do they hate that people have health care?

or is it something to do with their healthcare friends getting less money?

People can live longer with healthcare but it's clear they want anyone not super duper ultra rich who pays for their campaigns to fuck off and die.

 

[DrPizza]

If we have a voluntary system, then we need to make clear to everyone that "if you can't pay, the Emergency Room does not have to treat you. If you can't pay, then the ambulance doesn't have to scrape your body off the road. It's your relative's problem to retrieve your body if you're uninsured and in some sort of accident."

Or, maybe we should just have everyone pool our risk together and treat everyone, kinda like a civilized 1st world society.

 

[DrunkenSano]

Healthcare cost should be tiered. People who lead healthier lives should pay a lot less than those who lead unhealthy lives. If I watch what I eat, go the gym regularly, am not obese, I shouldn't be footing the bill for someone who just lies around at home and shoves whatever is in reach into their mouths everyday. One of the biggest issue with healthcare is the super corrupt and inflated medical cost that hospitals charge. That needs to be clamped down hard.

 

[Spungo]

Or, maybe we should just have everyone pool our risk together and treat everyone, kinda like a civilized 1st world society.

Rich people should also be aware that free healthcare for proles might save their life in the near future. When all social mobility is destroyed because a single medical problem can wipe out a lifetime of savings, people get stabby and shooty.

 

[hal2kilo]

Healthcare cost should be tiered. People who lead healthier lives should pay a lot less than those who lead unhealthy lives. If I watch what I eat, go the gym regularly, am not obese, I shouldn't be footing the bill for someone who just lies around at home and shoves whatever is in reach into their mouths everyday. One of the biggest issue with healthcare is the super corrupt and inflated medical cost that hospitals charge. That needs to be clamped down hard.

Funny thing, it seems to me that "active" people spend more money at the doctor getting all their sports injuries fixed on a regular basis.

 

[Spungo]

Funny thing, it seems to me that "active" people spend more money at the doctor getting all their sports injuries fixed on a regular basis.

I agree. Find me a soccer player who has not destroyed their ACL at some point. One of my friends had something crazy like 3 or 4 shoulder surgeries. Joe Rogan had ACL surgery in both legs. I sit on my ass all day and never get sick, never get injured. 0 broken bones, 0 stitches, 1 surgery to remove wisdom teeth.

What did people do in the past? Did they just kill the person? Soccer injury - take em out back.

 

[Hugo Drax]

Funny thing, it seems to me that "active" people spend more money at the doctor getting all their sports injuries fixed on a regular basis.

If you are not an idiot and do it right you do not get sports injuries. Low impact cardio etc.. using things like elliptical machines etc.. is the better route.

 

[Jhhnn]

why do they hate aca so much?

do they hate that people have health care?

or is it something to do with their healthcare friends getting less money?

Two things.

Repubs are ideological opposed to govt assuming any function served by the Jerb Creators, no matter how badly they perform at the task.

And because Obama, the Kenyan usurper, of course.

 

[motsm]

If you are not an idiot and do it right you do not get sports injuries. Low impact cardio etc.. using things like elliptical machines etc.. is the better route.

Your describing a controlled cardio workout, not a sport.

 

[Subyman]

ACA has done a lot of good. For example, my mom used to have to pay sky high rates and had to sign waivers due to her preexisting condition. Now her costs are reasonable. Single parent families used to not be able to apply for family insurance policies because a "family" was designated as two adults and children. Single parents had to pay a lot more to individually insurance each member. The costs have come down for people and it is a tiered system where people that do not qualify for medicaid but can not afford the high cost of insurance can have relief. They still have to pay in and pay the full deductibles and such, but getting them insured is helped by the government.

I think ACA is on the right track if we want to keep private insurance. Tearing it down is dumb. We've spent billions implementing it, so don't burn it to the ground. Instead, we should iterate. The only thing republicans want to do is turn ACA into an idealogical battle. There is no rational reason for the vitriol. There are certainly debates that can be had, but the amount of crap I see people say about ACA is mind numbing.

