PaulPisces Loc: San Francisco

I remain unclear on the answers to several important questions regarding The Affordable Care Act, its repeal and its replacement.
I'm hopeful the folks on OPP can help me out here. I realize I will get some amount of emotional invective, which is of course everyone's right to share. But I am more interested in a logical exploration of what is wrong and how to fix it.

1 - What are the parts of the ACA that so many people find objectionable? Please be specific.
- What is the path to fixing those things?
2 - The Republican leadership has had eight years to develop an alternative plan.
- Why was that plan not ready to roll out immediately? It seems to me that there has been ample time to not only develop an alternative, but to refine it and sell it to the American people. Why is this not a slam-dunk?

reconreb Loc: America / Inglis Fla.

Good question .. I do not what gov. in the middle of health care , other than making all markets open nation wide and competition from pharma .. other than that . FREE MARKET .. simple ..

pafret Loc: Northeast

What you are asking for would take a team of actuaries and researchers to fathom.

In general, the ACA has vastly increased medical expenses both for insurance fees as well as deductibles. In many cases it is cheaper to pay the penalty and do without insurance. It is a wealth transfer mechanism in that it takes money from those who worked for it and provides it to those who did not. It is also a control mechanism,. you now have a government agency controlling your health care. A simple case in point, in the interests of efficiency ACA limits the providers of health supplies and apparatus in a given area. My CPAP mask supplier was not chosen so instead of picking up my equipment in a store 2 miles away I now have to drive 60 miles round trip to the closest supplier. Another medical supply company lost the ability to sell breathing gases under this law, their name - Respiratory Specialists. What do you suppose happened to their employees?

The biggest problem is the distortion of our economy; the imposition of the ACA increased cost burden has caused many small employers to drop the medical coverage they provided and in many cases converted what used to be full time employment with benefits to part time employment without. Even worse, employers who might have expanded their work force to meet any demand increase are now delaying or deferring acquiring new employees. A significant portion of the Obama employment picture was junk job employment of illegal aliens and workers having to take one or more part time jobs to earn less than they did with one full time job.

As far as why a new plan wasn't ready to roll out immediately, the answer to that is simple. The problem is too complex to be addressed by the government. They would be better off minding the business of the government and staying out of private sector business. Make laws to keep hospitals, doctors and drug companies from killing us or robbing us blind but let the market allocate resources where and in what quantity they are needed. No government is ever going to have the wisdom to achieve even the slightest amount of precision the free market does with ease. Government can concern itself with charity, assuring that the poor get medical attention and leave the rest of us the hell alone.

archie bunker Loc: Texas

If a person can afford the premiums, the deductibles make it worthless unless you have a catastrophic event.

Availability of doctors/specialists in network for timely treatment.

Then there is the fact that we can't afford it, make too much for subsidies, and have to pay a fine for not purchasing a product that we can't afford.

That's for starters. And I agree with Recon.

Ricko Loc: Florida

Paul-this thing is an interwoven mess which probably cannot be fixed. If it is fixable , why did the democrats not fix it before now rather than let it go into what some say is a death spiral ? The GOP needs to be absolutely sure that they will not leave anyone behind and that everyone's premiums will be lower. From what I read, the current
proposal will favor the wealthier people at the expense of the lower income folks and that is not the way to go. The reason the plan was not ready to go is that the GOP , like everyone else, thought Hillary would win and knew that
proposing to repeal the ACA was a non-starter. Nothing that gets through congress is ever a slam dunk. There will always be some who idolize what is being proposed and others who despise the same legislation. We will never have an ideal Health Care law as long as humans are involved in crafting same. We will have to settle for something better than what we have though it will not be perfect and some will gain while others will lose in the process. What we do not want is for the rich to gain and the poor to lose. America First !!!

Quakerwidow Loc: Chestertown, MD

Sadly, the rich gaining and the poor losing is likely to be the end result.

JFlorio Loc: Seminole Florida

The ACA raised my premium from $350 a month to $1,100 a month. My out of pocket went from $2500 to $14,000. My income remained virtually the same. Does this make me rich in your eyes?

Quakerwidow Loc: Chestertown, MD

The replacement is likely to be even worse.

JFlorio Loc: Seminole Florida

Agree Ricko. Also,if pre-existing conditions are to be covered we must admit, one, that is not insurance but a new entitlement. Two, transparency. The only way to get the politicians, lobbyists out of health care is too pass a law demanding as consumers we have the right too see the cost of any product or procedure before insurance enters into the equation. I would let the states determine how to pay for the chronically sick and or pre- conditions. My suggestion would be high risk pools subsidized by a consumption tax. That way libs who love to be magnanimous with my money would have skin in the game. Capping damages, buying insurance across state lines and health savings accounts would also help bring costs down.

archie bunker Loc: Texas

It needs to go away altogether.

