The Affordable Healthcare Act and What's at Stake

[paft.livejournal.com]

Recently, at a dinner gathering, I took part in a discussion about the healthcare issue. One of the participants was shaking his head in bemusement over the ACA, and all that nonsense about healthcare being a right. Sure, he said, there was a healthcare crisis, but ACA was not the way to deal with it.

Naturally we asked for his solution, and he began talking about tax credits and percentages and refunds, plunging into a level of number intensive wonkery calculated to suck every bit of air out of the conservation.

“Wait a minute,” Someone asked, after almost a minute of this. “Just tell us how this would be applied. Let’s say I’m really, really sick with a debilitating illness. I don’t have insurance, can’t work, and can’t afford to pay for my badly needed medication and treatment out of pocket. How would your system help me?”

The other guy explained that what would happen, see, was that after the sick person had paid for his or her medical care, they could get a refund for the amount…

“So, in fact, a sick person would still have to somehow manage to raise the money to pay for the care first?” someone asked.

“Yeah, but they’d get it all back…”

Right. That’s the big issue in American Medical care. “I paid over million dollars for my hospital care, brain surgery and rehab and didn’t get any of that money back.”

This little incident serves as an object lesson in cutting through the crap. The minute someone opposedto healthcare reform descends into long, zestful disquisitions on tax credits etc., your bullsh*t meter should go off. They know that actually describing the effects of their policies on human beings would shoot their own arguments down, so they strive to make the discussion as abstract as humanly possible.

Here’s a good, NONabstract argument from Salon for the merits of the ACA or (as it’s increasingly being called ) Obamacare.

During our first three weeks of hospitalization Mason racked up $1.1 million in medical bills. I worried about butting up against the $5 million lifetime limit on Mason’s health insurance policy. We had a good policy with a good company. We always paid our premiums on time and in full. But Mason wasn’t getting out of the hospital at any time soon, and there were months of rehab ahead. My then 13-year-old son would have reached his lifetime limit of health insurance had such limits not been eliminated by Obamacare on April 1, 2011. That date felt like a birthday or anniversary, something to be celebrated, when it finally arrived and we weren’t yet dropped by our health insurance company.

These accounts resonate, not just because they are harrowing in their illustration of what’s at stake, but because they ring true. Many, many Americans who don’t qualify for Medicaid or Medicare and who’ve had to grapple with a serious illness or injury can tell similar stories.

Comments

[sophia-sadek.livejournal.com]

The thing that I find ironic is that many of the people who oppose universal healthcare claim that they favor life. I suppose life as a debt slave is the kind of life they favor.

[paedraggaidin.livejournal.com]

No, they only favor life if it's either a.) still in the fetal stage or b.) white, affluent, and Evangelical Christian.

[mrbogey.livejournal.com]

Impressive strawman.

[nahele-101.livejournal.com]

"This little incident serves as an object lesson in cutting through the crap. The minute someone opposedto healthcare reform descends into long, zestful disquisitions on tax credits etc., your bullsh*t meter should go off. "

Excellent point.

[zebra24.livejournal.com]

Death is normal thing if you can't buy yourself Elixir of life, then no insurance exists that can pay for it.
Never Obama will be able to pay for it, even if he kills and robs all the reach.
Unfortunately no magic exists, and believe me, Obamacare isn't magic as well, it's just another unfunded liability, and nobody will pay $1.1m for that man, unless real funds will be available, and some bureaucrat decide to fund his treatment, leaving hundreds without hope for treatment.

1st lie is "Obamacare can solve this".

2nd lie is "everybody can get a cure, no matter how ill they are" and therefore "everybody MUST get a cure".

3rd lie is "everybody can pay for cure, no matter how expensive it is" and therefore "others must pay for it".
That's a lie, based on possibility of wizard-Obama existence, who can make money out of nothing, without destroying economy.

Most crying example of Obamacare is Cuba - few normal clinics for Castro and his friends, same time simple medicine isn't available for most of the population.
Same thing in Libya, and so on...

If you can't guarantee you will pay your own medical bill, how you can help to others??
If you want to help people in trouble, you should raise real money, not fake ones.
Raise voluntarily, without using force and fear, like Obama is doing.
But even then It never will be sufficient to help everybody.

So unfortunately with limited funds somebody will have to choose, who will die today.

I can tell you that I know it very well - in USSR or in Cuba you had to just die if your illness is slightly more expensive than average.
They never tell you it is because of small funds on something. Sometimes they even not aware of possible treatment, because it is "really expensive" for their "free" medicine.

