Airforceone

The v**e on i******s obtaining guns is just not true. You just can’t cherry pick on a comment or misinformation on legislation that was never brought to the floor forca v**e. Actually the house and senate over the last 50 years no Republican has ever sponsored legislation on gun violence just propaganda and misinformation. So if you know of any legislation give me the HR number or the Senate bill number and the year it was proposed.

Obama took office during a major recession caused by Bush. But obama agenda began to put people back to work and as this country approached low unemployment wages began to increase. So don’t blame Obama for this problem it was created by the Bush recession. That’s why it’s difficult to get the right wing to understand why wages went down, why food stamps recipients increased, we were in a recession and this country went to 10.2% unemployment we were lucky we did not go into a depression. Obama created 76 straight months of positive job growth, he lowered the unemployment rate from 10.2% to 4.6% and as these numbers came down wages began to increase and less people relying on food stamps, Medicaid, CHIP all the cost went down.

Sorry about the r****t white Texan comment it was not right for me to categorizes an entire state for the actions and r****t comments by a guy who calls himself Archie Bunker on OPP and I apologize for that. But I will not take back those remarks and should have been directed at one individual. I have apoligized to many people on OPP
With using the PM message

archie bunker Loc: Texas

Don't worry Tom, my feelings aren't hurt. I understand, and you'll always be my favorite tennis ball. 😆

padremike Loc: Phenix City, Al

I mostly didn't read your post because I know that you're so full of the Marxist Progressive spin it's a total waste of time to engage you in any dialogue. And besides, you're usually so profane one feels the need for a shower after engaging with you. I did peruse one issue you addressed; the issue of the Red States that declined the Medicaid expansion. Do you know why? Do you even know it was a bait and switch? The smart governors turned away from the trap.

son of witless

How about the people who will suffer because they lost their health care under OBAMACARE ???????????????? After the Village I***t Obama promised them they would not lose their health care. How about that ? " If you like your health care, you can keep your health care . " Obama LIE !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Airforceone

There is no way that I am posting or advocate Marxism because there is no comparison between Marxism or a progressive agenda. I do support some of the progressive agenda but not all. It’s sad you did not read the entire topic hopefully in the future we can create a mature debate with no insults as I stated I was wrong in my approach.

No please explain your perception of Medicaid expansion. Not sure what you mean by bait and switch pertaining to Medicaid expansion.

I will attempt to explain my perception of Medicaid expansion and I hope you do the same.

But let me explain Medicaid expansion. It gave insurance to uninsured Adults and children whose income are at or below 138% of the federal poverty level, including people who lived with mental illness. These people could not afford insurance or could not get insurance at any cost and we’re rejected by the Private insurers. Medicaid expansion was subsidized by the federal government.

It has shown that Medicaid expansion produced net savings to states budgets. While the federal government was subsidizing 90% of its cost. The states that did not sign onto Medicaid expansion there premium cost we’re going up at a faster rate. Some states were going up as much as 50%. The state of Massachusetts which had the ACA prior to Obamacare were only seeing on average a 3% increase.

Let me try to give you an example. As more people gained coverage. You have to relize that hospitals were not receiving payments they were uncompensated for treating these people. The hospitals now had to increase there cost for medical treatment to cover the cost of the uninsured. This now drove up premium cost to all people.

When Trump repealed the mandate where every American was required to get insurance that will now drive up Premium cost down. What bothers me is there were many people not purchasing insurance but when they got sick or hurt the hospitals would care for these people free and the rest of the country picked up the cost.

Now let’s flip the coin what is so bad about giving the states federal subsidies to expand healthcare to all residents and save on premium costs for all there residents.
We gave subsidies to in the amount of billions of dollars to the most profitable private companies in the US. We gave massive tax cuts to these same profitable companies, we give these same companies major tax loopholes but we can’t subsidies healthcare for the elderly poor, mental health and children living at 138% of the US poverty level. To me this makes no sense. Please explain bait and switch.

