4 ms·

B.S. this was happening way before the affordable care act was passed.

PopAlongKid 4y ago
Further, like any massive new legislative program, there are plenty of improvements that can and should be made over time, no one can get everything right the first time. But we all know why every opportunity to make even slight improvements to ACA has been deliberately rejected.
sonotathrowaway 4y ago
Matt Stoller would never let a fact get in the way of hating the Libs.
- DangitBobby 4y ago
  I'm pretty much "the Libs". I view the ACA as guaranteeing private health insurance companies a future instead of granting them the death penalty like the country needs. Even so, I read through the entire article without once thinking "wow, this really is critical of Libs." What in particular would you characterize as "hating the Libs"?
  - wsatb 4y ago
    > I view the ACA as guaranteeing private health insurance companies a future instead of granting them the death penalty like the country needs. It was a step in the right direction at the time. We’ve done nothing to improve upon it since then because one side has spent the last decade trying to destroy it and the other seems mostly ok with our system as it stands.
    - DangitBobby 4y ago
      I don't know if it was a step in the right direction. It helped people in a very real way, my family included. But that was maybe the only shot we will have for the foreseeable future to unfuck our healthcare system. Who knows when the political will to really shake things up in healthcare will come back.
      - wsatb 4y ago
        If there's one thing I've learned about American politics in my adult life, it's that large changes like "unfucking" our healthcare system do not happen over night. It takes incremental changes over many years, perhaps decades. That definitely wasn't going to happen in 2010, and shouldn't have. We can't just destroy the private health care system tomorrow, it would have massive economic implications. It wasn't the only shot, we just need more politicians that want that change and are willing to not be so stubborn to try to do it fast.
        DangitBobby 4y ago
        I am not asking for it to happen over night, that's silly. What I'm asking for is effective plans that don't just further enrich politicians' private healthcare buds, executed when the time is right. Medicare for All would have worked and would be mostly implemented by now. Instead we still have an expensive trash heap. Not getting rid of an incredibly wasteful system because it negatively impacts the economic status of the people it unfortunately employs isn't even conservative thinking, especially when it's such a huge drain on the economy. In this case it even kills people. Why are we letting them hold everyone hostage? Why are their jobs more important than having affordable or quality care for the entire country? It's not a fucking jobs program! It's healthcare!
  - yabbutts 4y ago
    [dead]
DangitBobby 4y ago
It sort of puts the blame on one part of the ACA, but even if you find that distasteful or not compelling, the rest of the article is very interesting and informative.
derbOac 4y ago
Yes I had a similar reaction. I've been involved in healthcare long before the ACA, and my family before that, and I thought it was absurd to tie any of these trends to Obamacare. Pretty much everything decried in the piece was on track long before the ACA, in the sense that even if something occurred after the ACA, it was predictable from trends prior to the ACA. I'm also tired of all the focus on insurance and payment, and not on the monopolies (monopsonies?) in health care provision. We can focus on payment all we want but if we don't open up healthcare services to real competition and innovation prices will continue to go through the roof with declining returns. I give some credit to the piece for somehow touching on that issue, but it's superficial and again tied to insurance and payors. It's infuriating being on the inside of all of this and seeing the way it usually is discussed in policy forums. It's like everyone wants everything to remain the same but be cheaper, and that's not going to happen.
- DangitBobby 4y ago
  What does it take to open it up? You can't get to competitive pricing without transparent pricing, which you can't have with our opaque payment system. No one can tell you how much something is gonna cost, even after services are rendered, until much later usually with a bill in the mail. With how dysfunctional healthcare is, you'd think if real competition were possible we'd already be seeing disruption in this space. That's not happening! The most obvious culprit is the private payer, so that's a natural place to look.
  - maxerickson 4y ago
    A lot of the problems come from Medicare acting like a central planner that doesn't regulate prices for people outside of their system. Like my local hospital is blessed, it runs an ER in an area with few hospitals, so Medicare pays it at a higher rate for all care. But Medicare also won't make an agreement to pay for care if someone tries to open up a competing hospital (and investors know this, so they won't bother trying to compete), and they don't tell the hospital that they have blessed that it's not okay to charge ridiculous prices to other customers.
- rolenthedeep 4y ago
weare138 4y ago
Exactly. I'm from Gen-X and the author's assertion is patently false and conveniently ignores everything that happened prior to the Obama admin. Besides it was Republicans that deregulated the medical industry among others and removed limitations on how much market share any single company can control. This is what led to the mass market consolidation and mega-conglomerates we have today.
d23 4y ago
I started following Matt Stoller a long time ago when I found out about his anti-monopoly stuff. Then I started following on Twitter recently and yikes — it made me question how much undeserved credibility I had mentally assigned to him. He regularly says some pretty unhinged uber-confident things that are completely outside his lane.

