6 ms·

...or the liberating effect of knowing you'll have healthcare coverage wherever you go? (Chill with the downvotes, it's just a hypothesis.)

by pohl 12y ago

learc83 12y ago
That's a very good point. I didn't really support Obamacare when it passed, but if helps separates health insurance from employment it's probably a net positive.
- liveoneggs 12y ago
  this is a huge reason to support obamacare.. I know a guy who happens to be extremely specialized in a certain high-end medical finance suite. He could easily demand a very high consulting rate. However, his wife is a cancer survivor so under the old health laws he had to settle for a single employer at a hospital administration salary.
- maheart 12y ago
  As a non-American, can you explain why you would not support Obamacare?
  - gress 12y ago
    ObamaCare has a few good features - heavy subsidy for those with very low income, and not turning people away who have pre-existing conditions. However, it has some extremely serious downsides. Firstly, it's the same predatory insurance companies providing the insurance, only you're forced to buy from them. The available choices have gone down, and in particular there is no catastrophic cover anymore. Also, none of the plans are great - you still end up paying a huge amount out of pocket if you get seriously ill. Basically it's tuned for people who overuse healthcare. For someone who actually takes good care of themselves but recognizes that serious conditions and accidents can happen to everyone, it's an extortion racket that will take money that could have been used for prevention and give it to the insurers.
  - gress 12y ago
    ObamaCare has a few good features - heavy subsidy for those with very low income, and not turning people away who have pre-existing conditions. However, it has some extremely serious downsides. Firstly, it's the same predatory insurance companies providing the insurance, only you're forced to buy from them. The available choices have gone down, and in particular there is no catastrophic cover anymore. Also, none of the plans are great - you still end up paying a huge amount out of pocket if you get seriously ill. Basically it's tuned for people who overuse healthcare. For someone who actually takes good care of themselves but recognizes that serious conditions and accidents can happen to everyone, it's an extortion racket that will take money that could have been used for prevention and give it to the insurers.
  - learc83 12y ago
    2 reasons. Constitutional: If the government can force you to buy something from a private company there's not really much left that it can't do. In fact this was the argument the Supreme Court made when it refuted that governments argument that the Affordable Care Act was justified by the commerce clause--that such a broad interpretation of the commerce clause would essentially grant the federal government unlimited power. However, the justification that the Supreme Court actually went with, that the ACA was basically just a tax, is a bit ridiculous because it has almost all of the same problems. Basically the difference according to the supreme court is that congress doesn't have the authority to make it illegal not to buy health insurance. They can't throw you in jail for not buying health insurance. But they can tax you for not paying health insurance and throw you in jail for refusing to pay the tax. The end result is pretty similar. Practical: This has more to do with the Affordable Care Act after the Supreme Court made some alterations, rather than the bill that was passed. The subsidies provided by the ACA are only for people making an income above some multiple X of the poverty line, and below some multiple Y. People with very low incomes were supposed to be covered by an expansion of medicaid, but the Supreme Court ruled that congress can't force states to expand medicaid. So in more than half the states people making just above a certain threshold get essentially free healthcare, while people making below it get nothing. In these states the ACA has done almost nothing to help the very poorest. I would have honestly supported a single payer system and a universal (but progressive) tax instead of this public private hybrid with punitive taxes. However, i think removing the ability for insurance companies to charge based on preexisting conditions, and the supplements provided for most middle class people will go a long way towards decoupling employment and health insurance. I generally support anything that will increase personal autonomy and allowing more people to work for themselves is a great way to do that.
    - jared314 12y ago
      I do not understand your second reason. > So in more than half the states people making just above a certain threshold get essentially free healthcare, while people making below it get nothing. In these states ACA has done almost nothing to help the very poorest. The ACA, by itself, has done everything it could have to help the poorest, within the options that would actually pass the US congress (2009-2010). The Supreme Court said the ACA could not force the states to take the (federally funded) Medicaid expansion, so the state governments used that choice as a political party loyalty test. The state governments chose to refuse preallocated federal money, to help the poor, to show their loyalty for the next election cycle. I too would have preferred a single payer system, but the ACA is what passed and the state governments have made their choice.
monksy 12y ago
That is not necessarily true. Employers are moving to Employer contributed health insurance. Which means that there is a specialize payment option [given benefits of paying pre-tax] that subsidizes the health insurance option. So technically they do and don't offer the plan. This opens up the PHX (Private Health Exchange, market). The future effects are a little unknown at the moment, but the PHX is making bank. All the ACA (screw the name "Obamacare") just is a requirement that all citizens must have health insurance. It's no longer a situation where the "poverty" citizens and seniors are guaranteed health insurance anymore. So if you go jobless/self employeed, you'll have to get a plan on the private market. Good thing: The private market (which forces the carriers to actually compete for once). Also, the carriers have a requirement to serve their customers rather than administrative items. (Which also helps the secondary carrier supporting market) Bad: Employers are given more power to push their social/health agendas and will be going away from group based plans.
- jacalata 12y ago
  Underplaying the changes a little there. Even ignoring everything else, removing the pre-existing condition limitations made private/non-employer insurance an option for (at least) about 20% of working-age Americans who previously wouldn't have had the option.