From now on no more insults no more anger just post what I perceive as facts with hopes to generate a mature debate. There are 4 or 5 right wing bloggers that refuse to comment on my topics but use insults and I got into the insult game. And I was wrong to lower myself to there standards. No more insults.

Airforceone

First this is a typical right wing tactic the topic was on a national emergency and it turns into a debate over the ACA.

You asked where did I get my information on the ACA I read it. I have a son that got an incurable kidney disease. His medical insurance got cancelled and could not get medical insurance at any cost. Every insurance provider that I applied for insurance was rejected. So for over 1 1/2 years years the medical cost and prescriptive drugs were mounting. Then the ACA was signed into law and I spent day after day studying the ACA. I had to it was my son’s life.

So let’s address you comment or talking point created by the right wing you can keep your insurance company and yes you could. But the ACA eliminated bogus policies. Insurance companies could no longer write in the contract of Maxium payouts, or cancel your policy after you got sick. The insurance providers had to re-Write there policies and yes in some case premium cost went up. Most people did not relize they had these bogus policies and were happy to pay the premium cost increase.
Do you relize now that people understand what’s in the ACA they like it. 4 years ago the polling showed a negative reaction on the ACA the polls now show as people are beginning to understand what’s in the ACA they like it.
Polls show 62% of this country favor the ACA.

I have helped many people and Friends to get health Insurance. I sat Friends down and made them compare there old policies versus there new policies. I attend quarterly meetings at the Kidney t***splant center and I have helped these people to obtain health Insurance.

So do you want to live in a country if you get sick or disabled you cannot get insurance at any cost.
If you get sick and the insurance companies can put you in a high risk pool and charge you $9000 a month premium.

Idaho

First let me say I am sorry for the situation your son finds himself in. Unfortunately, the medical profession in the US, for many reasons, is hugely expensive - much more so than it needs to be. ‘Feeding the Beast’ via the ACA will do nothing to bring those costs down. Bringing down healthcare costs for everyone should be the goal. One problem with ACA is the huge cost added to people without major health issues to pay for those with major health issues. Your son happened to win - my partners son was one of those who lost out, who worked for a small startup. Since the start of the ACA, he had opted to pay the fine because the only ACA policy he could afford would have left him with $20,000 deductible.

But the ACA was only the stepping stone for the Dems and everyone knew that at the time. The goal was always single payer - and that’s what is on the table for discussion now. Everyone to get only what healthcare the State decides they can have, outlaw company group policies, make doctors choose between providing healthcare under the State system or privately - and then penalise the doctors who opt for private by driving them out of business with red tape and regulation. The Dems want to control who gets treatment and who does not.

It’s not just that the ACA creates a new set of unfairnesses - it’s that the Dems trajectory is always boiling the frog to continuously increase the size of the State and the power they wield - and along the way making their cronies rich.

Many Republican politicians are also corrupt - but the principle of putting a cap on the size of government and sticking with the constitution has got to be the basic starting point for every discussion.

Seth

Also sorry to hear about AF1's son, but this post hits the nail right on the head.

I have read of people in need of various critical medical applications in single payer health-care countries who found themselves unable to receive those applications in a timely manner, ie a CT scan that could only be scheduled for three months down the road, a Canadian whose private doctor said he needed some sort of brain scan immediately, but was told he had to wait a couple of months for the scan. He came down to the U.S. and paid to have it immediately and was told he needed immediate surgery -- to remain functional, so to speak.

He took out a loan on his house and got the surgery in the U.S., then attempted to get reimbursed by the Canadian healthcare system. Even though it had saved his life, he was told there would be no reimbursement because he hadn't been "authorized" by them to seek treatment in the States. Last I knew, he was fighting it in the Canadian Supreme Court.

There was another story about a Canadian woman pregnant with twins who had to come to the States to give birth because she couldn't get available maternity space in Canada.

