5 ms·

Nobody is talking about surrendering. Quite the opposite: big wars are won in small battles. There are a lot of small changes which can improve US healthcare:

Nobody is talking about surrendering. Quite the opposite: big wars are won in small battles. There are a lot of small changes which can improve US healthcare: untie health insurance from employers. Make hospitals responsible for the billing, do that people don't get separate bills from anesthesiologists and surgeons. Make catastrophic plans accessible for everyone. Give free health insurance to children under 5. All these are small things, but they are doable. Once done, let's pause and reconsider.

claudeganon 7y ago
Medicare, Medicaid, and Social Security are all still here while the incrementalism of the ACA is being torn to shreds. Big battles won, incrementalism undone. That’s exactly what surrender and defeat looks like. Thousands upon thousands are being denied care, bankrupted, and killed each year by the American healthcare system. This is the status quo you’re defending. People going broke because they have a disabled child, rationing care and medicines they can’t afford at great harm to themselves. These people, the people being ground up by this system, aren’t interested in pausing things so you can get more comfortable than you already are with this state of affairs.
- AlexTWithBeard 7y ago
  ACA is alive and chugging. An attempt to dismantle it has failed despite of a republican president with a republican congress. Which means most people agree that ACA does more good than bad. It may feel very good to fight for a noble goal without a compromise and half measures, but while you are fighting, the people you are fighting for are no better. But that's not your fault, right?
  - claudeganon 7y ago
    ACA plans are incredibly expensive and deny one in 5 medical claims. The law itself is under severe legal threat in the Fifth Circuit and has seen it’s Medicaid expansion undermined in many states by work requirements. It unlikely to survive much longer, whether by judicial decree or continued side channel attacks. I could care less about some contest of nobility, but I can tell you for certain that this kind of cowardly rhetoric, where you think you can deflect the blame of those who profit off the poor, the ill, and the disabled onto those who dare to fight for them, convinces absolutely no one.
    - tptacek 7y ago
      Read the actual Kaufmann report that generated that 1-in-5 claim to see how not probative it actually is. The actual rate of denied claims varies wildly from state to state and from insurer to insurer inside those states; some states have rejection rates in the single digits. Meanwhile, the report authors don't have the reason for rejection, and the reason matters a lot: providers have varying competence submitting claims, and a large chunk of denials are probably miskeyed services. Very, very few denials are appealed, suggesting either clerical errors or low-dollar claims (the financial value of those denials would be a number you'd really want to see but does not exist either). Much of this is covered in the Discussion section of the report. Right now, this 1-in-5 thing really just seems like a cudgel for people to swing randomly around in message board arguments.
      - claudeganon 7y ago
        So if you believe this to be inaccurate, then spell out for precisely me what level of suffering and expense that people should have to endure for this system to continue? What are you comfortable with maintaining? How many people should be bankrupted, denied care or self-ration to the point of harm? We should only have 25000 people go bankrupt each year or 25 million uninsured? What level of damage to these people’s lives do you think needs to be “reformed” away vs preserved?
        tptacek 7y ago
        You haven't so much responded to my comment so much as yelled incoherently at it. Can you instead address it directly? You made an argument: that the "1 in 5 ACA claims are rejected" stat is damning evidence of the system's failure. I rebutted. Am I just right, and that stat is no longer part of your argument?
        claudeganon 7y ago
        Why would I directly address someone who didn’t respond in good faith in kind to me last go around, but instead played semantic games when they exhausted their argument? Here’s my perspective: for profit healthcare is a form of eugenics against the poor and disabled. Insurance companies are parasitic middlemen who are directly responsible for the deaths and bankruptcy of many. Denial of claims under the ACA is done to preserve the existence and profits of these middleman. Thinking you can suss out whether the 20% of claims they deny are moral or necessary entirely misses the point.

claudeganon 7y ago

Medicare, Medicaid, and Social Security are all still here while the incrementalism of the ACA is being torn to shreds. Big battles won, incrementalism undone. That’s exactly what surrender and defeat looks like. Thousands upon thousands are being denied care, bankrupted, and killed each year by the American healthcare system. This is the status quo you’re defending. People going broke because they have a disabled child, rationing care and medicines they can’t afford at great harm to themselves. These people, the people being ground up by this system, aren’t interested in pausing things so you can get more comfortable than you already are with this state of affairs.

AlexTWithBeard 7y ago
ACA is alive and chugging. An attempt to dismantle it has failed despite of a republican president with a republican congress. Which means most people agree that ACA does more good than bad. It may feel very good to fight for a noble goal without a compromise and half measures, but while you are fighting, the people you are fighting for are no better. But that's not your fault, right?
- claudeganon 7y ago
  ACA plans are incredibly expensive and deny one in 5 medical claims. The law itself is under severe legal threat in the Fifth Circuit and has seen it’s Medicaid expansion undermined in many states by work requirements. It unlikely to survive much longer, whether by judicial decree or continued side channel attacks. I could care less about some contest of nobility, but I can tell you for certain that this kind of cowardly rhetoric, where you think you can deflect the blame of those who profit off the poor, the ill, and the disabled onto those who dare to fight for them, convinces absolutely no one.
  - tptacek 7y ago
    Read the actual Kaufmann report that generated that 1-in-5 claim to see how not probative it actually is. The actual rate of denied claims varies wildly from state to state and from insurer to insurer inside those states; some states have rejection rates in the single digits. Meanwhile, the report authors don't have the reason for rejection, and the reason matters a lot: providers have varying competence submitting claims, and a large chunk of denials are probably miskeyed services. Very, very few denials are appealed, suggesting either clerical errors or low-dollar claims (the financial value of those denials would be a number you'd really want to see but does not exist either). Much of this is covered in the Discussion section of the report. Right now, this 1-in-5 thing really just seems like a cudgel for people to swing randomly around in message board arguments.
    - claudeganon 7y ago
      So if you believe this to be inaccurate, then spell out for precisely me what level of suffering and expense that people should have to endure for this system to continue? What are you comfortable with maintaining? How many people should be bankrupted, denied care or self-ration to the point of harm? We should only have 25000 people go bankrupt each year or 25 million uninsured? What level of damage to these people’s lives do you think needs to be “reformed” away vs preserved?
      - tptacek 7y ago
        You haven't so much responded to my comment so much as yelled incoherently at it. Can you instead address it directly? You made an argument: that the "1 in 5 ACA claims are rejected" stat is damning evidence of the system's failure. I rebutted. Am I just right, and that stat is no longer part of your argument?
        claudeganon 7y ago
        Why would I directly address someone who didn’t respond in good faith in kind to me last go around, but instead played semantic games when they exhausted their argument? Here’s my perspective: for profit healthcare is a form of eugenics against the poor and disabled. Insurance companies are parasitic middlemen who are directly responsible for the deaths and bankruptcy of many. Denial of claims under the ACA is done to preserve the existence and profits of these middleman. Thinking you can suss out whether the 20% of claims they deny are moral or necessary entirely misses the point.