My Obamacare experience

“Forgive me, but you collectively voted for a President that consistently endorsed it and it has democratically passed through the Houses and been validated by the Supreme court.”
There are a lot of caveats to that talking point string.
1) People voted for a President who endorsed what he said was an entirely different plan…one that would cost those with insurance much less than what they were then paying, with a side effect of free insurance for millions of others. Further, there has been a significant group of people that like him personally, but not what he does; the plan has never had majority support amongst the populace.
2) When the plan was passed, it was pushed through after his Congress had been sufficiently defeated to result in a blocking of the plan, but it was rushed through before the new members could be seated. It was pushed through so fast after the election defeat that even the supporters of the plan did not know what was in it or what effects it would have even on them. Even the rather leftist state of Massachusetts voted in a member of the opposition to try to block the plan.
3) After both parties suffering substantial defeats in the 2010 elections by many groups opposed to the ACA (albeit more aligned with Republicans, and voting with them in caucusing), the Obama Administration placed holds on them forming any more groups to legally work towards that opposition until after the 2012 election (some are still on hold)…thus tilting the election balance towards his party.
4) The US Supreme Court ruled that the basis upon which a portion of the plan was passed did not in fact pass muster under the Commerce Clause of our Constitution, but in what was apparently a last-minute switch, a core portion was ruled a tax, and the government is allowed to impose taxes. Note that the Obama Administration vehemently opposed the classification of his plan as involving a tax, and demonized his opposition as extremists and liars on that point.
4a) The Supreme Court has not actually stated that the tax is Constitutional, as that question cannot be challenged until after someone has paid it. Further, all Bills imposing taxes must originate in the House, which this one did only in the sense that the Senate took a completely unrelated bill, stripped it of its contents and inserted this act…this could also be ruled unconstitutional. I don’t hold out much hope for these, but the issue is in fact far more unsettled than implied.
5) The opposition party was elected a majority in the House of Representatives again in 2012.

Cal…..Thanks for your excellent post. US healthcare is an expensive mess, and we should look to the experience of the UK and other countries for ways to improve it. Years of Republican control has brought little to end some of the insane features, such as health care by emergency room rather than publicly available preventative care. The affordable health care act is a first step in the right direction.

Fuzzy headed supporters of Obamacare see it as a simple moral imperative. We must provide healthcare for everyone, therefore any means necessary to do so must be undertaken, end of discussion. Anyone who opposes it is therefore evil, because they do not support providing healthcare to everyone. But, supporting healthcare for everyone is not synonymous with supporting Obamacare.
This is a bad law, and a bad approach, and it will end in disaster. We have a system which was already creaking under the strains of demand, and the solution Obamacare offers is… more demand. And, subsequent shrinkage of supply, due to current doctors and nurses who refuse to be enslaved retiring, going into other lines of work and, most portentously, future potential medical professionals choosing some other line of work.
In other parts of the world where socialized medicine has been put into place, the solution to the latter has been to import massive contingents of medical professionals from the less-developed world, robbing those nations of their own homegrown talent. When US demand for this pool of doctors and nurses kicks in, this oursourcing system will be put under severe strain. The competition for talented professionals from less-developed countries, who are willing to train extensively and work for a pittance, will effectively kill that system.
Supply and demand – it’s the Law. The equation is very simple. If you want to extend demand without exploding the costs, and diminishing the quality of the product, then you must increase the supply. This is the policy direction we should be taking. We should facilitate the training of new medical professionals, making it so that they do not have a mountain of debt to service when they graduate so that they can live on a reduced salary. We should invest in new medical plant and equipment. The Obamacare route of expanding coverage, and forcing new regulations and burdens on an already overburdened resource, can only lead to catastrophe.