...or the liberating effect of knowing you'll have healthcare coverage wherever you go? (Chill with the downvotes, it's just a hypothesis.)

by pohl 12y ago

...or the liberating effect of knowing you'll have healthcare coverage wherever you go? (Chill with the downvotes, it's just a hypothesis.)

learc83 12y ago

That's a very good point. I didn't really support Obamacare when it passed, but if helps separates health insurance from employment it's probably a net positive.

liveoneggs 12y ago
this is a huge reason to support obamacare.. I know a guy who happens to be extremely specialized in a certain high-end medical finance suite. He could easily demand a very high consulting rate. However, his wife is a cancer survivor so under the old health laws he had to settle for a single employer at a hospital administration salary.
maheart 12y ago
As a non-American, can you explain why you would not support Obamacare?
- gress 12y ago
  ObamaCare has a few good features - heavy subsidy for those with very low income, and not turning people away who have pre-existing conditions. However, it has some extremely serious downsides. Firstly, it's the same predatory insurance companies providing the insurance, only you're forced to buy from them. The available choices have gone down, and in particular there is no catastrophic cover anymore. Also, none of the plans are great - you still end up paying a huge amount out of pocket if you get seriously ill. Basically it's tuned for people who overuse healthcare. For someone who actually takes good care of themselves but recognizes that serious conditions and accidents can happen to everyone, it's an extortion racket that will take money that could have been used for prevention and give it to the insurers.
- gress 12y ago
  ObamaCare has a few good features - heavy subsidy for those with very low income, and not turning people away who have pre-existing conditions. However, it has some extremely serious downsides. Firstly, it's the same predatory insurance companies providing the insurance, only you're forced to buy from them. The available choices have gone down, and in particular there is no catastrophic cover anymore. Also, none of the plans are great - you still end up paying a huge amount out of pocket if you get seriously ill. Basically it's tuned for people who overuse healthcare. For someone who actually takes good care of themselves but recognizes that serious conditions and accidents can happen to everyone, it's an extortion racket that will take money that could have been used for prevention and give it to the insurers.
- learc83 12y ago
  2 reasons. Constitutional: If the government can force you to buy something from a private company there's not really much left that it can't do. In fact this was the argument the Supreme Court made when it refuted that governments argument that the Affordable Care Act was justified by the commerce clause--that such a broad interpretation of the commerce clause would essentially grant the federal government unlimited power. However, the justification that the Supreme Court actually went with, that the ACA was basically just a tax, is a bit ridiculous because it has almost all of the same problems. Basically the difference according to the supreme court is that congress doesn't have the authority to make it illegal not to buy health insurance. They can't throw you in jail for not buying health insurance. But they can tax you for not paying health insurance and throw you in jail for refusing to pay the tax. The end result is pretty similar. Practical: This has more to do with the Affordable Care Act after the Supreme Court made some alterations, rather than the bill that was passed. The subsidies provided by the ACA are only for people making an income above some multiple X of the poverty line, and below some multiple Y. People with very low incomes were supposed to be covered by an expansion of medicaid, but the Supreme Court ruled that congress can't force states to expand medicaid. So in more than half the states people making just above a certain threshold get essentially free healthcare, while people making below it get nothing. In these states the ACA has done almost nothing to help the very poorest. I would have honestly supported a single payer system and a universal (but progressive) tax instead of this public private hybrid with punitive taxes. However, i think removing the ability for insurance companies to charge based on preexisting conditions, and the supplements provided for most middle class people will go a long way towards decoupling employment and health insurance. I generally support anything that will increase personal autonomy and allowing more people to work for themselves is a great way to do that.
  - jared314 12y ago
    I do not understand your second reason. > So in more than half the states people making just above a certain threshold get essentially free healthcare, while people making below it get nothing. In these states ACA has done almost nothing to help the very poorest. The ACA, by itself, has done everything it could have to help the poorest, within the options that would actually pass the US congress (2009-2010). The Supreme Court said the ACA could not force the states to take the (federally funded) Medicaid expansion, so the state governments used that choice as a political party loyalty test. The state governments chose to refuse preallocated federal money, to help the poor, to show their loyalty for the next election cycle. I too would have preferred a single payer system, but the ACA is what passed and the state governments have made their choice.

monksy 12y ago

That is not necessarily true. Employers are moving to Employer contributed health insurance. Which means that there is a specialize payment option [given benefits of paying pre-tax] that subsidizes the health insurance option. So technically they do and don't offer the plan. This opens up the PHX (Private Health Exchange, market). The future effects are a little unknown at the moment, but the PHX is making bank. All the ACA (screw the name "Obamacare") just is a requirement that all citizens must have health insurance. It's no longer a situation where the "poverty" citizens and seniors are guaranteed health insurance anymore. So if you go jobless/self employeed, you'll have to get a plan on the private market. Good thing: The private market (which forces the carriers to actually compete for once). Also, the carriers have a requirement to serve their customers rather than administrative items. (Which also helps the secondary carrier supporting market) Bad: Employers are given more power to push their social/health agendas and will be going away from group based plans.

jacalata 12y ago
Underplaying the changes a little there. Even ignoring everything else, removing the pre-existing condition limitations made private/non-employer insurance an option for (at least) about 20% of working-age Americans who previously wouldn't have had the option.