Comment by p0w3n3d
2 months ago
Guy from Poland here. What happened to ObamaCare? I thought you got finally a primary healthcare for all?
2 months ago
Guy from Poland here. What happened to ObamaCare? I thought you got finally a primary healthcare for all?
Quick summary: the US does not have anything approaching a modern healthcare system. (And likely will not for quite some time due to a set of structural factors.)
Obamacare (the Affordable Care Act or ACA) was an attempt to expand coverage and slow the rate of increase of costs. It did the former but less well with the latter.
One other thing the ACA did is stop the scourge of scam insurers. This is a thing where people would pay for "insurance" and then find out later that their "insurance" did not actually afford them any meaningful coverage. The ACA tried to close a set of loopholes and overall regulate the insurance market more closely.
Anybody reading this from outside the US probably lives in a place where low-cost healthcare is more accessible than it is in the US.
Don’t forget the repeal of the ACA healthcare mandate: “The federal individual mandate of the Affordable Care Act, which required people to pay a tax penalty if they did not have health insurance, was repealed in 2019.”
https://pmc.ncbi.nlm.nih.gov/articles/PMC8886708/
Aka Republicans being pissy about the ACA (despite having come up with no feasible alternative plan at the time and unanimously voting against it even after it incorporated Republican characteristics) and choosing to try to intentionally financially torpedo it so they could campaign on its failure.
I'm pretty centrist, but the sheer evil of fucking over a country's access to health services for political points is appalling.
Especially since, you know, coming up with an alternative plan was eminently doable -- just not a priority for Republican leadership (then or "we have an idea of a plan" now).
Quick note that for people aged 65 and over the US does have a healthcare system somewhat like other developed nations.
Given that older people tend to be some of the main cost drivers in healthcare, it's sort of silly that we cover them and then refuse to allow younger (cheaper) people to opt in to the same system & perhaps defray costs that way.
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Medicare Advantage?
https://m.youtube.com/watch?v=Ejoi9yfLVCc
Health care is fine here if you have a decent job. Health care is not that great in public systems and you still pay for it with higher taxes
And naturally you make this absolute claim because you've undoubtably lived in more countries than just the United States, right?
As point of reference, I lived in Taiwan for years - they have a national health insurance system, and taxes are comparable if not lower in some situations to the United States.
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> Health care is fine here if you have a decent job
This statement is at odds with itself.
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ObamaCare (actually the Affordable Care Act: ACA) is a band-aid solution. It's a way to at least ensure that everyone has a pathway to insurance if they have enough money. Basically, the government negotiates some plans with private insurers and makes them available to the general population.
It's subsidized, but the new budget has drastically decreased these subsidies and so the cost to enroll in the ACA is about to go up for people who want to get insurance through their marketplace.
They stripped it of most meaningful changes to get it passed. What it ended up being was kind of the worst of both worlds. A federally related marketplace for private healthcare insurance. They did however ban coverage limits on “pre-existing conditions”. Before Obamacare an insurer could whine that you had cancer before signing up and refuse to cover your cancer care.
Obamacare failed at reducing costs. It mostly focused on insurance expansion and in consumer protections, not on dealing with hospital, drug, and provider pricing structures that actually drive the spending in the US healthcare system.
The ACA had its most effective cost-control mechanisms stripped by its political opponents. Sen. Lieberman (a turncoat Dem who had campaigned for John McCain) forced the removal of the public option, which would have helped hold prices down through competition. The Supreme Court struck the requirement for states to participate in Medicaid expansion, which limited the benefits for millions in a swath of conservative states. And Republicans in Congress removed the individual mandate, which enabled healthy people to go without coverage, raising prices for everyone else.
It's also important to keep in mind that reforming the US healthcare + insurance system was always going to be an evolutionary, multi-stage process, because of its complexity.
You shouldn't change all the parts in an engine to different specifications at the same time.
The ACA therefore blended structural improvements (insurer admin cost caps, standardized benefits, no prior condition exclusions, guaranteed access, etc.) with lubrication (individual mandate) in an effort to move the whole morass forward.
The worst part about the ACA is that neither party tried to pass ACA Pt 2, that went further. (And yes! That could have been a Republican effort too!)
The previous system was broken. The current system is less broken. It's possible to create an even less broken future system.
The real ridiculousness is anyone campaigning on status quo and/or 'it's impossible to improve things.'
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The Supreme Court is not “a political opponent.” It’s literally the way the country works. It found the requirements for states to participate to be unconstitutional. In fact, it was also SCOTUS who eventually determined in 2012 that the individual mandate penalty was functioning as a tax for constitutional purposes. This was the basis for upholding the law. The mandate itself was not upheld under the Commerce Clause but survived because the financial penalty was deemed a tax.
> The ACA had its most effective cost-control mechanisms stripped by its political opponents.
Because of lobbyism, healthcare sector is extremely strong politically and don't want to reduce their income, Democrats aren't immune to that they have mostly been just as pro corporate as the republicans are they just are pro different corporates.
Unfortunately not. It's still very broken, and next year it will be worse for a ton of people. I got AI to write a short answer for you:
> Short version: Obamacare never turned into “free primary care for everyone,” it was just a bunch of rules and subsidies bolted onto the same old private-insurance maze. It helped at the margins (more people covered, protections for pre-existing conditions), but premiums/deductibles can still go nuclear if you’re in the wrong income bracket, state, or employer situation. From an EU/Poland perspective it’s not a public health system at all, just a slightly nerfed market where you still get to roll the dice every year.
You comment sounds like snark but I understand if you don't know what Obamacare is.
(And I'm not an expert so hopefully people will correct any mistakes)
"Obamacare" was never healthcare for all. It is a GOP healthcare plan that heavily subsidizes private insurance. (Because free markets) And the current affordability crisis is the result of letting the government subsidies that help people pay for their Obamacare coverage lapse.
On a positive note: Obamacare (aka the ACA-PPP) did put some restrictions reasonable restrictions on the terrible things insurance companies used to do. For example, drop customers for "pre-existing conditions", impose lifetime payout maximums, etc.
All house and senate GOP members voted "no" on ACA. Obamacare is a lot of things, but a "GOP healthcare plan" isn't one of those things.
Strangely it actually was based on the GOPs 'Romneycare' that was promoted by The Heritage Foundation.
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