CAL and Climatereason: since you are not Americans, your understanding of life and politics here is limited. Many Americans are individually oriented, believing in personal responsibility. Many Americans dislike intrusive government and high, unnecessary taxes. Many Americans do not believe that a 17 trillion dollar national debt is healthy for anyone, a debt likely to be increased by ACA. Many Americans do not believe forced taxation and penalties, plus a bloated government bureaucracy are necessary to deliver good affordable health care to Americans. As enacted, ACA lacks many obvious reforms to lower costs, from tort reform to competition across state lines. It is pretty common for proponents of ACA to paint opponents as uncaring people who want to deny health care to the less fortunate, a lie which many people will fall for. But anyone with a real understanding of the law and it’s implementation understands that it’s not about providing affordable health care to the uninsured; it’s all about centralizing control of the health care industry under the thumb of the government. And you’ll never convince many Americans that inserting government between them and their doctors is a path to efficiency.

The lower cost for European health care systems exist partly because they’re indirectly subsidized by the US healthcare system. For instance, price controls are affixed to prescription drugs in Europe. However, most new drugs are developed in the US. Sales of these drugs in other markets do not cover development costs, shareholder dividends, or the profit margins that enable the former two. European sales probably only function as a cost center for operations and provide economies of scale to the industry. The US market is what provides the profits. When those profits go, and they will under ObamaCare, there will be no one to subsidize us. Since profits subsidize R & D, new drug development will cease.
In England pulmanologists favor using theophylline to treat lung conditions such as mine. Since theophylline is a pill it is a systemic medication which carries side effects for the entire body. In the US most pulmanologists will prefer to use Advair which contains a bronchodilator medicine (as does theophylline) combined with a steroid. Since Advair is a dry powder inhaler it primarily only medicates the lungs with only limited systemic absorption. There is some anecdotal indication that it may extend life expectancy for COPD patients although most pulmonalogists contend that COPD is strictly irreversible. You’ve probably guessed by now that theophylline is a much less expensive and, in my opinion, primitive medication compared to Advair. I have little doubt that cost is the reason for the differing opinions, and thus usage between US and UK doctors.
And as far as anybody who thinks that a national health plan will help anybody, anywhere, avoid bankruptcy due to the high cost of medicine, well, I would advise them to think again. I think we can all agree that Medicare is, indeed, a national health program. Now, I know of no employer sponsored group health policy that is so insufficient that it requires a supplemental to cover what it doesn’t. Well, Medicare does. It’s the dirty secret that’s screaming right in our ears. Now, if you’re on SS disability you will not qualify for a supplemental. As the Social Worker will explain to you, Medicaid can be your supplemental. But you can’t have more than $2,000 in cash assets of any kind: no 401K, no annuities, stocks, even cash in checking or savings accounts. Whoop dee do. If you have more you’ll have to use it to cover what Medicare doesn’t till you’ve spent down to that sum. Think about that: In Chicago an apartment will rent for $800-1,000/month and require 1-2 months security deposit. So, try living on a $2,000 safety valve. Bankruptcy, here i come. But cheer up, Medicaid will let you keep your house, your car, your furniture. Of course the state will take possession of those things when you die. You see, despite the fact that you and your employer (which means ‘your’ compensation) have paid into this system since the first job you got scooping ice cream or flapping burgers at the age of 16, you haven’t paid enough. Now, does anyone wonder why the President, Senate, and House are exempt from this pile of …? National Health: the low cost alternative!!! Bravo!!!

wow…lots of heat on this thread…like i said before i in the USA for 20 years…i came back home to Kerala state in india to retire…its beautiful here…very green…anyway i got dengue fever here…unheard of when i was a kid…migrant labour bringing these diseases here…i almost died…spent two days in the ICU…total hospital bill was $400…this is a poor state in a poor country..life expectancy about 80 years…about the same as the the very rich USA

andrewmharding says:
October 13, 2013 at 5:27 am
Fellow Limey here, confirming what Andrew wrote. The NHS is collapsing, largely because as it’s excellence as a health service has collapse in direct ratio to the number of managers it has employed.
None of whom, when anything goes wrong, are ever responsible. And if they leave, they leave with huge pay-offs and step straight into another job, where they fuck up again. Google “CYNTHIA BOWERS” if you want to see how that works; a top executive at the Mid-Staffs Hospital, now known to have been responsible for the death of ~1200 patients in not a very long time, through appalling levels of care, walked straight into a top job at the laughably named “Care Quality Commission” – a quango set up to monitor hospitals. Which it was incapable of doing, as demonstrated by what happened above.
Drinks all round. Taxpayer pays.