Other horror stories out of the UK...

The best results always come from the private sector, and while I honestly don't have an answer, some serious effort needs to be made to keep most health insurance and hospital access out of the hands of the politicians while making sure needed medical treatment is available to every citizen.

It has been suggested that instead of giving cumbersome and clueless federal bureaucracies control, s certain amount of money could be disbursed to each state to take care of those who can't afford an HMO or whose treatments, for wh**ever reason, are not adequately or fully covered.

Government control of our healthcare, however, is not an answer -- people who gravitate to government careers are rarely capable of managing anything, forever losing their effectiveness in a bureaucratic quagmire.

Their penchant for believing that big government is the answer to every problem is one of the Democrats' issues with which I majorly take umbrage.

Louie27 Loc: Peoria, AZ

I see that you consistently follow the lefts talking points. you really need to get a life and some real sensible thoughts.

Airforceone

Let me try to explain there is so much in your post I wish you would take one issue at a time. So let’s discuss Idaho and there high premiums in part it was caused by Idaho not signing onto Medicaid Expansion. Idaho residents in the Nov. e******n through an initiative called Prop. 2. This will now provide health Insurance services to 91,000 residents these residents were receiving free medical care where they went to emergency rooms that drove up medical cost. Which drove up premiums. Also insurance providers did an age analysis by each state and the depending of your age demographics that determined premium cost. Now with Medicaid expansion the federal government picks up 80% of that cost and the hospitals no longer provide free healthcare and charging the insurance providers.

Uninsured patients last year cost the hospitals over $10 billion a year. The hospitals passed this cost off to Insurance providers that drove up premiums.

We live in a aging society where people from the ages of 50 to 65 see the doctors and hospitals a lot more. So the elderly that have not reached the age to get Medicare are still on private provider insurance. How many times do most people have to go to the doctors or end up in the hospital between the ages of 18 and 40. Then look up the stats on 50 to 65. We are living in an aging society because of the baby boomers.

The other issue driving up the premiums epidemic of preventable diseases. They could either be prevented or cost a lot less to treat, such as Hart disease caused by poor nutrition, and Obesity which causes diabetes. Smoking causes cancer and COPD. If these people had insurance and were seeing a primary care maybe these could be prevented or a lot less to treat.
Now people without Insurance go to the emergency room for treatment this is very expensive making up one third of healthcare cost in this country every year. It was tracked and approximately 136 million people visited emergency rooms instead of seeing your primary care. With insurance you go to your primary care not for treatment not a emergency room.

So thru my reseach from 1966 to 1973 healthcare spending increased by an average of 11.9% per year, from 1974 to 1982 it rose at 14.1% per year this was driving up premium cost by an average of 12 to 18% per year prior to the ACA. Since the inception of the ACA medical cost only rose by 4.3%.
Now since the early 80’s prescriptive drugs were rising by 12.1% per year. Premiums since 2010 have stabilized after the original roll out and on average states with Medicaid expansion only average 3% till Trump appeared and is trying to eliminate the mandate now it is projected to go up at least 8% and when that happens Trump will blame the ACA and not his policy change.

There are so many variables that cause medical cost to go up but not none of them are caused by the ACA after the roll out. The final results on Medical cost, and premiums will be published by the CBO at the end of 2020.

There are some great articles that address your concerns and all you have to do is google

Rising cost of Health Care and it’s csuses.

Read the article by (THE BALANCE)

Tug484

They certainly did move money out of Medicare and it's my understanding there are more uninsured people now than before their debacle.

Airforceone

Well Not sure how and why you have drawn that conclusion but if you toke $785 billion out of Medicare the program would be broke. It’s just not true.

Not sure about the statements of more uninsured at thats not true.

Not one dime was moved out of Medicare it’s a total misinformation agenda created by the republicans in Congress. Actually it was Sarah Phalin that started that lie.

But the $700 billion is a savings not cuts over 10 years because it will slow Medicare’s future growth.