JFlorio Loc: Seminole Florida

In my estimation it can't be. Use your brain for once. Even the democrats admit the ACA is imploding. It is a failure. Why do you still defend it? Perhaps because you are a liberal lemming.

lpnmajor Loc: Arkansas

I have touched on these matters many times here before. Most people just want to try and justify the GOP's lack of planning, foresight and incompetence, rather than explain it. Republican lawmakers KNEW how complicated this is, but were too timid to tackle properly, preferring to ride the wave of anti "obamacare" ( a term THEY coined ) rhetoric into power - where they would "deal with it latter".

#1. People rejected the mandate to buy health insurance, not because it was a bad idea, but because republicans kept hammering people with "government overreach" rhetoric, triggering their innate fear of the Government. Add to that the tax penalty, and an emotional response was guaranteed.

#2. Democrats weren't the champions of the ACA they should have been, meaning, they should have been assiduously seeking to improve the bill by acknowledging the errors and flaws, thus forcing the GOP to fix those things. Instead, Dem lawmakers walked away from Obama and the ACA, in an attempt to keep their seats.

#3 The GOP did nothing to stem the tide of exchange failures, gleefully watching it all fall apart, because it helped them at election time and indeed, did everything in their power to see that it DID fail.

#4 The GOP assumed that they could simply match their 7 year old rhetoric and everyone would be happy, i.e., get rid of the mandate and tax penalty, subsidies and Medicaid expansion - but pretty much leave the rest in place WITH a new name.

In the final sum of things, democrats and republicans alike failed the American people, preferring to adhere to stupid partisan platforms rather, than respond to real time issues related to healthcare. In a piece I wrote here yesterday titled "another healthcare picture", you'll see how silly this really is. We have spent so long building these "healthcare boxes" we are arguing about, that we can't see beyond them - or get out of them.

If I showed Americans how they could get top quality healthcare for $100 per year, per person, where every person had to pay the same amount for this insurance, I imagine everyone would agree and rejoice, until some political operative came along and called it "universal healthcare" or "socialized medicine" - where upon their immediate kneejerk emotional response would be "oh, hell no!".

PaulPisces Loc: San Francisco

Thanks for a clear, cogent response lpnmajor. I wish we had more who would approach it similarly.

archie bunker Loc: Texas

I call bullshit on #1
Why should I pay a penalty for not buying something I can't afford?

Bullshit on #2 also.
This disaster was slammed down our throats without a single GOP vote.
This business about one side fucking it all up, and passing it off to blame the other is bullshit!!

I can agree with #3.

#4 is true.

Please show me how to get good health insurance for a hunsky a year. Please! I'll pay 10 years up front today.

pafret Loc: Northeast

Except he is full of do-do. The "Republicans did nothing to prevent the exchange implosion" -- what were the Democrats doing? It was their idea to pass it before we knew what was in it.

First of all, it is government overreach and it was never a health insurance program but an experiment in Socialism which was designed to share the "wealth" of those who work for a living with those who vote for a living. It also concentrated power in the hands of the government, with all of the abuses that governments are famous for. If you don't believe that, talk to the families of the Vets who died waiting for the government to provide health care.

The Dems forced this bill down everyone's throats over the objections of the Republicans, not one Republican voted for it so how were the Dems going to force the Republicans to fix it. The Dems were in control and have 100% of the responsibility for this debacle.

The GOP did not regain the majority in congress until this last election, no matter what the house proposed the Dem controlled Senate blocked it. This fiasco is Democrat all the way and after the insurance companies fail there is very little fixing that can be done. Even the outrageous reimbursement for losses couldn't keep them alive.

Yes both gangs failed us, primarily because they are not there to represent the American people but to consolidate power and graft for their particular faction. They haven't represented the American people for scores of years and they give no indication that they will start any time soon. Which is why we need term limits. Two terms are enough of any of these jackasses, any more and you get Harry Reid, Nancy Pelosi, Maxine Waters and Dick Cheney.

His offer of 100 health care would be snatched up in a heartbeat, no one is so stupid as to believe you can get anything more than a Cooty shot and a Bandaid for that kind of money. To use such an argument is a charlatan's ploy. It doesn't matter what you call it, the government needs to stay out of my life with regard to my medical care. -- If or when I become indigent they can help all they like but while I am paying the tab I will call the shot.