That's all - no magical funds for multimillion operations in Cuba or Russia or other country with nationalized medical services.

I can tell you that even $10-50k for medical service or drugs, is often is a line between death and life, and you can't get it for free from government, and you are dying if can't pay for it.


Here in USA at least you know everything, including price of live, sometimes you can pay a bill, sometimes can't. Sorry, but it is true.

[fizzyland.livejournal.com]

And yet, the entire rest of the industrialized first world manages to fund and run universal health care systems. Amazing how defeatist the thinking of American conservatives manages to be on this topic with their rigid 'No we can't!' position.

[paft.livejournal.com]

z: Death is normal thing if you can't buy yourself Elixir of life, then no insurance exists that can pay for it.

Nobody's asking for an "elixir of life." Just basic healthcare.

Are you saying that if the family had been unable to pay for this boy's very impressive treatment, he should simply have been allowed to die because "death is a normal thing?"

z: 1st lie is "Obamacare can solve this".

Did you read the link? I ask because it's a concrete example of Obamacare making a positive difference.

z: 2nd lie is "everybody can get a cure, no matter how ill they are" and therefore "everybody MUST get a cure".

I haven't heard anyone telling this lie. Where did you hear it?

z: Raise voluntarily, without using force and fear, like Obama is doing.

As most people actually involved with charity will tell you, relying solely on that will result in countless people dying of or being permanently disabled by treatable injuries or illnesses.

That's okay with you?

[sandwichwarrior.livejournal.com]

You seem to be forgetting that Cuba universal healthcare system makes it's citizens functionally immortal. How else do you think Castro's been able to hang on so long?

The same technology also works on cars (http://en.wikipedia.org/wiki/Yank_tank).

[rick-day.livejournal.com]

Western Medicine does not 'cure', it only wound heals, manages or ameliorates diseases. Name one disease that can be 'cured' by Western Medicine.

Oh and Obamacare. Just because.

[underlankers.livejournal.com]

Actually the USSR just adopted the simpler policy of regulating every step and stage of life. The USA wouldn't have the discipline to even make an effort at it, it's a nation of wannabe hacks that think they're something they never were by piggybacking off the hard work of others and rising from a fluke of circumstance. If the USA tried to become the USSR it couldn't even make it to something like the blundering idiocy of the Tsars.

[mrbogey.livejournal.com]

Terrorism is very serious and I'm amazed anyone could oppose the Patriot Act. Something needs to be done and we can't sit around while people are dying trying to debate minutia.

The Act was passed democratically by a majority of Congress so it'd be unprecedented to overturn it.

If t>=2009 then argument invalid.

[paft.livejournal.com]

You're comparing the Patriot Act to Obamacare?

Well, I guess that's easier for you then actually talking about the Affordable Healthcare Act.

[underlankers.livejournal.com]

It's actually not as serious as you say it is, otherwise we'd object to things like Communist terrorists taking over an entire country. It's not terrorism it's specific stripes of domestic criminality in other parts of the world. And frankly put aside from bloating the government still further in size, has the Patriot Act genuinely contributed to anything other than the gallery of Republican hypocrisy?

[badlydrawnjeff.livejournal.com]

The account resonates because it confirms what you already believe about health care. That proponents need to rely on emotional arguments means they've already lost.

[rowsdowerisms.livejournal.com]

Really? Bush's appeals to mushroom clouds certainly worked for getting us into Iraq. I'm surprised you don't think emotional arguments are a winning strategy.

[paft.livejournal.com]

Yeah, people get so gosh darned EMOTIONAL about seriously ill children being denied treatment. I guess the correct attitude is to avoid talking about such unpleasantries.

[kylinrouge.livejournal.com]

Again I'll quote from a friend: "I believe that in a society with things such as free universal health care and guaranteed retirement income, humans will be much more free to make 'rational' decisions. Finances and health, in my opinion, are two of the greatest emotional factors at play in human decision making. It seems natural in my mind that philosophies which rely on rational action would desire to eliminate the sources of emotional stress in human action. "

[zebra24.livejournal.com]

Nothing is "guaranteed" especially if it is just bankrupt government's promise.
http://www.youtube.com/watch?v=Ln559gjNpW4

With those "guaranteed" thinking your friend will end-up without pension and without medical insurance at all.

But before he realized the fact, his actions will be "rational".

Rational enough to spend on BS and ignore coming medical costs and coming ages with inability to work in future.

[harry-beast.livejournal.com]

No such society is possible, because nothing is free, certainly not universal health care or guaranteed retirement income. One needs only to look at the enormous and fast growing health care budgets of countries that provide universal health care, or the massive amounts needed to fund public pensions.
Also, eliminating the sources of emotional stress in human action is a pretty tall order.

