Affordable Care Act (AKA Obamacare)

[pioneer98]

It's like the ol' baseball argument of hitting the pitcher 8th. Yeah, you can do it, but you have to hit everyone else in their optimized spot in the order to get the full result, and it doesn't work if you put the pitcher 8th and don't optimize the rest.

Here's annualized GDP growth since 1923 and up to 2009.


That big block of blue growth after the recession was the result of massive public works and a war. Every year in that span our economy grew more than it has in any single year the last 40 years or so. Our tax dollars were spent on putting people to work, either on roads or killin' Nazis. People were lifted out of poverty and into the middle class. Everyone was working and contributing.

In 1941 the tax rate on those making over $5 million was 81%. It was 70% for over $150,000.
Mark that up for inflation and $5 million today = almost $84,000,000 and $150,000 in 1941 is $2.5 million today.
Today if you make $84 million or if you make $2.5 million your tax rate is 39.6%. Anyone over a half million is the same.
The tax rate is half. We have less money for public works. Our economy grows slower. We have more people in poverty. We have a bigger divide between the ultra-rich and everyone else.

We need that combo of taxing the wealthy and corporations (and mega-churches while we're at it) plus a government that will use that money to put people to work. We can build solar power, wind-power farms, new roads, new sewers. Anecdotally, they are changing all the water pipes on Logan Boulevard, my street. The guys out there last week were telling me those pipes were from the late 1800s. Given urban density growth in neighborhoods like mine there's probably plenty of room to improve infrastructure so the amount of people on the grid doesn't crash stuff like our sewers and electric lines.

The formula by conservatives in the last 30-40 years has been:

1. Make tax cuts and starve government services
2. Government then struggles to provide services, mistakes are made, problems arise
3. Use the fact government is struggling so much to argue for more tax cuts, go back to step 1

[pioneer98]

I think the general rule of thumb if you're a person of good or better means is that the answer to "who has to foot the bill?" is: you do.

That's a thing that although individually and along some very firmly drawn party lines some don't agree on, but that we collectively as a country based on the values we established and most of us carry do share. Give us your tired, your poor and all that jazz. That's the deal in a country like this. We pay taxes so those who are in great need can be assisted in their mission to join us in the middle- or higher class.

So are people moving up or are we creating a class that relies on assistance because they don't know anything different.

The best thing for all Americans is for everyone to be employeed and contributing.

I agree that the best thing is for everyone to be employed and contributing. If we want children to grow up and to be able to contribute, investing in their health, well-being and education is exactly how to do that. Housing, food, education, and health care are all things that are critical for children. It's probably not the worst idea in the world to help their parents be healthy, either, so they can work and provide income for their children. It's also kind of important that pregnant women are healthy and have a safe childbirth that doesn't bankrupt them.

[lukethedrifter]

I think we, or at least I, have hit a stalemate here. I appreciate all the thoughts and comments.

they do that only because we are asking them to act like a business and cover their costs instead of a public good as the usps was meant to be

Also, UPS, FedEx, et al have taken the really profitable business (package shipping) away leaving the Post Office to deliver junk mail and bills, so the cross subsidy is gone.

http://gatewayredbirds.com/forum/viewto ... =9&t=51135

[Diddy]

But we've got health care with no incentives for preventative care so it's not taken advantage of. ER's are full of people using them like primary care running up costs.

Were lower middle class and our health care costs have sky rocketed under ACA. Personally I'm not able To find much value in it. When someone is lower middle class and it's increased our burden by thousands it's bothersome.

[lukethedrifter]

But we've got health care with no incentives for preventative care so it's not taken advantage of. ER's are full of people using them like primary care running up costs.

Were lower middle class and our health care costs have sky rocketed under ACA. Personally I'm not able To find much value in it. When someone is lower middle class and it's increased our burden by thousands it's bothersome.

Problem is anytime* someone (Bloomberg, Michelle Obama) tries to do something they get shot down by the Freedom crowd.


*i might be exaggerating but not much

[Joe Shlabotnik]

But we've got health care with no incentives for preventative care so it's not taken advantage of. ER's are full of people using them like primary care running up costs.

You need to ask yourself why people are using the ER as their primary care provider. Do you think they want to? Who would? Do you think that if they had access to affordable preventative care and checkups they would choose to be at the ER?

They are there because that is their only rational option open to them.

That needs to be fixed.

[planet planet]

A great deal of activity in this thread the last two days. I'll say 33 and Arthur Dent really contributed with some great content/perspective (and admittedly align with my beliefs). As someone who logged some serious healh care bills due to my cancer treatment in 2015, I expressed my serious apologies to my company. It's a company of 30+ employees. Bottom line is you're 100% healthy, until you're not. I was so grateful to only pay $2k out of pocket throughout my experience, where my total bill was prob at least $100k. I was always for universal health care beforehand though, including pre-existing conditions.