This has been debunked years ago

Idaho

From Money.com:

“The health reform law known as Obamacare (officially the Affordable Care Act) is paid for with a combination of cuts in government spending and new revenue from several sources, including tax increases.

On the spending side, cuts in Medicare payment rates and reductions in payments to the Medicare Advantage program will trim spending by more than $700 billion by 2025, according to the Congressional Budget Office’s most recent estimate.”

padremike Loc: Phenix City, Al

89,592 viewsAug 16, 2012, 01:46am
Fact-Checking the Obama Campaign's Defense of its $716 Billion Cut to Medicare
The Apothecary
Avik Roy
Forbes Staff
The Apothecary
Contributor Group
Pharma & Healthcare
Commentary from Forbes’ Policy Editor



English: Deputy Senior Advisor to the Presiden...
Stephanie Cutter, Deputy Senior Advisor to the President, in 2011. (Official White House Photo by Pete Souza) (Photo credit: Wikipedia)

Five days ago, Democrats were cheering the se******n of Paul Ryan as Mitt Romney’s choice for Vice President. Democrats thought that Ryan’s efforts at Medicare reform would terrify seniors (with Dems' encouragement, of course), thereby handing the e******n to President Obama. Contrary to their expectations, however, it has been the Obama campaign that has been forced to defend its $716 billion in cuts to the Medicare program, cuts that Mitt Romney promises to repeal. In the weeks ahead, those defenses won’t hold up. Here’s why.

(DISCLOSURE: I am an outside adviser to the Romney campaign on health care issues, but the opinions in this post are mine, and do not necessarily correspond to those of the campaign.)



Defense #1. Paul Ryan’s GOP budget preserved Obamacare’s Medicare cuts

Yuval Levin calls this the “Ryan did it too” defense. It has the merits of being factually accurate, up to a point. As I discussed on Tuesday, it’s true that the House GOP budget preserved Obamacare’s Medicare cuts. But it’s hard to see how “Ryan did it too” allows Democrats to say that Ryan is throwing granny over a cliff, unless they are confessing guilt to the same crime.


There are two other points to bear on this subject. The first is that Ryan’s Medicare cuts were solely used to extend the solvency of the Medicare trust fund, and not to fund new spending elsewhere. By contrast, Obamacare cut $716 billion from Medicare in order to fund $1.9 trillion in new health care spending, through the law’s expansion of Medicaid and its new subsidized exchanges.

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The second point is that Mitt Romney is not campaigning on the Ryan budget. He’s campaigning on his own budget, which fully repeals Obamacare, and eliminates that law’s Medicare cuts.

APOTHEFACT CONCLUSION: Romney’s budget doesn’t preserve Obamacare’s Medicare cuts. Simple as that.

Defense #2. Obamacare’s Medicare cuts don’t harm seniors’ health benefits

“Mitt Romney’s Medicare ad is dishonest and hypocritical,” claims Obama campaign spokeswoman Lis Smith. “The savings his ad attacks do not cut a single guaranteed Medicare benefit.”

This is a deeply misleading statement by the campaign. It’s true that the Obamacare Medicare cuts don’t make any changes to the Medicare insurance benefit, which means that the health-care services covered by the Medicare insurance plan are technically unchanged. But Obamacare’s Medicare cuts are bluntly structured, in ways that will harm seniors’ access to care.

Of the $716 billion in cuts, $415 billion come in the form of “updates to fee-for-service payment rates,” a euphemism for reducing Medicare’s payments to doctors and hospitals. But what happens when you reduce payments to doctors? Doctors stop being willing to see Medicare patients. And if you can’t actually get a doctor’s appointment, what does it really matter what your insurance plan covers on paper?

We already see this happening in the Medicaid program, where sick and injured children can’t get appointments to deal with urgent medical conditions, because Medicaid so severely underpays doctors relative to private insurers. By the end of this decade, under Obamacare, Medicare reimbursement rates are set to fall below those of Medicaid.



