Healthcare Law - still not fully understood

[Guest EXPAT]

http://www.latimes.com/health/la-na-obama-healthcare-20120321,0,7589480.story

This is a good article I think on why so many people are having difficulty with the Affordable Healthcare Act. So many of the provisions haven't kicked in and all we have heard is the Republican rhetoric that it is all bad and must be repealed and as usual their base do not do their own homework and believe everything they hear.

I for one am grateful for this law so far because it limits cancellation and it has abolished lifetime limits.

[lookin]

I was initially disappointed in the bill as it stopped short of a single-payer model. My hope was that they'd do something simple like gradually extend Medicare to more of the population until, after a decade or two, everyone would be covered. When they didn't do that, I lost interest.

However, as I learn more, especially about the insurance exchanges and the possibility of increased government involvement if private insurers decide not to offer any acceptable plans, I think it may be possible that we could move gradually toward a single-payer option. Hard to say where it will lead.

Especially hard to predict is what will happen if the Supreme Court decides that the government cannot mandate that everyone either buy insurance or pay a penalty. I don't think the Court is expected to strike down all the provisions of the AHA, so much of it will be left in place. If they decide to strike down the universal coverage part of the Act, it will cause problems for the insurance companies who were counting on thirty percent more customers. That means they will probably price their offerings higher, and I think that means there will be more of an opening for a government plan.

It seems to me that another benefit of moving toward a single-payer system like Medicare is that employers could eventually get out of the healthcare business, and that should make them more competitive with other countries which have adopted government-run systems.

Hard to see how this will all play out but, if I had to guess where things will end up ten years from now, I'd put my money on a greater role for the Federal government than we have today.

I'm not sure my reasoning is valid, and would love to hear what others think.

[Guest EXPAT]

I think it will be hard to be viewed as impartial of SCOTUS rules against the affordable healthcare act. The only way insurance can work is everyone is in it. I also agree with you that the exchanges may end up being a single payer model modified at some point depending on how the private companies work this over time.

I frankly am glad that my insurance company can't cancel me or have lifetime limits now. That was worth the price of admission so far.

[Guest hitoallusa]

The US came to a point where a few group of people who are not necessarily innovative and efficient but think highly of themselves without any reason. tweak the system to maintain and expand their wealth.

There are two ways to overcome this. A major crisis that will fundamentally change our society or another innovation gradually reduce the cost of health care. I don't see a lot of the latter. So is the former inevitable??? I hope not. I don't want Karl Max to tell me "I told you so" from his grave. There must be some innovative ways of doing so. People are not so ethical or willing to give up their wealth and what they enjoy now. The only way is become more efficient through innovation. Obama and his people should focus on that in my opinion.

[Guest EXPAT]

Mitt Romney wrote an editorial in USA Today on the anniversary of the legalization of The Affordable Healthcare Act.

Huffington Post's take on the editorial: http://www.huffingtonpost.com/2012/03/22/mitt-romney-usa-today-obamacare-editorial_n_1374152.html?ncid=edlinkusaolp00000009

USA Today Romney editorial link: http://www.usatoday.com/news/opinion/forum/story/2012-03-22/mitt-romney-health-reform-repeal-obamacare/53711598/1

From USA Today:

Why I'd Repeal ObamaCare by Mitt Romney

Friday is the second anniversary of ObamaCare. It is past time to abolish the program, root and branch. The Supreme Court will soon have a crack at this; arguments about the program's constitutionality open before it next week. But whatever the justices decide in what is certain to be a landmark decision, the case against ObamaCare extends far beyond questions about its constitutionality. President Obama's program is an unfolding disaster for the American economy, a budget-busting entitlement, and a dramatic new federal intrusion into our lives.

In addition to its own editorials, USA TODAY publishes a variety of opinions from outside writers. On political and policy matters, we publish opinions from across the political spectrum.

Roughly half of our columns come from our Board of Contributors, a group whose interests range from education to religion to sports to the economy. Their charge is to chronicle American culture by telling the stories, large and small, that collectively make us what we are.