[kayjayuu.livejournal.com]

Honest question: why do accounts like these not fall into the category of "anecdata"?

[kylinrouge.livejournal.com]

They're anecdata if you're empirically talking about the effects of Obamacare, since paft isn't citing any statistics for how many people avoided bankruptcy with the changes to lifetime maximums.

They're not anecdata if you're philosophically talking about people's behavior with regards to health care when they know they don't have to worry about lifetime maximums.

[sandwichwarrior.livejournal.com]

You seem to be functioning on the faulty assumption that Obamacare can or should save this man.

For the sake of playing devils advocate...

If the choice were between spending 1.1 million dollars curing 1 man's brain cancer or spending that same money to cure 100,000 cases of childhood influenza, which should the government choose?

We live in a world of finite resources so you truly believe in the "greater good" than you must let 1 man die to save thousands.

That or simply admit that your argument is based purely on emotion rather than any coherent logical position.

[il-mio-gufo.livejournal.com]

firstly, i personally cannot stand the use of this slang term 'Obamacare.' Be serious people! Ah

sencond, do you think that the problem with healthcare is that we have allowed it to overlap with the world of insurance? i mean, insurance is a business . . . people insure autos, boats, homes, phones, etc.

Healthcare, however, is an activity that requires whole-body treatment, preventative and corrective care, etc.. Why do we allow for healthcare to be superimposed with a business-model, let alone the structure of an insurance-plan?? questions i've always wondered >>>

[badlydrawnjeff.livejournal.com]

Healthcare, however, is an activity that requires whole-body treatment, preventative and corrective care, etc.. Why do we allow for healthcare to be superimposed with a business-model, let alone the structure of an insurance-plan?? questions i've always wondered >>>

We got there because businesses needed a way to work around FDR's wage controls.

We're there now because we never abandoned the practice after we abandoned FDR's wage controls.

You're on the right track, I think - a lot of the problem is job-dependent insurance, not insurance itself. It's not healthcare-as-a-business that's at issue - health care is a commercial transaction at its core. The problem is how we've become accustomed to having said transaction delivered.

[gunslnger.livejournal.com]

Let’s say I’m really, really sick with a debilitating illness. I don’t have insurance, can’t work, and can’t afford to pay for my badly needed medication and treatment out of pocket. How would your system help me?”

Why assume that it should? It's nice to try for it, but to actually assume that it should be guaranteed? That's the craziness.

[paft.livejournal.com]

g: Why assume that it should?

For the same reason I expect the fire department or the national guard to help me in the event of a fire or disaster. For the same reason I expect to be given a blood transfusion if I'm brought to the emergency room, bleeding profusely after an accident.

But then, maybe you feel those expectations are unreasonable too.

[michael barnett (from livejournal.com)]

I think what gets lost in all these discussions on health care is this simple fact: there was a time when health care in the United States was affordable, even to the poor, and even for serious illness and injury. For christ's sake, doctors used to make house calls -- at all hours of the night! To me, it would seem prudent to investigate the reasons why this is no longer the norm and why prices have skyrocketed BEFORE implementing any policies which at best will be be short-term bandaid relief. Because, if policy makers don't understand HOW the current condition came to be, they certainly won't know where it's going as a result of their policies.

Just my two cents.

[rasilio.livejournal.com]

False dichotomy.

The choice is not laws eliminating lifetime maximums or people dying because of them.

There are other choices available.

For example why not make laws that make it easier for there to be more options.

A good one is I was running some back of the envelope numbers yesterday and if we assume that the average person who exceeds his lifetime limit does so by $7 million dollars (so in this case $12 million in medical bills on average, some would be much higher, most would be in the $6 - $7 million range) one could build a very profitable business model offering "Over the lifetime limit" insurance for less than $20 A month.

So why not pass a law that requires all health insurance policies to offer such a rider?

Not provide it, but at least offer it.

[paft.livejournal.com]

Not sure what "dichotomy" you're talking about here. My point is not that there's no alternative to the ACA (which I don't think goes far enough, frankly.) My point is that people who offer alternatives that consist mostly of jargon (or hyperbole, as is used here), and are as far removed as possible from actually addressing the human impact of our badly broken healthcare system, are generally trying to conceal the fact that their alternative won't really help many of those who most badly need it.

A lot of people here and offline seem to have graduated from the old, "No, no, OUR approach will help more people!" to "Those people don't deserve help. They should just be allowed to die or be disabled."