SCOTUS upheld the Affordable Care Act - Again

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BeaArthur
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17 Jun 2021, 10:20 am

The title says it all. Look this up on whatever reputable news site you prefer - the decision just came down this morning.

One lovely irony of opponents jeeringly naming the ACA "Obamacare" is that Obama's name will be repeated for generations. He who laughs last, laughs best.


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Fnord
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17 Jun 2021, 10:34 am

BeaArthur wrote:
... One lovely irony of opponents jeeringly naming the ACA "Obamacare" is that Obama's name will be repeated for generations...
Barack Obama's name will be associated in each of those generations with affordable medical care for all...

... and NOT with being a sore loser on the short end of an honest and legal election.


:D


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VegetableMan
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17 Jun 2021, 10:42 am

Yeah, the ACA is wonderful! My premium went from $450 a month to over $1100 a month, all because the Dems failed to give the people single-payer. They had a super majority in Congress and a mandate from the people. (Polls indicated that about 70% of Americans were in favor of single-payer.)


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Fnord
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17 Jun 2021, 10:49 am

Some people's costs went up.  Other people's costs went down.  So what?

Everbody gets medical care is what matters.


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VegetableMan
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17 Jun 2021, 11:38 am

So, you don't care that the Dems caved to insurance companies and didn't act in the best interests of the people? You don't care that these companies can keep jacking up the rates, rake in all that subsidy money, and drive the drive the cost of the program through the roof?

Wow!


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kraftiekortie
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17 Jun 2021, 1:40 pm

Some of the Obamacare plans are horrendous----especially the "bronze" plans. I would say one might as well not have health insurance at all under the "bronze" plans.

I know somebody in a place where I used to work who paid $700 a month for a health insurance plan with a $5,000 yearly deductible.

I would like basic single-payer insurance for everybody who is not on Medicaid or Medicare.



Daddy63
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17 Jun 2021, 2:22 pm

The better plans cost in the range of $25,000 a year for a family of 4 in my area unless you can get a subsidy and there are no other options. That's the issue with the way it works now. It's unaffordable or worthless. At least now it's a choice though there are no other viable options if a family cannot claim financial need.

The SCOTUS simply ruled that there was no standing (no one could claim damages) because the Trump administration already killed the financial penalties associated with the individual mandate.



BeaArthur
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17 Jun 2021, 5:35 pm

Don't you people get employer-paid health insurance?


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kraftiekortie
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18 Jun 2021, 6:46 am

I get excellent health insurance because I’m a civil servant.

Many private companies offer health insurance…..but it is usually inferior to that offered to civil servants (especially if it is a small and newer company), and you usually have to pay more.

Obamacare for the people in the “uninsured bubble” usually is pretty expensive, and has high deductibles.

I just might have just paid the $600 (if one was purposely uninsured, one had to pay $600 extra in taxes before the “mandate” was removed) if I was uninsured and within the “bubble.”



Daddy63
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18 Jun 2021, 7:42 am

BeaArthur wrote:
Don't you people get employer-paid health insurance?


Entrepreneurs don't always have access to insurance. If you want to start a business today in the US, the ACA makes it challenging to get adequate insurance at an affordable price in the initial stages. Once the business is established and grows, getting insurance for employees is not difficult.

There are lots of other examples. Not all people have traditional employers and not all employers provide insurance.



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18 Jun 2021, 8:11 am

kraftiekortie wrote:
I get excellent health insurance because I’m a civil servant.

Many private companies offer health insurance…..but it is usually inferior to that offered to civil servants (especially if it is a small and newer company), and you usually have to pay more.

Obamacare for the people in the “uninsured bubble” usually is pretty expensive, and has high deductibles.

I just might have just paid the $600 (if one was purposely uninsured, one had to pay $600 extra in taxes before the “mandate” was removed) if I was uninsured and within the “bubble.”


That's what my wife and I did. The only plans we could afford were $250+/month each and had $5000+ deductibles. Some didn't even pay for "preventive care" until the deductible was met. Basically paying $500/month for the privilege of paying out of pocket. The tax penalty was much cheaper, and any medical care would have been out-of-pocket either way.
Now I'm (for a couple more weeks, they're screwing us out of it, but that's another subject) on a plan with my work. I pay $100/month and would basically have to pay for almost anything if I used it. If we wanted to insure my wife, it would be a further $600/month and we would be in serious financial trouble, just for the same plan with almost nothing covered until you're $7500 out of pocket for the year. It's disgusting.

Years back, when I first had the chance to do so, I paid to insure my wife. It was expensive, but she had been uninsured for so many years that she wanted to get a checkup, see how her health was, etc. When she had the chance to go get the checkup, we still ended up paying over $200! There was a $25 copay, not just for a "visit" but for anyone you see. The NP she saw kept bringing in other specialized NPs, every time she mentioned something it was "Oh, hang on, this person can talk to you about that," but they never mentioned that it was another copay to see THAT person. She saw 5 "specialists" and got one prescription for some TAC cream for a rash. That was all. We had to pay just over $200, after I had already paid almost $10,000 in premiums for her that year. We decided against insurance for her after that.

