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"ObamaCare" Ramifications


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Hey guys,

 

As I'm sure all of you are aware, the Supreme Court upheld all of the aspects of the ACA yesterday afternoon. Assuming it does not get repealed, it means over 34 million new patients will be in need of healthcare. Of course, that means more doctors will be needed. Unfortunately, it seems that there is some concern that with the large amount of doctors and retiring and insufficient residency spots for new medical graduates, there may not be enough doctors to go around.

 

Do you guys believe the US government will now be pressured into creating more residency spots, thus increasing the chances of Canadian and international students to obtain a residency?

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I think they are planning to decrease the number of residency spots in 2015

 

That would be very strange, given the 2014 date that the ACA will be instituted. I understand that the reason why residency spots have grown much is because of a 15 year freeze in Medicare support, thus hospitals don't have enough funding to support medical graduate training. In the current economic climate, it doesn't seem likely that freeze will be lifted. All of this points to you being right, unfortunately.

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I thought Medicare and Medicaid were being expanded, that's what CNN says at least.

 

I believe the guidelines are being expanded to include more people.

 

The reason some doctors are objecting to it is that Medicare/caid reimbursements will be tied to as-yet-undefined performance metrics. For instance, right now they have the joint commission and the CMS that measure things like post-op infection rates, average operating time per procedure, etc. on a per hospital basis, with rather serious consequences to reimbursements (which make up a significant portion of revenue) if they dont measure up. But this will be expanded to a provider basis, not just hospitals. The exact methods, I don't know at this point but there is some discomfort that things beyond the physicians' control (compliance, primarily) may be metrics in the new formula.

 

However, it also does more than just expand and modify Medicare/caid. It removes the ability for insurers to refuse coverage on the basis of preexisting conditions (or charge significantly higher rates) and to ensure that pts will not just avoid buying insurance until they are sick - which they technically could now do - introduces a penalty on middle/higher income families around 1-2.5% for *not* buying insurance if they are of means to do so.

 

It also bars insurance companies for canceling policies because someone gets sick with something expensive (currently a fairly big problem) and they can no longer place lifetime caps on insurance (I personally know two people whose babies - micropreemies - hit their lifetime caps before their first birthdays.) And it makes premiums more equal - instead of the current issue where it can cost as much as double for a woman to get insurance compared to a male of same age and smoking status in many areas. The companies won't be able to charge people with poor health history more (although I think some factors like smoking status, weight, etc. can still be included.)

 

It also caps profit as a function of revenue, I believe. Somewhere around 20% I heard someone say.

 

There's actually a lot of really good stuff in the package. I've been reading bits and pieces as well as summaries. A good portion of my friends are American, several are uninsured, so I was following it. Don't feel like pulling up citations for this, it's all from memory but I believe is completely correct. Google is available if you want to check.

 

I seem to recall that states have an opt-out option, but they have to demonstrate a planned implementation of similar measures.

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There's actually a lot of really good stuff in the package.

 

It's scary when I hear people say this. Is this how people actually think? No wonder China is getting ahead of us. Obamacare was designed to benefit the insurance companies and big government, NOT American citizens as a whole.

 

Because everybody now has to pay for insurance, you can expect the costs of it to skyrocket. But of course, the bill also caps the premiums that poor people pay, meaning that it's the middle and upper classes that lose in the end. But of course it's the middle class that gets screwed moreso than the upper class - an extra $5K per year in insurance costs is going to hurt someone who makes $50K, but not someone who makes $1M per year. Because everybody is FORCED to pay for insurance, you can also expect extremely crappy service, and be nailed with all kinds of fees that aren't regulated.

 

It also forces businesses to give their full-time employees health insurance... except for mega-corporations whos' employees' insurance is going to be paid for by the taxpayers - corporate welfare on a massive scale.

 

Insurance companies are happy because they make a lot of extra cash. Big government is happy because it now controls the health insurance market, gets to enforce a bunch of regulations, and gets to make health decisions for everybody. American citizens get screwed yet again: it's not a surprize that the majority disapprove of the bill.

 

I get it - you're the type of person who just wants big government to wrap you up in a nice warm coccoon, insulating from the harshness of the big scary world, because apparently you don't like taking care of yourself or believe yourself incapable of doing so. But look at what is lost. The bill imposes the biggest tax hike in the history of the world, is an obvious bone to big business, and screws the middle class harder than anyone else. And for what? To help the idiots who spend their money on dirt bikes and big screen TVs intead of health insurance - people who can't live within their means.

