3 ms·

This shouldn't be downvoted, because this was was what the ACA was meant to do. Exacerbate the cost problem (which it has done), restrict doctor-run hospitals (

This shouldn't be downvoted, because this was was what the ACA was meant to do. Exacerbate the cost problem (which it has done), restrict doctor-run hospitals (which it does), and lead to a problem where the "solution" is a single-payer system so that 11% of the economy (back then), could be "captured". Many democrats thought (and said so) that there was a huge problem of all this money moving around without government control. The first attempt, which failed badly under Hillary Clinton's leadership during her time as First Lady, failed because it tried to do everything at once. It could therefore be seen as a massive power-grab. The ACA on the other hand, delivered an incremental approach that included lots of things people wanted: ignoring pre-existing conditions, broadening coverage. But it also did things like say there could be no new doctor-run hospitals, and existing ones could not add beds. Doctor-run hospitals, at the time, were actually a success of the free market in health care. Their outcomes in terms of patient recovery and survival rates were higher than state run hospitals. They were a direct threat to the idea that the government should run health care. The ACA also set the stage for the failure of private medical insurance. We're in limbo on that score, but the needle has moved toward that failure.

guntars 7y ago
And now you’re being downvoted because all of this is unsourced speculation and people here don’t really care for that.
- ryguytilidie 7y ago
  Also because he is literally blaming Hillary Clinton for stuff that happened while she was first lady. I swear modern Republicanism is just agreeing with Donald Trump and blaming anything that goes wrong on Hillary or Obama.
  - slowmovintarget 7y ago
    Hillary Clinton led the effort to reform health care during her husband's first term in office [1]. I am literally claiming that Hillary did things that she actually did. I'm sorry you weren't aware of history. That Hillary led this effort was actually noteworthy less for its failure and more for the fact that this was the first time a First Lady took a publicly visible hand in core policy-making. I don't think Donald Trump is truly fit to be president, and I don't think the modern Republican party represents my views. Nor do I think Hillary Clinton was a suitable choice either. But disagreeing with the modern Democrat party is often met with derision, even if it is reasoned objection. I actually remember the political discourse during President Clinton's first term, having been part of it back then. I remember the speeches Hillary Clinton gave as chair of the task force, including the notion that it was tragedy to allow so much of the economy to flow outside the purview of government. The notion of regulatory capture is not new [2]. It is my opinion that the purpose of the ACA was to lead to single-payer. It was the kind of boiled-frog strategy that Democrat party leaders had been using successfully for decades at the point ACA came a along. The restrictions on doctor-owned hospitals are part of the law [3]. That the law would cause increased costs and dramatic deficits was predicted by the Congressional Budget Office (CBO) [4, 5]. The way I formed my opinion was taking all of this into account, including the model Hillary's task force put forth in the 90s as being what Democrats actually wanted. It is a reasonable opinion that if the ACA didn't deliver all of the things from the original plan, yet it opened up many unsolved problems, that the intent was to "continue reform" and make the "natural solution" a single-payer system. I do wish we could have discussion without every comment on politics becoming a college paper. [1] https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993 https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_19... [2] https://en.wikipedia.org/wiki/Regulatory_capture https://en.wikipedia.org/wiki/Regulatory_capture [3] https://www.cms.gov/medicare/fraud-and-abuse/physicianselfreferral/physician_owned_hospitals.html https://www.cms.gov/medicare/fraud-and-abuse/physicianselfre... [4] https://www.cbo.gov/topics/health-care/affordable-care-act https://www.cbo.gov/topics/health-care/affordable-care-act [5] https://www.factcheck.org/2017/03/cbos-obamacare-predictions-how-accurate/ https://www.factcheck.org/2017/03/cbos-obamacare-predictions...
    - guntars 7y ago
      Thanks for adding sources. This is the first time I’ve heard about physician owned hospitals and I found this study useful: https://dash.harvard.edu/bitstream/handle/1/22856850/4558297.pdf?sequence=1&isAllowed=y https://dash.harvard.edu/bitstream/handle/1/22856850/4558297... TLDR; Previous research found that speciality physician owned hospitals (POHs) are treating less Medicare patients that are also healthier and focusing on more profitable patients while still receiving whatever benefits being a Medicare provider gets them. This lead to a blanket restrictions on all POHs in ACA. The above paper compared both specialty and non specialty POHs, which is what ACA actually targets, and found no significant differences between them and non POHs in terms of types of patients, cost of care and outcomes. This suggests that the policy has been too broad and is in need of a revision.
deleted 7y ago
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guntars 7y ago

