Affordable Care Act

weso1 said:
A myriad of reasons. Human nature, lack of a high and consistent labor force, global tax shelters, political corrupotion, corrupt unions, etc. The free market typically weeds these things out. Of course we don't really have a free market these days. These huge social programs are in a constant state of crisis. There's always a question of how do we fix them?
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we fix them by fixing them

instead of each side making sure it doesn't work
 
sturg33 said:
From your question, "why doesn't it work," to me you're implying that you think it does, and need him to explain why he thinks it doesn't
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the question doesn't imply anything

it is a question

if you could follow the conversation

instead of having your mind made up before responding

you could tell i don't think it works and have been asking for both sides to work together to make things work instead of the other way around
 
goldfly said:
the question doesn't imply anything

it is a question

if you could follow the conversation

instead of having your mind made up before responding

you could tell i don't think it works and have been asking for both sides to work together to make things work instead of the other way around
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I don't understand what you have to be a dick about it. So sorry
 
I think the main reason the government doesn't work is because they have their special interest lobbying groups they have to appease, and they're dealing with basically an unlimited sum of money. Since there is no budget, and since there is no reason for anyone to be efficient with the money available, and since there is no punishments for having trillion dollar deficits, things just don't work the way they should.

But we can NEVER shrink the size of the government. Because that would me some bureaucrat would lose his job… A job which probably didn't exist 5 years ago - but now that we created it out of nothing, we can never get rid of it.
 
sturg33 said:
I think the main reason the government doesn't work is because they have their special interest lobbying groups they have to appease, and they're dealing with basically an unlimited sum of money. Since there is no budget, and since there is no reason for anyone to be efficient with the money available, and since there is no punishments for having trillion dollar deficits, things just don't work the way they should.

But we can NEVER shrink the size of the government. Because that would me some bureaucrat would lose his job… A job which probably didn't exist 5 years ago - but now that we created it out of nothing, we can never get rid of it.
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Try again. Link: http://economix.blogs.nytimes.com/2...nment-federal-employment-at-47-year-low/?_r=0
 
I don't have that figure on me, but my guess is the ballooning of the federal budget is due more to the increase in direct payments to individuals and to the defense budget as compared to the remuneration of federal employees.
 
That was meant to be a rhetorical question. I meant to imply that that question will always be there, because it can never be fixed. The system will eventually collapse on itself. The only solution is to delay the collapse as long as you can. Some think it will take longer than others. Maybe one day when the government turns us all into robots the problem will go away.

You consistently state on this board that you work to live rather than live to work. Well, the only way to sustain huge social programs is to have a strong and consistent work force that pay taxes. Talk about living to work. As you get further and further away from the free market you get deeper and deeper into living to work.

Also, one of the other reasons you'll never get these fixes you seek is because both sides work too hard to increase their voter base. Everything the dems do is to increase their voter base... welfare, immigration, etc. And for the pubs its religion, military, etc. It's all about votes.
 
Pretty screwed up way of seeing the world IMHO.

you must have never heard of Bernie Sanders or Elizabeth Warren. Gabby Giffords got shot so she could garner all the anti-gun votes I take it.
John Lewis of Ga was thinking walking across the bridge in Selma as a young man -- just think how many votes I can get by doing this. And, Barry Obama's mother thought that him moving to Hawaii to live with his Grandfather that participated in DDay would add to his bonafides come 2008 when he would run for POTUS>

The southern Strategy as spelled out by Kevin Phillips to gather the anti-segregation white vote does not have an equal. No matter how hard CNN,Fox or Tom Brokow sells it. If you bought that notion you sir are a sucker.

I'm sure there are some (R) pols that are in it to provide a civic service. Their names are not on the tip of my tongue. You are more than welcome to fill in the blanks.
I'll take my answer off air.
 
57Brave said:
How much in specific dollars and cents -- has ACA cost you?

Just curious -- let's hold you to the same accounting standard you insist of others

How much has ACA cost you personally -- the guy in the tennis sweater????
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Plan doesn't renew until next summer. Should be a whale of an increase like most folks. I see low enrollment as a huge issue that will probably throw the expense right back to taxpayers. Hard to quantify...yet.

It is also costing employers capital they could otherwise be investing in growth. Brutal on their bottom line really.
 
How brutal in hard cold dollars and cents?

Should be a whale ... ?

Hard to quantify ... ?

You some kinda Nostradamas? or is that Palin talk?
 
57Brave said:
...and here is the macro problem

http://prospect.org/article/how-republicans-lost-chance-win-obamacare
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Unrecoverable website on my system. Thanks IE.

ACA is here. No doubt about it. Shame we aren't Atlanta having 36 markets compete, but we have 1, sometimes 2. In the short term we are going to pay more without a doubt . My hope is we can get HC markets intrerested in doing business in our region again, after our hospitals all blew the budget on indigent care last year. What happens to the money spent when we see enrollment numbers at a fraction of the projected amount? After all, that was one of the big things that made this whole deal solvent?
 