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Because without health insurance people don't get health care and get thrown out onto the street, or go bankrupt.

 

+ 1 ... exactly, because alot of people dont have insurance and are screwed when a major health disaster occurs. This includes the poor or even the middle class who choose not to have insurance (some of which possibly due to priorities) have a kid break and arm and WALLOP they are in financial hell ...

 

If you read Birdy's post you will read some of the benefits:

 

1) More of the population will receive medical coverage.

2) It removes the ability for insurers to refuse coverage on the basis of preexisting conditions (or charge significantly higher rates)

3) Introduces a penalty on middle/higher income families around 1-2.5% for *not* buying insurance if they are of means to do so. Thus given families an incentive to plan for health issues which could otherwise ruin them financially. There are too many people running around buying the next shiny thing and have no concept of planning for the future (i.e. health problems/savings) this will force those people to be better prepared.

4) It also bars insurance companies for canceling policies because someone gets sick with something expensive (currently a fairly big problem)

5) They can no longer place lifetime caps on insurance (I personally know two people whose babies - micropreemies - hit their lifetime caps before their first birthdays.)

6) And it makes premiums more equal - instead of the current issue where it can cost as much as double for a woman to get insurance compared to a male of same age and smoking status in many areas.

7)The companies won't be able to charge people with poor health history more (although I think some factors like smoking status, weight, etc. can still be included.)

 

These are all things just cut and paste from Birdy's post so obviously you didnt read it to understand many peoples' reason for supporting 'Obama Care'. If you can not agree that those items, most of which, if not all are positive than you have taken a stance on an issue and are trolling rather than having a discussion in which you are open to having you position modified with logic and fact.

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Hey guys,

 

As I'm sure all of you are aware, the Supreme Court upheld all of the aspects of the ACA yesterday afternoon. Assuming it does not get repealed, it means over 34 million new patients will be in need of healthcare. Of course, that means more doctors will be needed. Unfortunately, it seems that there is some concern that with the large amount of doctors and retiring and insufficient residency spots for new medical graduates, there may not be enough doctors to go around.

 

Do you guys believe the US government will now be pressured into creating more residency spots, thus increasing the chances of Canadian and international students to obtain a residency?

 

Well, wait till the November election. Romney will strike down the Obama care on the first day of his presidency, if gets elected.

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Well, wait till the November election. Romney will strike down the Obama care on the first day of his presidency, if gets elected.

 

Actually, he can't. He needs congress to pass such a repeal. And congress is currently enjoying a democratic majority. Soooo, that's not gonna happen.

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Well, wait till the November election. Romney will strike down the Obama care on the first day of his presidency, if gets elected.

 

Can't happen, but at least that would make Romney "14% income tax paid" consistent in flip-flopping on just about everything.

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+ 1 ... exactly, because alot of people dont have insurance and are screwed when a major health disaster occurs. This includes the poor or even the middle class who choose not to have insurance (some of which possibly due to priorities) have a kid break and arm and WALLOP they are in financial hell ...

 

If you read Birdy's post you will read some of the benefits:

 

1) More of the population will receive medical coverage.

2) It removes the ability for insurers to refuse coverage on the basis of preexisting conditions (or charge significantly higher rates)

3) Introduces a penalty on middle/higher income families around 1-2.5% for *not* buying insurance if they are of means to do so. Thus given families an incentive to plan for health issues which could otherwise ruin them financially. There are too many people running around buying the next shiny thing and have no concept of planning for the future (i.e. health problems/savings) this will force those people to be better prepared.

4) It also bars insurance companies for canceling policies because someone gets sick with something expensive (currently a fairly big problem)

5) They can no longer place lifetime caps on insurance (I personally know two people whose babies - micropreemies - hit their lifetime caps before their first birthdays.)

6) And it makes premiums more equal - instead of the current issue where it can cost as much as double for a woman to get insurance compared to a male of same age and smoking status in many areas.

7)The companies won't be able to charge people with poor health history more (although I think some factors like smoking status, weight, etc. can still be included.)

 

These are all things just cut and paste from Birdy's post so obviously you didnt read it to understand many peoples' reason for supporting 'Obama Care'. If you can not agree that those items, most of which, if not all are positive than you have taken a stance on an issue and are trolling rather than having a discussion in which you are open to having you position modified with logic and fact.