 

[Jhhnn]

Healthcare cost should be tiered. People who lead healthier lives should pay a lot less than those who lead unhealthy lives. If I watch what I eat, go the gym regularly, am not obese, I shouldn't be footing the bill for someone who just lies around at home and shoves whatever is in reach into their mouths everyday. One of the biggest issue with healthcare is the super corrupt and inflated medical cost that hospitals charge. That needs to be clamped down hard.

So we should make healthcare insurance unaffordable for people with unhealthy habits so that they pay nothing & get nothing until their problems become acute & they land in the ER where they still pay nothing because it's like trying to get blood out of a turnip. When those neglected issues render them unemployable they'll land on SSDI & Medicaid.

So FYGM anyway, right?

 

[Gonad the Barbarian]

why do they hate aca so much?

do they hate that people have health care?

or is it something to do with their healthcare friends getting less money?

Because the ACA helps more poor and/or rural white people (the R base) than anything the federal government has done in the past 30 years. All those cashiers, waitresses, stockboys, etc. in "real America" working barely-above minimum wage jobs because that's all that's left and even a lot of blue collar trade people have access to healthcare for the first time and pretty soon they're going to catch on to who gave it to them if the Reps can't put the kibosh in it before all their OMGOBUMMER!!1 fever breaks. I think already it's too late, but they (establishment R) apparently don't.

 

[Homerboy]

If you are not an idiot and do it right you do not get sports injuries. Low impact cardio etc.. using things like elliptical machines etc.. is the better route.

LOL That's exercising -- not sports.
Reminds me of Kenny Powers

 

[hal2kilo]

The thing that's so sad about this is that the Republican Congress squandered an opportunity to reach across the isles and work with the Democrats to fix the things that are wrong with the ACA. Hell, the Republicans could have actually run on something positive like, "in spite of Democratic opposition, we fixed the ACA. You know, something constructive for the people. Instead, 50/60 or so, I lost count, bills of wasted time trying just to kill it were introduced.

Maybe someday we can get back to the that horrible concept called compromise again. I doubt it though.

 

[interchange]

ACA has some positive things in it, but I'd be hesitant to call it a net gain at this point from any of my personal experience. There are plenty of people who now have access to healthcare they didn't before, and there are plenty of people who now can't afford healthcare they could before.

I'm not sure Paul Ryan's idea is inherently worse than any other system, although it's pretty disastrous if it is estimated wrong (which it seems he is exceedingly off base).

Personally, I think a single payer + private supplement / private replacement option would be the best overall system. I'm not sure we could move to anything sensical in our current political and economic climate. I wouldn't want to propose changes unless we were pretty certain they would be systemic instead of incremental. Otherwise, speculation about change drives rates up and causes healthcare systems to try to cut costs.

 

[Lash444]

The thing that's so sad about this is that the Republican Congress squandered an opportunity to reach across the isles and work with the Democrats to fix the things that are wrong with the ACA. Hell, the Republicans could have actually run on something positive like, "in spite of Democratic opposition, we fixed the ACA. You know, something constructive for the people. Instead, 50/60 or so, I lost count, bills of wasted time trying just to kill it were introduced.

Maybe someday we can get back to the that horrible concept called compromise again. I doubt it though.

You think that a priority of a Republican Congress, is to try and make Obamacare a success? That is never going to happen.

If we are going to get a working system, its going to have to be either A.) a Democratic Congress B.) scrapping the current system for something completely new.

Aint no way in hell these clowns are going to improve your life and risk sabotaging their political gains. The absolutely last thing they want is for Obamacare to look even slightly positive in the eyes of voters.

 

[Jhhnn]

There are plenty of people who now have access to healthcare they didn't before, and there are plenty of people who now can't afford healthcare they could before.

Half true. Perhaps you could attempt to document the second part, the part that's bullshit.