And now you’re being downvoted because all of this is unsourced speculation and people here don’t really care for that.

ryguytilidie 7y ago
Also because he is literally blaming Hillary Clinton for stuff that happened while she was first lady. I swear modern Republicanism is just agreeing with Donald Trump and blaming anything that goes wrong on Hillary or Obama.
- slowmovintarget 7y ago
  Hillary Clinton led the effort to reform health care during her husband's first term in office [1]. I am literally claiming that Hillary did things that she actually did. I'm sorry you weren't aware of history. That Hillary led this effort was actually noteworthy less for its failure and more for the fact that this was the first time a First Lady took a publicly visible hand in core policy-making. I don't think Donald Trump is truly fit to be president, and I don't think the modern Republican party represents my views. Nor do I think Hillary Clinton was a suitable choice either. But disagreeing with the modern Democrat party is often met with derision, even if it is reasoned objection. I actually remember the political discourse during President Clinton's first term, having been part of it back then. I remember the speeches Hillary Clinton gave as chair of the task force, including the notion that it was tragedy to allow so much of the economy to flow outside the purview of government. The notion of regulatory capture is not new [2]. It is my opinion that the purpose of the ACA was to lead to single-payer. It was the kind of boiled-frog strategy that Democrat party leaders had been using successfully for decades at the point ACA came a along. The restrictions on doctor-owned hospitals are part of the law [3]. That the law would cause increased costs and dramatic deficits was predicted by the Congressional Budget Office (CBO) [4, 5]. The way I formed my opinion was taking all of this into account, including the model Hillary's task force put forth in the 90s as being what Democrats actually wanted. It is a reasonable opinion that if the ACA didn't deliver all of the things from the original plan, yet it opened up many unsolved problems, that the intent was to "continue reform" and make the "natural solution" a single-payer system. I do wish we could have discussion without every comment on politics becoming a college paper. [1] https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993 https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_19... [2] https://en.wikipedia.org/wiki/Regulatory_capture https://en.wikipedia.org/wiki/Regulatory_capture [3] https://www.cms.gov/medicare/fraud-and-abuse/physicianselfreferral/physician_owned_hospitals.html https://www.cms.gov/medicare/fraud-and-abuse/physicianselfre... [4] https://www.cbo.gov/topics/health-care/affordable-care-act https://www.cbo.gov/topics/health-care/affordable-care-act [5] https://www.factcheck.org/2017/03/cbos-obamacare-predictions-how-accurate/ https://www.factcheck.org/2017/03/cbos-obamacare-predictions...
  - guntars 7y ago
    Thanks for adding sources. This is the first time I’ve heard about physician owned hospitals and I found this study useful: https://dash.harvard.edu/bitstream/handle/1/22856850/4558297.pdf?sequence=1&isAllowed=y https://dash.harvard.edu/bitstream/handle/1/22856850/4558297... TLDR; Previous research found that speciality physician owned hospitals (POHs) are treating less Medicare patients that are also healthier and focusing on more profitable patients while still receiving whatever benefits being a Medicare provider gets them. This lead to a blanket restrictions on all POHs in ACA. The above paper compared both specialty and non specialty POHs, which is what ACA actually targets, and found no significant differences between them and non POHs in terms of types of patients, cost of care and outcomes. This suggests that the policy has been too broad and is in need of a revision.

deleted 7y ago

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