We also publish weekly columns by Al Neuharth, USA TODAY's founder, and DeWayne Wickham, who writes primarily on matters of race but on other subjects as well. That leaves plenty of room for other views from across the nation by well-known and lesser-known names alike.

It is precisely for those reasons that I've opposed a one-size-fits-all health care plan for the entire nation. What we need is a free market, federalist approach to making quality, affordable health insurance available to every American. Each state should be allowed to pursue its own solution in this regard, instead of being dictated to by Washington.

But abolishing ObamaCare will only be half the battle. Just as important is the question of what to put in its place. Instead of the massive new taxes, trillions of dollars in new spending, and top-down bureaucratic decrees of ObamaCare, we need to limit Washington's control by spurring competition, creating maximum flexibility and enhancing consumer choice.

I would begin by changing the tax code, which currently offers a subsidy for employers who purchase health insurance for their employees. This discriminates against individuals who want to buy insurance on their own. We should let individuals continue with the current arrangement if it suits their needs. But I would also offer a tax benefit for those who wish to purchase insurance outside their workplace.

A key question is how to provide care for the poor, the uninsured and the chronically ill. My program begins by taking seriously the words of the 10th Amendment to the Constitution: "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." In line with the intentions of our Founding Fathers, I favor giving each of the 50 states the resources and the responsibility to craft the health care solutions that suit their citizens best.

When I was governor of Massachusetts, we instituted a plan that got our citizens insured without raising taxes and without a government takeover. Other states will choose to go in different directions. It is the genius of federalism that it encourages experimentation, with each state pursuing what works best for them. ObamaCare's disregard for this core aspect of U.S. tradition is one of its most egregious failings.

To the extent that we have any federal regulation, it should focus on helping markets work. Thus, to take one much discussed problem, individuals with pre-existing conditions who have maintained continuous health insurance coverage should be guaranteed the ability to retain coverage. Also, individuals are currently prohibited from purchasing health insurance across states lines, which reduces competition and makes many plans subject to expensive state benefit requirements. The federal government can open up these restricted markets. States could still regulate their insurance industries, but consumers across the U.S. would benefit from lower costs and greater choice.

Finally, we need to address out-of-control medical malpractice litigation, which is costly not only in direct terms, but also in its distortion of the way patient care is administered. We can start by capping non-economic damages, but the federal government should also encourage states to pursue additional reforms such as specialized health care courts or other alternatives for resolving conflicts.

The reforms I propose for the country could not be more different from Barack Obama's. They entail no new taxes, no massive diversions of funds away from

Medicare, no tax discrimination, and no new bureaucracies. At the same time, they increase consumer choice, lower health care costs, decrease government spending, and give states responsibility for dealing with the uninsured. Whatever the Supreme Court decides about the constitutionality of ObamaCare, we already know that it is bad policy and wrong for America. Abolishing it and putting sensible changes in its place will be one of my highest priorities as president.

Mitt Romney is seeking the Republican presidential nomination.

[Guest hitoallusa]

As I have said doctors will want more money to maintain their clinic and hospitals and they will not take pay cuts. Insurance companies more profit and won't take any lesser income either. If people can choose when to get sick or not then I think they will have more power and the market will be able to adjust the price. But that's not the case. So what can you do? Either become very rich so you don't have to worry about the whole system or try to make the system reasonable enough for the middle class and below. It's not out of charity but for the stability and health of the country.

It's not an easy problem to solve but we need innovation in all this. Finding a way to give more to the rich and also for others can only be through innovation. I hope young people can come up with good ideas. But let's not be all ethical and judgmental. I think the main problem is that some people think too highly of themselves and think they have all the answers but actually don't do anything sipping expensive wine. We will be heading to serfdom or worse if we don't wake

[Guest EXPAT]

I think addressing the cost of healthcare has to be next. Without regulation a free market will just keep increasing prices.

It's hard to price shop when you're sick.