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Affordable Care Act

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  • Affordable Care Act

    So? Discuss among yourselves....

    Sent from my SM-G920V using Tapatalk
    Wife and #1 Fan of Attending Adult & Geriatric Psychiatrist.

  • #2
    I want to see the proposed replacements and how they will be a vast improvement.
    I am concerned about what total repeal would mean.


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    Wife to Family Medicine attending, Mom to DS1 and DS2
    Professional Relocation Specialist &
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    • #3
      I realize that the current system is far from perfect but I don't have high hopes for improvement. The ACA has allowed my sister to have decent insurance for her family (they have a small plumbing business). She is very afraid of going back to the way things were. I have not heard a real plan yet but I haven't been impressed with my if the ideas being discussed.


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      • #4
        Last year my family paid about $1000 of Additional Medicare Tax. So when this new budget passes, we're looking at a tax reduction right off the bat (an amount we neither needed nor missed.)

        I dunno. I do see a conservative angle to all this. I mean, who's to say that just because ACA-related provisions are no longer mandated, the insurers won't opt to keep the popular ones because of market pressures? Do we really need gobs of laws to make people do things?

        Unfortunately for that angle, in the end I'm pretty dang liberal, and yeah, I do think we need a nanny state on some stuff. We need a law to make people wear their seatbelts, because some people just don't have the foresight to value preventive measures otherwise. Same goes for healthcare, I think. If we don't go single-payer (and that's always been an uphill battle for our disparate country of fiercely independent individuals) then we've got to have some way to keep the current system working for those who need it most.

        In fact, I had some thoughts brewing about the relationship between people who want all the provisions of ACA except the individual mandate, and people who want all the benefits of mass vaccination except the teeny-tiny risk and inconvenience to their own families of actualy getting their vaccines. Haven't yet gotten those thoughts into useful words though.
        Alison

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        • #5
          [MENTION=985]spotty_dog[/MENTION] I guarantee that if something isn't mandated by the ACA it will get dropped from plans or premiums will rise. Insurance is a for profit venture and that is the crux of the private option in the plan.
          Kris

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          • #6
            I don't know what the best option is, but I will admit that with C, I have concerns about him not being able to be insured at some point due to his preexisting condition, or hitting a lifetime max. He's already hit over 900k in claims, before his first birthday.

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            Allison - professor; wife to a urology attending; mom to baby girl E (11/13), baby boy C (2/16), and a spoiled cat; knitter and hoarder of yarn; photographer

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            • #7
              I'm 100% on team single payer.
              Heidi, PA-S1 - wife to an orthopaedic surgeon, mom to Ryan, 17, and Alexia, 11.


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              • #8
                Originally posted by HouseofWool View Post
                [MENTION=985]spotty_dog[/MENTION] I guarantee that if something isn't mandated by the ACA it will get dropped from plans or premiums will rise. Insurance is a for profit venture and that is the crux of the private option in the plan.
                Oh, I'm quite aware that the insurance industry will squeeze every drop of profit they can out of the system. I'm just saying that when supporters of the ACA say, "I might be paying higher premiums now, but at least I can get insurance with my pre-existing condition," that it's possible that the companies will hear this message and continue to offer higher-premium options for people with pre-existing conditions. Or that there could be enough actuarial data about the value of preventive care, that vaccines and well checks and pregnancy prevention could remain free at point of service. That sort of thing.

                I dunno. It's just a devils-advocate position. In my heart I'm not at all comfortable ceding basic human rights and protections to the whims of corporate interest. I just think that I can understand if some Republicans aren't comfortable ceding control of those things to a bloated inefficient federal government either.
                Alison

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                • #9
                  Affordable Care Act

                  That's the thing. People claim bloated government, but Medicare runs at a lower administrative overhead. Most private insurers are way higher.

                  http://www.politifact.com/truth-o-me...far-lower-pri/

                  #Medicareforall
                  Last edited by Vanquisher; 01-15-2017, 03:28 PM.
                  Heidi, PA-S1 - wife to an orthopaedic surgeon, mom to Ryan, 17, and Alexia, 11.


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                  • #10
                    Preventive care and vaccinations probably won't get cut by plans because it is more cost effective to keep people healthy, but I would put money on the fact that if the pre-existing condition clause is struck down that it insurance will follow suit as soon as possible.
                    Kris

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                    • #11
                      Although I'm Canadian, I have a widowed sister-in-law in the US getting by on a low salary. Despite its flaws, the ACA has helped her out greatly. I also have an old friend in Texas whose premiums tripled under the ACA and he concluded he was better off doing without insurance, paying the fine, and waiting to be old enough for medicad. I'm hoping that American politicians will eventually do what Canadians did and reach across the political aisle to develop some form of universal affordable healthcare they can all support. I too would feel better if the new guys would present a replacement plan first before changing a status quo (the ACA) that is clearly addressing the healthcare needs of some.

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                      • #12
                        Originally posted by Vanquisher View Post
                        That's the thing. People claim bloated government, but Medicare runs at a lower administrative overhead. Most private insurers are way higher.

                        http://www.politifact.com/truth-o-me...far-lower-pri/

                        #Medicareforall
                        But Medicare doesn't cover enough. At least in my husband's practice, they lose money because the reimbursement for medicare/medicaid is too small.

                        I don't know what the answer is. I'm afraid of the repeal. People need to be covered. On the other hand, we are paying about 3 times as much as when it was first passed. Our rates went up every quarter just about.

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                        • #13
                          My heart is 100% single payer. My head as the spouse of someone just about to start their career is that single payer will mean a huge squeeze on the only group without a huge unified lobbying position: the individual doctor.

                          But I don't think insurance companies are going away. They employ too many people!


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                          Married to a Urology Attending! (that is an understated exclamation point)
                          Mama to C (Jan 2012), D (Nov 2013), and R (April 2016). Consulting and homeschooling are my day jobs.

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                          • #14
                            Originally posted by TulipsAndSunscreen View Post
                            My heart is 100% single payer. My head as the spouse of someone just about to start their career is that single payer will mean a huge squeeze on the only group without a huge unified lobbying position: the individual doctor.

                            But I don't think insurance companies are going away. They employ too many people!


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                            This is where I am. Conflicted bc single payer seems like the right thing to do. But at 30/31 years old, almost $350k in debt, and 5-6 more years of training left, I do worry about earning potential. Selfish, maybe, but that's where I am this debt isn't going anywhere and being able to earn and support a family and retire someday needs to be an achievable goal. Sometimes it doesn't seem like it ever will be. I can't see how you dig out of this much debt. And the idea of lower salaries yes, is very scary.


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                            • #15
                              If individuals were to pay more in premiums and buy into a Medicare like program it might work. The higher premiums would allow for higher reimbursement.

                              Yes, Medicare reimbursements are low, but for many procedure based practices you won't need to get as many prior authorizations for services reducing the amount spent of time staff spends dealing with insurance companies. Medicare also typically pays quickly.
                              Kris

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