 

Thanks for your input. Here's mine.

 

1) The bill raises taxes on Americans by $1.4 trillion dollars. This is the biggest tax hike on any population in the history of the world.

 

2) Collectively, Americans will spend even more of their money on healthcare because of the bill. The US spends more of its collective wealth on healthcare than any other nation.

 

3) For the majority of Americans, healthcare premiums will increase and will receive poorer service, due to the inability of them to not buy insurance.

 

4) Introduces a huge number of regulations on the healthcare industry, which will require a massive expansion of the government bureaucracy to enforce. The law specificies the creation of numerous government committees.

 

5) Forces companies with 50 or more employees to pay for their workers' health insurance. This will result in either higher prices of goods and services being passed on to consumers, or a drop in wages. This will result in smaller companies hiring fewer workers to avoid going over the 50 worker limit. This will result in increased rates of unemployment, and a stiffling of economic expansion.

 

6) Reduces physician compensation resulting in a less competent group of people being attracted to the job.

 

7) Increases the amount of paperwork for insurance companies. For example, insurance companies now have to tell customers what their money is being spent on, instead of just "administration fees." This creates inefficiencies in the system, resulting in higher premiums.

 

8) Creates numerous government subsidies for drugs and certain treatments, which simply amounts to a giveaway to big business who will simply increase their prices in response to this.

 

9) Cuts medicare spending, while increasing the number of people who are eligible for it, resulting in a decrease in the amount of medicare funding per person, resulting in poorer quality of healthcare for all.

 

In response to your points:

 

1, 3) Basically, what you're saying is that because some poor people are unable to act in the way that is best for them, we have to make government make their choices for them, and everybody else has to suffer in the process. How is it fair that 8 people have to suffer because of the stupid decisions of 2?

 

2) Why is this a bad thing? People with "pre-existing conditions" are ***holes trying to cheat the system by buying insurance the moment they get sick, and expecting treatment without paying the premiums. Why should everybody else, who fairly paid their premiums, be forced to pay for these cheaters? "Pre-existing conditions" wouldn't be a problem if people stayed honest and didn't try to cheat the system by not paying their premiums (contributing to the pot).

 

4, 5) Perhaps people should actually read their health insurance contracts BEFORE they sign them? When you sign up for health insurance, those are the terms you agree to. Don't like it? Take your business elsewhere, or pay higher premiums for more complete coverage. This is only a problem because of STUPIDITY (failing to read contractual agreement, or taking a risk then complaining about it), or GREED (not wanting to pay for more complete coverage).

 

6) It does NOT make health insurance premiums more equal. In fact, it makes them less equal. Those who are close to the poverty line will have to pay barely anything for insurance, the cost of which will be picked up by those with higher incomes (read: the middle class).

 

7) Once again, if you have poor health, you should have to pay more. Use more = pay more, simple logic, no?

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Actually, he can't. He needs congress to pass such a repeal. And congress is currently enjoying a democratic majority. Soooo, that's not gonna happen.

 

Romney was talking about placing an executive order, which does not require a republican majority in congress. With the current Republican house majority Romney can dismantle Obama care. Having said that I think this election is going to be a really close one, if the unemployment rate for September is above 8%.

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it's a tradeoff… our inefficient pub system gives everyone 5/10 care… america is well all over the place… public health care is obvs ideological choice if we could make it more efficient, less nepotistic, self serving and inefficient.

 

Because without health insurance people don't get health care and get thrown out onto the street, or go bankrupt. Either you're a very bad troll, or our education system has seriously failed you.
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I hope they do. Obamacare is a terrible idea that benefits nobody but the insurance companies.

 

You're right. Unfortunately, in the US every new bill that gets passed either benefits big business or big government in some way. The people there have pretty much no representation. Their system is rotten to the core... not to say that ours is much better.

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Although I understand why some of you guys are pro-Obamacare, you are not looking deep enough into the bill and/or are not seeing the long-term impact of it. What Birdy mentioned earlier in her post are some of the things that sound good and thus make people think Obamacare is a fantastic idea. I don't like writing a lot so I'm going to mention one of the things wrong with Obamacare. Atom already mentioned a few.