 

[Jhhnn]

You think that a priority of a Republican Congress, is to try and make Obamacare a success? That is never going to happen.

If we are going to get a working system, its going to have to be either A.) a Democratic Congress B.) scrapping the current system for something completely new.

Aint no way in hell these clowns are going to improve your life and risk sabotaging their political gains. The absolutely last thing they want is for Obamacare to look even slightly positive in the eyes of voters.

They've mostly lost that last part, I think. They keep people ignorant in the States they control by not instituting the Medicaid extension. It would be particularly helpful to people in some of the low income places they have a political stranglehold on.

Can't have that. Can't allow Obama any victories. Can't let people think that the ebil gubmint could possibly help them at all.

 

[Mxylplyx]

I think it's about time for democrats to stop beating around the bush, and come out in support of the only sensible solution to healthcare, which is a single payer public healthcare plan, ie medicare for all. We already have the infrastructure for it. Just scale it up to cover the entire population. Once this is done, the government would be in a position to tell all the providers and medical suppliers to charge a reasonable price or fuck off. Overnight these specialty drug makers would suddenly discover that they could charge 5% of their previous price and still turn a profit. Many specialists who currently make many millions of dollars a year would also have to take a big haircut. If they dont like it they can feel free to pack their shit and practice elsewhere, though we all know they wont.

 

[Jhhnn]

I think it's about time for democrats to stop beating around the bush, and come out in support of the only sensible solution to healthcare, which is a single payer public healthcare plan, ie medicare for all. We already have the infrastructure for it. Just scale it up to cover the entire population. Once this is done, the government would be in a position to tell all the providers and medical suppliers to charge a reasonable price or fuck off. Overnight these specialty drug makers would suddenly discover that they could charge 5% of their previous price and still turn a profit. Many specialists who currently make many millions of dollars a year would also have to take a big haircut. If they dont like it they can feel free to pack their shit and practice elsewhere, though we all know they wont.

Please. We'll have trouble enough holding on to the real improvements of the ACA with Repubs having any power in Congress.

Politics is the art of the possible, not the art of wishing for puppies & rainbows.

 

[wirelessenabled]

The ACA "Obamacare" is a huge improvement in health care in the US.

We should have gone the whole way to National Health Care. Everybody covered. No medical bill bankruptcies. Eliminate the medical insurance companies and have the government as the single payer at a cost of about 1.5% of the bills instead of the 30% or so the insurance companies rake off for the same work.

The US is the only country in the world with this crazy public/private medical system the end result of which is that we pay 40-50% more for the health care system and get a worse result, shorter life expectancy, worse infant mortality etc.

Eliminating the insurance companies would result in a savings of about a third of the medical bills or over $1 trillion per year.

I know, rationing health care blah, blah. Of course health care is rationed. It is rationed now with the crazy private insurance scheme we are under. Now it is the insurance companies who are setting the rationing instead of the government. Who cares?

If we go to 100% National Health Care we have about a 1/3 cushion by eliminating the insurance companies to figure out what rationing we are willing to accept.

 

[Sheik Yerbouti]

Healthcare cost should be tiered. People who lead healthier lives should pay a lot less than those who lead unhealthy lives. If I watch what I eat, go the gym regularly, am not obese, I shouldn't be footing the bill for someone who just lies around at home and shoves whatever is in reach into their mouths everyday. One of the biggest issue with healthcare is the super corrupt and inflated medical cost that hospitals charge. That needs to be clamped down hard.

And don't forget those thoughtless children who had the temerity to be born with a congenital defect that needs lifelong attention. Those fuckers are draining the system. Time to separate the wheat from the chaff.

 

[OverVolt]

"Proposes scam as Obamacare replacement" seems to imply that Obamacare isn't also a scam.

The Cadillac tax being pegged to regular inflation all but guarantees that employer based low deductible FFS plans will be obsolete by 2025 or something like that. Right when you and me are all old. But you're too retarded to figure it out.