5 ms·

I don't begin to understand the US health system (I live in the UK with its National Health), but didn't Obama try bring in compulsory health insurance to count

by SeanDav 13y ago

I don't begin to understand the US health system (I live in the UK with its National Health), but didn't Obama try bring in compulsory health insurance to counteract just this sort of thing and it was defeated?

Moto7451 13y ago
Not defeated, it just hasn't rolled out fully yet. States are figuring out how to implement everything, and of course the partisan foes of his health plan stage votes in Congress to repeal it (which never pass) every month or so.
- btilly 13y ago
  It gets worse. According to CBO estimates, the plan underestimated the costs of the original rollout severalfold. Republicans are gleefully attempting to guarantee failure by refusing to approve any additional funds for that purpose.
  - specialist 13y ago
    underestimated the costs I could have told them that. I designed and implemented portable electronic medical records for 5 regional exchanges. Hospitals, clinics, pharmacies, ambulances, permanent stays (nursing homes), insurers, labs, etc. Coordination was tough, because everyone thinks they own the data (and loathe to share) and are often competitors. It's all about the incentives. The only fix I can think of is single payer, which will compel everyone to play nicely together. That said... Simply having the state by state insurance comparison portals seems to be very effective for price competition, better than I could have predicted. So on balance, it looks like the impact of Obamacare / ACA will be really good, if not perfect.
  - parasubvert 13y ago
    Citation please. As of February, it was about $130 billion off over 10 years (i.e. $1.3 trillion vs. $1.17 trillion). That is not 'severalfold'. http://www.californiahealthline.org/articles/2013/2/6/cbo-updates-spending-projections-for-aca-medicare-medicaid http://www.californiahealthline.org/articles/2013/2/6/cbo-up... And insurance premiums on ACA exchanges are coming in 20% lower than expected: http://aspe.hhs.gov/health/reports/2013/MarketCompetitionPremiums/rb_premiums.pdf http://aspe.hhs.gov/health/reports/2013/MarketCompetitionPre... I do agree Republicans believe this thing is going to fail and are trying hard to encourage that.
    - btilly 13y ago
      The figure that I was comparing is the initial cost of setting up the exchanges in the first place. From memory it was estimated by the CBO at about 6 billion, but only 1 billion was allocated for it. That is several-fold, though only a drop in the bucket compared to the 10 year figures once it is rolled out. I can't easily find a citation for it right now though. But http://www.cbsnews.com/8301-250_162-57589988/smooth-on-time-obamacare-rollout-no-sure-thing-gao/ http://www.cbsnews.com/8301-250_162-57589988/smooth-on-time-... confirms that at this point the rollout is facing potential trouble and needs billions more.
      - parasubvert 13y ago
        Thanks. I have heard some republican state governors are pushing exchange setup to the Feds as part of their "gum it up" strategy, which may be pushing setup costs up. That said, as strange as it is to say, 5 billion is a relatively small number for the US government or the US economy.
meowface 13y ago
It was not actually defeated, but if a Republican wins the next election (which is possible) and the senate and house can achieve a Republican majority, it will almost definitely be repealed.
- krapp 13y ago
  The next election, or the election after that, or the election after that... As soon as they can, even if it takes then twenty years, they'll stab it in the heart with jubilant rapture. They're still attacking Roe vs. Wade, after all.
  - earh 13y ago
    1. Roe vs Wade is a court ruling, not a law. 2. There is a theory that Roe vs Wade is such a good campaign issue that no one wants to actually "accomplish" any changes.
- parasubvert 13y ago
  It's highly unlikely they would repeal it unless they had an alternative. No serious proposals have been forthcoming (party because the ACA was actually the conservative proposal in the 1990's...) It would be political poison, especially given the rollout will have had a few years to cement by March 2017 (the earliest anything could be taken to floor). Hard to tell what public opinion will be like in 3.5 years, but I'd wager it will be net-positive on ACA.

by SeanDav 13y ago

Moto7451 13y ago

Not defeated, it just hasn't rolled out fully yet. States are figuring out how to implement everything, and of course the partisan foes of his health plan stage votes in Congress to repeal it (which never pass) every month or so.

btilly 13y ago
It gets worse. According to CBO estimates, the plan underestimated the costs of the original rollout severalfold. Republicans are gleefully attempting to guarantee failure by refusing to approve any additional funds for that purpose.
- specialist 13y ago
  underestimated the costs I could have told them that. I designed and implemented portable electronic medical records for 5 regional exchanges. Hospitals, clinics, pharmacies, ambulances, permanent stays (nursing homes), insurers, labs, etc. Coordination was tough, because everyone thinks they own the data (and loathe to share) and are often competitors. It's all about the incentives. The only fix I can think of is single payer, which will compel everyone to play nicely together. That said... Simply having the state by state insurance comparison portals seems to be very effective for price competition, better than I could have predicted. So on balance, it looks like the impact of Obamacare / ACA will be really good, if not perfect.
- parasubvert 13y ago
  Citation please. As of February, it was about $130 billion off over 10 years (i.e. $1.3 trillion vs. $1.17 trillion). That is not 'severalfold'. http://www.californiahealthline.org/articles/2013/2/6/cbo-updates-spending-projections-for-aca-medicare-medicaid http://www.californiahealthline.org/articles/2013/2/6/cbo-up... And insurance premiums on ACA exchanges are coming in 20% lower than expected: http://aspe.hhs.gov/health/reports/2013/MarketCompetitionPremiums/rb_premiums.pdf http://aspe.hhs.gov/health/reports/2013/MarketCompetitionPre... I do agree Republicans believe this thing is going to fail and are trying hard to encourage that.
  - btilly 13y ago
    The figure that I was comparing is the initial cost of setting up the exchanges in the first place. From memory it was estimated by the CBO at about 6 billion, but only 1 billion was allocated for it. That is several-fold, though only a drop in the bucket compared to the 10 year figures once it is rolled out. I can't easily find a citation for it right now though. But http://www.cbsnews.com/8301-250_162-57589988/smooth-on-time-obamacare-rollout-no-sure-thing-gao/ http://www.cbsnews.com/8301-250_162-57589988/smooth-on-time-... confirms that at this point the rollout is facing potential trouble and needs billions more.
    - parasubvert 13y ago
      Thanks. I have heard some republican state governors are pushing exchange setup to the Feds as part of their "gum it up" strategy, which may be pushing setup costs up. That said, as strange as it is to say, 5 billion is a relatively small number for the US government or the US economy.

meowface 13y ago

It was not actually defeated, but if a Republican wins the next election (which is possible) and the senate and house can achieve a Republican majority, it will almost definitely be repealed.

krapp 13y ago
The next election, or the election after that, or the election after that... As soon as they can, even if it takes then twenty years, they'll stab it in the heart with jubilant rapture. They're still attacking Roe vs. Wade, after all.
- earh 13y ago
  1. Roe vs Wade is a court ruling, not a law. 2. There is a theory that Roe vs Wade is such a good campaign issue that no one wants to actually "accomplish" any changes.
parasubvert 13y ago
It's highly unlikely they would repeal it unless they had an alternative. No serious proposals have been forthcoming (party because the ACA was actually the conservative proposal in the 1990's...) It would be political poison, especially given the rollout will have had a few years to cement by March 2017 (the earliest anything could be taken to floor). Hard to tell what public opinion will be like in 3.5 years, but I'd wager it will be net-positive on ACA.