The Obama administration's own Medicare actuary, Richard Foster, has explained that the Obamacare Medicare cuts could make unprofitable 15 percent of hospitals serving Medicare patients. "It is doubtful that many [hospitals and other health care providers] will be able to improve their own productivity to the degree" necessary to accommodate the cuts, Foster has written. "Thus, providers for whom Medicare constitutes a substantial portion of their business could find it difficult to remain profitable, and, absent legislative intervention, might end their participation in the program (possibly jeopardizing care for beneficiaries. [Our] simulations...suggest that roughly 15 percent of [hospitalization] providers would become unprofitable within the 10-year projection as a result of the [spending cuts]."

Sarah Kliff cited a study yesterday that showed that every $1,000 that a hospital lost in Medicare reimbursements was associated with a 6-8 percent increase in mortality rates from heart attacks. John Goodman pointed out in the Wall Street Journal that Obamacare’s coverage expansion will not be accompanied by an increase in the supply of doctors, which will lead doctors to focus their time on the privately-insured patients who pay them the best.

APOTHEFACT CONCLUSION: Seniors’ benefits won’t change on paper. But they will change in reality, because fewer and fewer doctors will accept their insurance.

Defense #3. Obamacare cuts wasteful spending from the Medicare Advantage program

Of the $716 billion in Medicare cuts, the next biggest chunk, $156 billion, is taken out of the market-oriented Medicare Advantage program, known to wonks as Medicare Part C. Nationwide, 24 percent of all seniors are enrolled in Medicare Advantage, though that percentage is meaningfully higher in important swing states like Florida (32 percent) and Ohio (34 percent).



The rationale for cutting Medicare Advantage’s rates is that, prior to Obamacare, the government paid $1.14 per retiree in an MA plan, vs. $1.00 per retiree in a traditional plan. President Obama has called these differences “unwarranted subsidies [that] pad [private insurers’] profits but don’t improve the care of seniors.”

But the comparison between MA and government-run plans can’t be made on price alone. Due to the constraints placed on MA plans, those plans are incentivized by Congress to offer more benefits at the expense of lower prices. Imagine if you were searching airfares from New York to London, but couldn’t shop on price, only on what the planes served for food, and what movies were on board.

However, on an apples-to-apples basis, if you take out the extra benefits, Medicare Advantage plans are 9 percent cheaper than government-run plans. That was the finding of three Harvard economists, published in the Journal of the American Medical Association this month.



So, how will Obamacare’s Medicare Advantage cuts affect seniors who are currently enrolled in MA plans? My co-blogger, Robert Book, published a 2010 paper on this subject, along with Jim Capretta. Robert and Jim found that “Medicare beneficiaries who would have enrolled in the Medicare Advantage program under prior law will lose an average of $3,714 in 2017 health care services.” You can see a state-by-state distribution of the effects on the map below.



Personally, I have no problem with eliminating the extra subsidy for Medicare Advantage plans. But that elimination should have been accompanied by regulatory changes, so that Medicare Advantage plans could compete on price with traditional government-run Medicare. That would have saved the government even more money, instead of forcing seniors out of the program.

APOTHEFACT CONCLUSION: Medicare Advantage offers seniors higher-quality care at a lower cost than government-run Medicare. Obamacare should have sought to save money by expanding the program, instead of undermining it.

Defense #4. The Romney plan for Medicare is worse, because it would shift costs to seniors

A talking point that President Obama has repeated on the campaign trail is that the Romney Medicare plan would “shift costs to seniors.” This is plainly dishonest, and the President knows better.

The 2011 version of the Ryan plan required that those younger than 55 enroll, upon retirement, in privately-run Medicare plans. These future retirees would be able to choose among a menu of plans, and would get a fixed amount of “premium support” with which to choose among those plans. Because the amount of premiums support would increase at the rate of inflation, whereas health-care costs have historically grown at a faster rate, critics have worried that these trends, if continued into the future, would expose seniors to higher health-care costs out-of-pocket.

