3 ms·

Health care law stands in U.S.

16 points by leothekim 14y ago

tzs 14y ago
Long term, we probably would have been better off if the individual mandate had been struck down but the rest left intact. That would have had a decent chance of forcing us toward a real national healthcare system. Consider the lesson of Washington State: http://seattletimes.nwsource.com/html/localnews/2017852301_insurancemandate28m.html http://seattletimes.nwsource.com/html/localnews/2017852301_i... In 1993, Washington passed a law that guaranteed access to health insurance, and required all residents to purchase insurance. Two years later, the Republicans gained control and set about repealing this. However, much of the law was extremely popular, such as the parts guaranteeing affordable access. The Republicans let those stand, but went ahead and repealed the mandate. Result: people dropped insurance until they got sick, then bought it, then dropped it when they were better. Insurance companies started losing a lot of money. That led insurance companies to pull out of the market, and it became virtually impossible as an individual to buy health insurance in Washington at any price. Around 2000, the law was changed again, allowing insurance companies to make people with preexisting conditions wait nine months before coverage starts, and allowing them to reject the sickest applicants. The state created a state run high risk pool to cover those people. Imagine if something like this happened nationally. The individual mandate goes, but the rest remains. I think a similar thing would happen nationally. Polls show that when people are asked about the various major provisions of the Affordable Care Act (but are not told that they are being asked about that Act, so that they aren't prejudiced by the ridiculous claims the Tea Party spread about it, such as the "death panel" fantasy) they are overwhelming in favor of everything except the mandate. No way would the Republicans be able to get repeal of those through without committing political suicide with the voters. That would leave us with the Washington situation--the insurance companies bearing increased costs, without the mandate to ensure that enough healthy people are paying premiums to cover this. We'd get a health care crisis similar to what happened in Washington. Congress would HAVE to act, and I think the outcome would be some sort of true national health care system, with a mix of private and government provided services, open to everyone.
- cantastoria 14y ago
  I think a similar thing would happen nationally. Polls show that when people are asked about the various major provisions of the Affordable Care Act (but are not told that they are being asked about that Act, so that they aren't prejudiced by the ridiculous claims the Tea Party spread about it, such as the "death panel" fantasy) they are overwhelming in favor of everything except the mandate. But the mandate is what makes everything else possible. This is like saying "we polled peopled about getting more services from the government and they were in favor of it except for the parts about taxes going up". Which, as of this morning, is essentially what's going on as the "mandate" is now going to have to be implemented as a tax penalty. So that polling just shows how clueless people are about how this whole scheme works. No way would the Republicans be able to get repeal of those through without committing political suicide with the voters. I think the more likely proposal would be to "put it all back the way it was before" instead of a full government takeover. At that point the current situation would be ,rightly, described as being caused by the government (i.e. ObamaCare). I'm not sure how easy a sell a full government take over would be.
- Lazare 14y ago
  Yeah. One of the ugly little truths about PPACA is that it's really a terrible law even if (or especially if) you are in favour of a government-run single-payer system. Given that polls indicate that even a majority of PPACA supporters are against the mandate, it's actually highly plausible that we're about to see a repeat of Washington's experience: a repeal of the mandate, followed my a complete meltdown of the healthcare system, followed by sensible reforms. In which case, it's going to be a really bumpy ride, and today's decision is just going to prolong the agony a bit. But we'll see...

16 points by leothekim 14y ago

tzs 14y ago

Long term, we probably would have been better off if the individual mandate had been struck down but the rest left intact. That would have had a decent chance of forcing us toward a real national healthcare system. Consider the lesson of Washington State: http://seattletimes.nwsource.com/html/localnews/2017852301_insurancemandate28m.html http://seattletimes.nwsource.com/html/localnews/2017852301_i... In 1993, Washington passed a law that guaranteed access to health insurance, and required all residents to purchase insurance. Two years later, the Republicans gained control and set about repealing this. However, much of the law was extremely popular, such as the parts guaranteeing affordable access. The Republicans let those stand, but went ahead and repealed the mandate. Result: people dropped insurance until they got sick, then bought it, then dropped it when they were better. Insurance companies started losing a lot of money. That led insurance companies to pull out of the market, and it became virtually impossible as an individual to buy health insurance in Washington at any price. Around 2000, the law was changed again, allowing insurance companies to make people with preexisting conditions wait nine months before coverage starts, and allowing them to reject the sickest applicants. The state created a state run high risk pool to cover those people. Imagine if something like this happened nationally. The individual mandate goes, but the rest remains. I think a similar thing would happen nationally. Polls show that when people are asked about the various major provisions of the Affordable Care Act (but are not told that they are being asked about that Act, so that they aren't prejudiced by the ridiculous claims the Tea Party spread about it, such as the "death panel" fantasy) they are overwhelming in favor of everything except the mandate. No way would the Republicans be able to get repeal of those through without committing political suicide with the voters. That would leave us with the Washington situation--the insurance companies bearing increased costs, without the mandate to ensure that enough healthy people are paying premiums to cover this. We'd get a health care crisis similar to what happened in Washington. Congress would HAVE to act, and I think the outcome would be some sort of true national health care system, with a mix of private and government provided services, open to everyone.

cantastoria 14y ago
I think a similar thing would happen nationally. Polls show that when people are asked about the various major provisions of the Affordable Care Act (but are not told that they are being asked about that Act, so that they aren't prejudiced by the ridiculous claims the Tea Party spread about it, such as the "death panel" fantasy) they are overwhelming in favor of everything except the mandate. But the mandate is what makes everything else possible. This is like saying "we polled peopled about getting more services from the government and they were in favor of it except for the parts about taxes going up". Which, as of this morning, is essentially what's going on as the "mandate" is now going to have to be implemented as a tax penalty. So that polling just shows how clueless people are about how this whole scheme works. No way would the Republicans be able to get repeal of those through without committing political suicide with the voters. I think the more likely proposal would be to "put it all back the way it was before" instead of a full government takeover. At that point the current situation would be ,rightly, described as being caused by the government (i.e. ObamaCare). I'm not sure how easy a sell a full government take over would be.
Lazare 14y ago
Yeah. One of the ugly little truths about PPACA is that it's really a terrible law even if (or especially if) you are in favour of a government-run single-payer system. Given that polls indicate that even a majority of PPACA supporters are against the mandate, it's actually highly plausible that we're about to see a repeat of Washington's experience: a repeal of the mandate, followed my a complete meltdown of the healthcare system, followed by sensible reforms. In which case, it's going to be a really bumpy ride, and today's decision is just going to prolong the agony a bit. But we'll see...