Edit: I'm sorry, I've shared the same same story several times, but I think it's important as I've been covered by employer provided insurance during my career, but I had a few lapses in my 20's and once in my 30's. I will never do that again and luckily I'm protected now under ACA if I leave my current company!

[33anda3rd]

But we've got health care with no incentives for preventative care so it's not taken advantage of. ER's are full of people using them like primary care running up costs.

You need to ask yourself why people are using the ER as their primary care provider. Do you think they want to? Who would? Do you think that if they had access to affordable preventative care and checkups they would choose to be at the ER?

I think one also have to ask ones self a really basic question, which is: is there information out there about the issue and how can I learn about it?

So in this example, in countries in which there is socialized medicine. Not Socialist countries but Democratic Socialist countries like the one in which we live. Countries like Canada and basically all of western Europe, where there is socialized medicine. Do we see more people treating the ER as their primary care, or do we see people using the socialized medicine to go to the doctor regularly, cutting off illnesses early, living healthier lives, and not sucking so much resources out of emergency rooms? Do we see a healthier populace in those countries contributing more to their country than maybe we do here because of better health.

Luckily, we can google and look around the internet for that stuff and we can come to some conclusions based on data rather than on drawing our conclusions based on a biased belief. And what we find is that the belief that socialized medicine means more people taking advantage of honest taxpayers footing the bill doesn't hold water. We can look at spending on healthcare by country among civilized Western countries and see that the US--the lone free-market country among them--has a higher per capita spend each year on healthcare. We spend more to be less healthy. There's data there to debunk the notion that having socialized medicine means people will take advantage.

[33anda3rd]

The formula by conservatives in the last 30-40 years has been:

1. Make tax cuts and starve government services
2. Government then struggles to provide services, mistakes are made, problems arise
3. Use the fact government is struggling so much to argue for more tax cuts, go back to step 1

Good point, and this has especially ramped up the last 10 years or so, and I think there's a reason. I think that for the GOP it's getting REALLY hard (and I can't capslock 'REALLY' enough to emphasize this fully) to win on some issues. When we look at the issues they were using just 3-5 electione cycles ago to appeal to voters, a lot of that stuff has become a non-issue.
--"I didn't inhale". No one cares now. Obama wrote in his book about doing blow. IL just became the 21st state to decriminalize up to a certain weight. No one cares. We're probably under 20 years from Smoke Em If You Got Em.
--Gay marriage. SCOTUS says it's cool. Only the backwater ignorant people are fighting this, and every time a governor or assembly in a state like IN or NC decides to put up a block to gay marriage or equal rights for LGBTQ people they lose industry and jobs for their citizens. It's like 2-3 years from being a non-issue.
--Abortion. Other than some very polarized people, a non-issue.

What's the social issue on which the GOP has won? There isn't one. So they're left with little to resort to. And that's, to me as a liberal, really great. They still have the race resenters, and I guaran-god-damn-tee you after this election cycle they're going to take a step back from that one, and then they have the small-government voters. So they bang that small government drum really hard because it's one of the few things they have left to fall back on.

This is all just leading, frankly, to the death of the GOP as we know it. People are saying Drumpf is going to kill the party, and he's not going to do it solo, but he's going to put the last nail in the coffin of the party as it's been for 50 years. They have been a party built on extreme special interests--anti-abortion, anti-gay, anti-black, anti-hispanic, small government/anti-tax, and as all those issues become crystalized in the right way to the public they lose legs on which to stand. As the people who skew toward multiples of those anti-s above die and younger voters don't see those as viable positions, they're left with not much but "tax is theft" and that's a mathematically/historically bad stance to take. The GOP is basically [expletive] if they don't turn the whole thing over.

Problem is, you don't change institutions like that from the inside with change. You disrupt them from outside and either kill them or make them change themselves wholesale. Apple didn't fine-tune the Nokia phone, they re-invented cell phones to put a supercomputer in everyone's pocket. That's what the GOP needs, but I am skeptical they will get or accept if opportunity arises. They're too dug in with the kinds of voters who think Sarah Palin is viable.

Ugh. I've had too many beers to be posting in political threads at 2am. G'night y'all.

[pioneer98]

If you're concerned about having fewer options and/or being able to keep your current physician, tell me why this won't work...

We expand medicare to cover all citizens. They get to select from PUBLIC providers. Maybe this list is limited, but everyone is guaranteed quality healthcare from SOMEWHERE.

Now, if you're rich and wish to buy extra PRIVATE insurance so you can continue to see your favorite provider, then more power to you.

Does this model sound familiar? I basically just described the public/private education system we have. Why won't this approach work in healthcare???

Yeah but doesn't our public/private education system have problems today? Yeah, maybe that system has raised tens of millions of people out of poverty and helped employers by providing them with a more skilled work force. But because it has some issues today there is nothing to be learned from the last 2 centuries of using that system. Good try though.


The delivery service sector is also a public/private system. Need something there cheap, and don't care how long it takes? Use the USPS. Need something there ASAP? We have premium private services that do that.