What would it take?

[Giantone]

Originally Posted by JoeRedskin

It's a good article and I agree with a lot of his points. Healthcare reform was a messy business the first time around and the ACA was a horrible compromise that basically poured gas on the old broken system.

I do think the author's downplaying the role of malpractice is disingenuous. The study he cites analyzes only actual payments for lost claims and legal costs. The study says only these factors are the "costs" of malpractice and to include premiums would be to "double count" those costs because that is what the premiums are intended to cover. Okay, true enough BUT (and it's a big Kim Kardashian type but) the study uses this rational to entirely ignore insurance company profits saying they are not a "cost" of the doctor's actual malpractice. Sorry, that's just intellectual dishonesty. Insurance companies, the premiums they charge, and the profits they make are an essential element of malpractice costs. If insurers don't make a profit, the indemnity payments don't get made, doctors go bankrupt, and injured patients get no financial recoveries. W/out insurance companies, their profits, and the profits the make, the risk of being a doctor would be to great for anyone to bear.

We had a looong discussion about the whole healthcare reform issue back in the day. At the time, I think I predicted the ACA would be good for about four or five years and then competition would dry up because of the structure's systemic unprofitability and shortly thereafter the exchanges would become the only options. Once that occurred, costs would spiral out of control very quickly. The article cited fails to note that it's not just Kentucky where private carriers are leaving; almost every exchange has fewer private carriers than when first enacted - 38% now have only one or two [In 2016, that number was 14%. Even more stark is the growth of single-insurer states: 2% in 2016; 19% in 2017].

Preliminary Data on Insurer Exits and Entrants in 2017 Affordable Care Act Marketplaces | The Henry J. Kaiser Family Foundation

The ACA is imploding. Once it does, simple market dynamics of insurance and the ACA's structure of allowing opt outs with penalties will easily double and treble costs to the government through the exchanges.

The ACA was a Band-Aid to a broken system. It barely addressed the symptoms and most certainly did not address the underlying flaws of our current health-care system. The benefits that it has provided (and there are many) will be short-lived or force draconian economic cuts to other programs.

... but, four years ago, we walked down the road of least resistance. The piper will be coming for his payment shortly.

You're right but as I remember and I have been wrong before wasn't it all so mentioned how close the ACA was to what Mitt Romney had done in Massachusetts and had he won we would be in a similar situation,so the republicans can't just blame Obama for the mess.

[JoeRedskin]

Originally Posted by Giantone

You're right but as I remember and I have been wrong before wasn't it all so mentioned how close the ACA was to what Mitt Romney had done in Massachusetts and had he won we would be in a similar situation,so the republicans can't just blame Obama for the mess.

The dems modeled it on the Massachusets plan that was put in place while Romney was governor. I think he was instrumental in getting passed there.

However, my recollection is that Romney opposed the ACA and that it was not the plan put forward by the R's at the time or even really close to it.

... and I don't JUST blame Obama, I blame everyone who voted for it:

In December 2009, the U.S. Senate voted 60 to 39 for Obamacare. The Washington Post reported “The Senate bill passed without a single GOP vote.”

In March 2010, the U.S. House voted 219 to 212 for Obamacare. 34 House Democrats and all of the House Republicans voted against Obamacare. The NO votes were the only bipartisan votes.

oh, the Democrats.

http://oregoncatalyst.com/25561-remi...lican-vote.htm