 

The penalty that is forced against people who do not buy health insurance is minimal compared to the cost of health insurance. Therefore this "penalty" is not going to change anything because people are going to pay the "penalty" rather than buying an expensive health insurance until they are at a point where they get sick and have to do so. So this penalty is not changing anything other than putting money in the government's pocket.

 

Ultimately though, Obamacare will drive up health care costs and reduce quality of health services. Atom kind of mentioned why but those of you who are pro-Obamacare should really break it down for yourselves and come to the conclusions.

 

I did mention before that Atom's opinions are most of the time against most other peoples', so I guess I was right since I didn't say ALWAYS. :P

 

If Americans want a better health care system, they have got to get rid of government's involvement.

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2) Collectively, Americans will spend even more of their money on healthcare because of the bill. The US spends more of its collective wealth on healthcare than any other nation.

More efficient healthcare spending with more healthy people paying into it (who don't make claims) should actually lower prices. More insured Americans means fewer people going to the "free" ER for their heatlh care when they actually get sick, and better controlled chronic disease = decreased health care costs for the US.

 

3) For the majority of Americans, healthcare premiums will increase and will receive poorer service, due to the inability of them to not buy insurance.

This makes no sense. Also again , premiums should stay the same or even lower once the health insurance companies are forced to be more efficient due to capped profits. The ulterior goal to this is actually to run insurance companies out of business so that a single payer system can be implemented. Single payer systems are the only ones which are efficient enough to work.

 

4) Introduces a huge number of regulations on the healthcare industry, which will require a massive expansion of the government bureaucracy to enforce. The law specificies the creation of numerous government committees.

Again, caps on profit force efficiencies or they bust.

 

5) Forces companies with 50 or more employees to pay for their workers' health insurance. This will result in either higher prices of goods and services being passed on to consumers, or a drop in wages. This will result in smaller companies hiring fewer workers to avoid going over the 50 worker limit. This will result in increased rates of unemployment, and a stiffling of economic expansion.

Lots of speculation but no hard data here...

 

6) Reduces physician compensation resulting in a less competent group of people being attracted to the job.

This is going to happen regardless of what system is in place. Insurance companies will start hiring more midlevels as health care is going to become unsustainable no matter what type of delivery model exists.

 

7) Increases the amount of paperwork for insurance companies. For example, insurance companies now have to tell customers what their money is being spent on, instead of just "administration fees." This creates inefficiencies in the system, resulting in higher premiums.

See 2,3,4.

 

8) Creates numerous government subsidies for drugs and certain treatments, which simply amounts to a giveaway to big business who will simply increase their prices in response to this.

Easy to prevent this with appropriate legislation...

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Some years ago, when I first heard Obama were planning for something like this, I thought that gvnt will kind of nationalize a health insurance company that would be used only by the poorer or simply refund the health insurance cost for those below the poverty line. Something like that. Well, I think I can be call an optimistic.

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Some years ago, when I first heard Obama were planning for something like this, I thought that gvnt will kind of nationalize a health insurance company that would be used only by the poorer or simply refund the health insurance cost for those below the poverty line. Something like that. Well, I think I can be call an optimistic.

 

Wasn't it his idea at the beginning? I'm not entirely well versed on the subjet, but is it possible that the Republican majority in Congress helped the Affordable Care Act pass as it is AKA just as an insurance reform and not a total health care reform? So Obama couldn't pass the project he would've wanted to?

 

The ACA is a step in a better direction, but still... when you can't have health care because you're not insured in the supposedly "most advanced country in the world" (or so say the Americans), one can wonder about the legitimacy of their system and how they can sustain this system any longer. I actually read a book on the decline of the US a long long time and most of the neo-liberal measures taken had supposedly led the country downhill... :(

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Wasn't it his idea at the beginning? I'm not entirely well versed on the subjet, but is it possible that the Republican majority in Congress helped the Affordable Care Act pass as it is AKA just as an insurance reform and not a total health care reform? So Obama couldn't pass the project he would've wanted to?

 

The ACA is a step in a better direction, but still... when you can't have health care because you're not insured in the supposedly "most advanced country in the world" (or so say the Americans), one can wonder about the legitimacy of their system and how they can sustain this system any longer. I actually read a book on the decline of the US a long long time and most of the neo-liberal measures taken had supposedly led the country downhill... :(

 

Atleast if the US breaks up, we may take some pieces where the climate is better. :P

But first, we need to oust Harper.

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