I never use mine. I make it a point to never use it, as the medical group we're insured through has done nothing but earn my contempt over the years. I had no idea how bad the care I had been given through this group was, until I started my nursing training and learned that I could maybe have had a malpractice case against them (except that they can afford better lawyers than me.) Then, I became a nurse and have dealt with their docs/NPs/etc. for long enough that I refuse to even try with them. I've seen too much of what they do, and how badly they do it. I don't carry the card, and if I were in an accident or whatever, I would lie and say I was uninsured.



BeaArthur
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18 Jun 2021, 8:52 am

I'm fortunate to be on Medicare. I don't deal directly with Medicare as I have a Medicare Advantage (HMO) plan. My monthly premium is $100, I pay $5 co-pay with my primary doctor, $25 with any specialist, and $40 for any PT, OT, or other therapy service visit. I get 12 free (zero co-pay) massage visits a year. The plan is 5-star rated. I'm very happy with it.

This should be the model for everyone.

Didn't Biden's big care act that he passed through reconciliation provide better ACA marketplace premiums? I don't recall.


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Daddy63
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18 Jun 2021, 9:57 am

BeaArthur wrote:
I'm fortunate to be on Medicare. I don't deal directly with Medicare as I have a Medicare Advantage (HMO) plan. My monthly premium is $100, I pay $5 co-pay with my primary doctor, $25 with any specialist, and $40 for any PT, OT, or other therapy service visit. I get 12 free (zero co-pay) massage visits a year. The plan is 5-star rated. I'm very happy with it.

This should be the model for everyone.

Didn't Biden's big care act that he passed through reconciliation provide better ACA marketplace premiums? I don't recall.


The Biden deal provided more subsidies for lower and middle class wage earners. Overall I think premiums are flat to up slightly. If you fall outside the subsidies, you pay more and options are limited.

Today nearly all medical innovation comes from the US for the simple reason that American insurance will pay for what works while other developed nations many provide off patent care that can be afforded based on government budget levels. Other nations basically add new procedures and medications from the US medical market once they are off patent or otherwise become affordable. This is why the US dominates medical innovation.

If the US moves towards a single payer plan and no longer funds innovation, this issue must be addressed.



Jiheisho
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18 Jun 2021, 10:31 am

Daddy63 wrote:
BeaArthur wrote:
I'm fortunate to be on Medicare. I don't deal directly with Medicare as I have a Medicare Advantage (HMO) plan. My monthly premium is $100, I pay $5 co-pay with my primary doctor, $25 with any specialist, and $40 for any PT, OT, or other therapy service visit. I get 12 free (zero co-pay) massage visits a year. The plan is 5-star rated. I'm very happy with it.

This should be the model for everyone.

Didn't Biden's big care act that he passed through reconciliation provide better ACA marketplace premiums? I don't recall.


The Biden deal provided more subsidies for lower and middle class wage earners. Overall I think premiums are flat to up slightly. If you fall outside the subsidies, you pay more and options are limited.

Today nearly all medical innovation comes from the US for the simple reason that American insurance will pay for what works while other developed nations many provide off patent care that can be afforded based on government budget levels. Other nations basically add new procedures and medications from the US medical market once they are off patent or otherwise become affordable. This is why the US dominates medical innovation.

If the US moves towards a single payer plan and no longer funds innovation, this issue must be addressed.


How so? Most medical research is publicly funded in the US. The innovation is not coming from companies and private funding. Our medical system is expensive because it is for profit and unnecessarily complex. We have higher cost and lower outcomes compared to other advanced economies.



Daddy63
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18 Jun 2021, 11:09 pm

Jiheisho wrote:
Daddy63 wrote:
BeaArthur wrote:
I'm fortunate to be on Medicare. I don't deal directly with Medicare as I have a Medicare Advantage (HMO) plan. My monthly premium is $100, I pay $5 co-pay with my primary doctor, $25 with any specialist, and $40 for any PT, OT, or other therapy service visit. I get 12 free (zero co-pay) massage visits a year. The plan is 5-star rated. I'm very happy with it.

This should be the model for everyone.

Didn't Biden's big care act that he passed through reconciliation provide better ACA marketplace premiums? I don't recall.


The Biden deal provided more subsidies for lower and middle class wage earners. Overall I think premiums are flat to up slightly. If you fall outside the subsidies, you pay more and options are limited.

Today nearly all medical innovation comes from the US for the simple reason that American insurance will pay for what works while other developed nations many provide off patent care that can be afforded based on government budget levels. Other nations basically add new procedures and medications from the US medical market once they are off patent or otherwise become affordable. This is why the US dominates medical innovation.

If the US moves towards a single payer plan and no longer funds innovation, this issue must be addressed.


How so? Most medical research is publicly funded in the US. The innovation is not coming from companies and private funding. Our medical system is expensive because it is for profit and unnecessarily complex. We have higher cost and lower outcomes compared to other advanced economies.


Global medical innovation comes primarily from US private industry and global private industry developing treatments and procedures for the US market.

If you look at top medical innovations over the last few years, you'll struggle to find many that come public sources. Nearly all are developed by private industry starting with preclinical research up through clinical trials and FDA approval. There is a significant amount of base scientific research from public sources that creates ideas for new products and procedures but the real development, testing and approval is nearly always lead by private industry specifically for the US market.