Advocates of the 2011 Ryan plan, myself included, argue that precisely because of the premium support mechanism, seniors would be incentivized to shop for value with their insurance plans, creating a market incentive that would moderate health care cost growth. But the Congressional Budget Office assumes that market competition would have no effect on spending growth, hence the argument that the 2011 Ryan plan would shift costs to seniors.

However, Mitt Romney pointedly refused to endorse this 2011 plan. Instead, he offered his own plan, one which addressed the above critique of the 2011 Ryan reform using a mechanism called competitive bidding, whereby seniors would be guaranteed to be able to purchase a fully-subsidized plan offering Medicare’s traditional set of insurance benefits. Weeks later, Paul Ryan and Democratic Sen. Ron Wyden (Ore.) produced a very similar plan, a plan that was incorporated into the 2012 GOP budget.

APOTHEFACT CONCLUSION: President Obama is not being honest about the Romney Medicare reform plan, which was expressly designed to respond to the cost-shifting critique of the 2011 Ryan plan. The Romney plan preserves Medicare’s benefits without exposing seniors to rising health-care prices.


Medicare reformers just might win this debate

It’s only been a few days since Mitt Romney picked Paul Ryan as his running mate. My strong impression is that a lot of Democrats weren’t even aware that Obamacare cut Medicare by $716 billion, which is why they’ve been caught off-guard by how the 2012 Medicare debate has evolved thus far.

The good news is that we’re having a substantive, policy-based debate about the program. The dream scenario is possible: that the 2012 e******n gives Medicare reformers a mandate to put the program on permanently stable footing. One might even call it the audacity of hope.

Follow Avik on Twitter at @avik.

UPDATE 1: Several commentators have expressed displeasure that Romney won't preserve Obamacare's Medicare cuts. In this post for National Review, I explain why Romney's approach is sensible.

UPDATE 2: As a matter of clarity, I should point out that Medicare reimbursement rates were already set to eventually fall below Medicaid's under the Sustainable Growth Rate schedule instituted with the Balanced Budget Act of 1997. Obamacare significantly worsens and accelerates this problem with its additional cuts. More details here and here.

UPDATE 3: Lanhee Chen, policy director of the Romney campaign, has put out his own memorandum on this topic:

President Obama knows exactly what [Obamacare's Medicare cuts] will mean. In his own words, sharp cuts to the payments that Medicare makes to providers will “jeopardize … our seniors’ health care.” You can watch him explaining at length how reduced Medicare reimbursements will harm seniors in this address from 2010. In that context he was referring to the threat of failing to extend the “Doc Fix” for another year, thereby triggering a 21% cut in payments that would cost approximately $280 billion to avoid over ten years. Obamacare’s $415 billion in cuts over ten years are deeper.

UPDATE 4: The Wall Street Journal demolishes the "$6,400 myth" that the Romney plan would force seniors to pay more for their health care. "Merely because [Obama] keeps repeating this doesn't mean it's in the same area code of accurate," the editors write.

I write further on the impact of Obamacare's cuts to reimbursement rates to doctors and hospitals in a new piece here.

Avik Roy
Avik Roy Forbes Staff
I am Forbes' Policy Editor, and president of a non-partisan think tank, the Foundation for Research on Equal Opportunity (FREOPP.org), which develops policy reform i... Read More
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The Apothecary is Forbes' acclaimed and influential blog on health care and entitlement reform, led by Forbes Opinion Editor Avik Roy (@avik). The Apothecary's aut... Read More
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Louie27 Loc: Peoria, AZ

This cut was taken out of Medicare by cutting payments to health providers, which in turn cut the number of providers that would accept Medicare patients and another thing is that later cuts in hospital and health agencies payments would have to grow more slowly. This is added money that the Medicare patients have to pay out of pocket.