Nobody ever had any intention of seeing to it that Americans could afford to be looked after by the sickness-marketing industry.
This is a rather large shift of the discussion away from the (a) mechanism of coverage to the (b) cesspool which is our medical “industry.”
If you take (b) for granted, then (a) is a legitimate discussion. And, as is obvious, not often a fruitful one.
On the other hand, if you don’t take (b) for granted, you have to start figuring out why (b) is so overpriced. And what you find as you peel back the onion is layer after layer of profit-taking which is enabled by (a), and will continue to be enabled regardless if the mechanism is private insurance, the ACA, or the wet dream of the left, single payer.
Because if you don’t control costs, which is the problem generated by (b), any insurance scheme that you decide to use is nothing more that rearranging the deck chairs on the Titanic. Medicare, medicaid, ACA, AHCA, CHIPS…..doesn’t matter. None of them can keep up with escalating costs.
There is way too much profit on the line for it ever to be anything but an overpriced complex of enforced addictions, making people sick more than keeping them healthy, and doing more to impoverish them than it ever does to help them remain able to make a living so they can afford just to live their lives.
I quite agree that there are negative incentives in the marketplace that do not have the best interests of the patient at heart.
Seriously? Sophistry? I see all this gobbledygook about “means tests”, “tax returns”, “penalties” et cetera, not one goddman iota of it having the least bit to do with caring for anyone’s health or even giving a rat’s ass of caring ABOUT anyone’s being healthy. It is a political football, they’re all having a blast being seen kicking it around, and nobody has the least clue, nor the least intention, regarding ever making it right, for anyone.
Well, that’s ANOTHER digression from the (a) and the (b) above (let’s call it (c ), but you’re incorrect about that nobody’s tried to address it. One of the better elements of the ACA is that it penalizes institutions for bad performance, essentially saying that “any rework is on you”; institutions were suddenly incented financially to check up on their patients after sending them home. Another positive aspect of it is that it financially incents what is colloquially known as the “medical home”, an integrated clinic approach which is able to provide a full range of care for the patient, rather having that patient kicked around like a football from provider to provider. This approach is known to provide some cost control and improve care outcomes (it’s the model used by Mayo and Cleveland Clinics, to varying extents) but obviously requires a critical mass of doctors and patients to function.
Nothing in all human history, has required more common defense than injury and ill health. It is the regime’s duty, which it has never seen fit to fulfill, that no such thing as any “doctor bill” ever even confront the ordinary citizen, much less that one such is all it takes to drive any of us into destitution.
Well, now we’re on (d), it seems. Food, clothing, and shelter come to mind as even more basic than health care. Put another way, any rationalization as to why health care should be 100% subsidized (let’s put aside the impossibility of that for a moment) can be used even more effectively to argue that all food, basic clothing, and housing should also be 100% subsidized.
So, in that you’re a contractor, I think……welcome to your new government job. Paycheck’s in the mail. Don’t expect much, not in compensation or creative license. Just build the same track home over and over again.
Until that is lived up to, this is basically an occupied country, with a lawless junta running it. One that has not the least intention, and never has, of fixing anything about “health care.”
Well, hard to argue that one. :-). The government gave up giving a shit about the people after WW2, in various ways.
Because you know better. I don’t get why you pretend not to.
Nobody’s pretending anything. You jumped into an argument about (referring to my first paragraph above) (a) and are demanding that we discuss (b), (c ), and (d) instead. That’s fine, glad to have a broader discussion, but be aware that you’re moving the goalposts not just 10 yards back, but into the next state. :-)
I quite agree that (a) doesn’t get truly “fixed” (and this comment would include the fiscal imbalances of Medicare and Medicaid which will also force cutbacks in those programs in the 2020–2030 window) unless (b) is addressed. If you address (b), (c ) kind of gets fixed along with it.
I have no idea how to fix (d), since it seems to be impervious to electoral politics. It was noted that the stream of criticism of Trump only abated twice, and that was when he used the military to blow something up.