Tapate50 said:
Unrecoverable website on my system. Thanks IE.
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How Republicans Lost the Chance to Win Obamacare

Jonathan Bernstein

November 19, 2013

Conservatives had the chance to test their favorite health-care ideas in state-run exchanges. They decided bullying Obama was a better use of their time than ideological consistency instead.
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AP Photo/The U.S. Centers for Medicare & Medicaid Services

The argument for the national government administering things over the states has always been summed up, I thought, by an old James Carville joke: I’ll race you from Disneyland to DisneyWorld. I get to take the federal roads.

That joke, however, has been turned upside down by implementation of the Affordable Care Act (ACA). The whole sequence has been weird. After all, the law—as a concession to moderate Democrats who feared Republican attacks about a federal-government takeover—wound up asking the states, and not the federal government, to run the exchanges. But Republican-led states refused to do so. When the federal-run Healthcare.gov crashed, the odd result is that the current winners of the federalism battle—which is often waged, at least rhetorically, by Republicans dead set on keeping the feds out of their local government—are Democratic states such as California and New York where things are running reasonably smoothly. Or at least far better than the federally-run exchanges.

One possible result of all this? A revival of the reputation of the state governments, which are (as the Carville joke suggests) not always thought of as synonymous with efficiency and effectiveness. Now we have Tennessee’s state-run exchange running rings around Healthcare.gov.

A larger question, however, is exactly what might have happened had Republicans attempted to achieve their own policy goals, rather than just automatically opposing and resisting every bit of Obamacare (in part, as part of an extreme longshot opportunity to upend the ACA in the courts; in part as just a strategy of being fully against whatever the Kenyan socialist in the White House was for).

In particular, the state-run exchanges seem like a real lost opportunity.

Imagine if, right now, there were only a handful of states in the federal exchange, and some of the more aggressive and innovative conservative governors were running their own exchanges.
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There’s a good chance that they would have been very different from Kentucky or California or New York’s exchanges. While you wouldn’t know it from listening to post-policy Republican politicians, conservative health care wonks really do have some ideas on how to do health care that could be tested outside the punditsphere. For example, Ross Douthat uses every excuse—including the current media frenzy—to trot out his case that the ACA’s big mistake is going for comprehensive insurance. Douthat argues that health insurance shouldn’t attempt to cover relatively small, relatively predictable expenses, just as car insurance doesn’t attempt to cover oil changes and trips to the car wash.

Whether or not that’s something that most people want, it does make sense from a conservative perspective. Insurance generally is about sharing risks. The more comprehensive coverage is, the more risks—the most health-care costs—are shared. Liberals who take seriously the idea of health care “as a right, not a privilege” support that idea, but it’s certainly understandable that conservatives see things differently.

Under the current ACA, states are allowed waivers for policy experimentation—but generally only in a liberal direction. In particular, plans still must have at least the same comprehensive benefits, if not more.

However, suppose that several Republican governors had pushed for a deal in which they would implement Obamacare, including setting up exchanges in their states, if and only if they were given waivers and allowed to try some conservative policy ideas. The pressure would have been intense on the administration to allow at least some of them. After all, the administration never wanted to build all those different state exchanges in the first place. And certainly the president didn’t want obstruction verging on sabotage from Republicans across the board, as is de rigueur now. In order to get some Republican buy-in, there’s a very good chance Obama would have been extremely willing to cut deals, even if liberals would have been appalled at the results for the affected states.

As for Republicans, there remains no real conservative principle violated by government-supported private insurance markets. Government intervention remains necessary because of the particular nature of the insurance market. That’s true whatever the eventual market looks like; it’s true of the pre-reform insurance market just as much as it’s true of insurance under ACA.

Of course, principles like that rarely govern what politicians and political parties do. Republicans have pursued a complete rejectionist strategy when it comes to health-care reform from day one through today. Whatever the electoral effects of that choice, the policy costs to conservatives are clear: they had little or no say in how reform played out, and they squandered an opportunity for a true “laboratories of democracy” test for their own health-insurance ideas.

Republican governors who attempted such policies would have been taking on some real risk—not all of the states that did decide to take on the exchanges have seen success, and experimentation would have upped the chances of snafus and slow starts. Not only might their experiments turn out badly, but they would have taken on the responsibility of building the exchanges in the first place—responsibility-taking has not been the favored political position of the right wing as of late. The payoffs would have been very nice, too; imagine if right now a dozen or more Republican states had smoothly functioning marketplaces. It certainly might have been a far better bargaining position than they have now, given that they still have no alternative to propose to the Democrats’ version of reform.

It’s one of the more interesting might-have-beens of the health-care reform story.
 
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