Further, like any massive new legislative program, there are plenty of improvements that can and should be made over time, no one can get everything right the first time. But we all know why every opportunity to make even slight improvements to ACA has been deliberately rejected.

sonotathrowaway 4y ago

Matt Stoller would never let a fact get in the way of hating the Libs.

DangitBobby 4y ago
I'm pretty much "the Libs". I view the ACA as guaranteeing private health insurance companies a future instead of granting them the death penalty like the country needs. Even so, I read through the entire article without once thinking "wow, this really is critical of Libs." What in particular would you characterize as "hating the Libs"?
- wsatb 4y ago
  > I view the ACA as guaranteeing private health insurance companies a future instead of granting them the death penalty like the country needs. It was a step in the right direction at the time. We’ve done nothing to improve upon it since then because one side has spent the last decade trying to destroy it and the other seems mostly ok with our system as it stands.
  - DangitBobby 4y ago
    I don't know if it was a step in the right direction. It helped people in a very real way, my family included. But that was maybe the only shot we will have for the foreseeable future to unfuck our healthcare system. Who knows when the political will to really shake things up in healthcare will come back.
    - wsatb 4y ago
      If there's one thing I've learned about American politics in my adult life, it's that large changes like "unfucking" our healthcare system do not happen over night. It takes incremental changes over many years, perhaps decades. That definitely wasn't going to happen in 2010, and shouldn't have. We can't just destroy the private health care system tomorrow, it would have massive economic implications. It wasn't the only shot, we just need more politicians that want that change and are willing to not be so stubborn to try to do it fast.
      - DangitBobby 4y ago
        I am not asking for it to happen over night, that's silly. What I'm asking for is effective plans that don't just further enrich politicians' private healthcare buds, executed when the time is right. Medicare for All would have worked and would be mostly implemented by now. Instead we still have an expensive trash heap. Not getting rid of an incredibly wasteful system because it negatively impacts the economic status of the people it unfortunately employs isn't even conservative thinking, especially when it's such a huge drain on the economy. In this case it even kills people. Why are we letting them hold everyone hostage? Why are their jobs more important than having affordable or quality care for the entire country? It's not a fucking jobs program! It's healthcare!
- yabbutts 4y ago
  [dead]

DangitBobby 4y ago

It sort of puts the blame on one part of the ACA, but even if you find that distasteful or not compelling, the rest of the article is very interesting and informative.

derbOac 4y ago

Yes I had a similar reaction. I've been involved in healthcare long before the ACA, and my family before that, and I thought it was absurd to tie any of these trends to Obamacare. Pretty much everything decried in the piece was on track long before the ACA, in the sense that even if something occurred after the ACA, it was predictable from trends prior to the ACA. I'm also tired of all the focus on insurance and payment, and not on the monopolies (monopsonies?) in health care provision. We can focus on payment all we want but if we don't open up healthcare services to real competition and innovation prices will continue to go through the roof with declining returns. I give some credit to the piece for somehow touching on that issue, but it's superficial and again tied to insurance and payors. It's infuriating being on the inside of all of this and seeing the way it usually is discussed in policy forums. It's like everyone wants everything to remain the same but be cheaper, and that's not going to happen.

DangitBobby 4y ago
What does it take to open it up? You can't get to competitive pricing without transparent pricing, which you can't have with our opaque payment system. No one can tell you how much something is gonna cost, even after services are rendered, until much later usually with a bill in the mail. With how dysfunctional healthcare is, you'd think if real competition were possible we'd already be seeing disruption in this space. That's not happening! The most obvious culprit is the private payer, so that's a natural place to look.
- maxerickson 4y ago
  A lot of the problems come from Medicare acting like a central planner that doesn't regulate prices for people outside of their system. Like my local hospital is blessed, it runs an ER in an area with few hospitals, so Medicare pays it at a higher rate for all care. But Medicare also won't make an agreement to pay for care if someone tries to open up a competing hospital (and investors know this, so they won't bother trying to compete), and they don't tell the hospital that they have blessed that it's not okay to charge ridiculous prices to other customers.
rolenthedeep 4y ago

weare138 4y ago

Exactly. I'm from Gen-X and the author's assertion is patently false and conveniently ignores everything that happened prior to the Obama admin. Besides it was Republicans that deregulated the medical industry among others and removed limitations on how much market share any single company can control. This is what led to the mass market consolidation and mega-conglomerates we have today.

d23 4y ago

I started following Matt Stoller a long time ago when I found out about his anti-monopoly stuff. Then I started following on Twitter recently and yikes — it made me question how much undeserved credibility I had mentally assigned to him. He regularly says some pretty unhinged uber-confident things that are completely outside his lane.