Should we return to prior healthcare system

[donheff]

In the ongoing poll about healthcare virtually everyone is dissatisfied with both the pre-Obamacare status quo and with Obamacare. Many of us would prefer something closer to a single payer Euro style system. Others of us would prefer a system with much less government involvement. Given the realities of Congress and the American electorate do you believe it would be preferable for Congress to 1) Overturn Obamacare returning us to the status quo and then start over, or 2) Allow the existing (Obamacare) legislation to stand while working to improve it. Note: I realize that in real life the President would veto and overturn. But I am interested in seeing how people feel about going back or moving forward.

 

[M Paquette]

We should return to the medical practices of our Founding Fathers.

Allowing barbers to once again practice medicine would immediately alleviate the shortage of practitioners, although it might be best to go with more modern practices and restrict the practice of major surgery to those barber-surgeons who had completed an apprenticeship program.

Medications should similarly be limited to the apothecary standards of our Founding Fathers. This naturally would permit advanced medication such as digitalis, quinine, and calamine, along with ground mercury and herbal poultices.

The adoption of these practices would also serve to alleviate the fiscal stress on both Social Security and Medicare, as the portion of the population that would be claiming such services would naturally be significantly reduced. By simply rejecting medical activism and holding with the original state of practice as when the framers of our Constitution laid pen to paper and founded this great nation, we can readily address a host of problems within our country.

Thank you for your attention. If anyone needs me, I'll be in Switzerland...

(Not a big fan of moving backwards...)

 

[samclem]

(Not a big fan of moving backwards...)

If only it were clear where "forward" is. The previous series of events ain't a good guide for what should be "next," except to the degree that we've tried something and it doesn't work. We sure can't say we've tried the market based approach or lots of the other good ideas yet.

 

[Bestwifeever]

...Allowing barbers to once again practice medicine would immediately alleviate the shortage of practitioners, although it might be best to go with more modern practices and restrict the practice of major surgery to those barber-surgeons who had completed an apprenticeship program....

A good barber/hair cutter is hard enough to find already!

 

[huusom]

Going back to the previous system is not a choice. Our healthcare system was already broken before the reform. We must go forward and expand on the current system. There are many flaws with the reform but its main purpose to get everyone covered is the right thing to do. Like education, healthcare is not a right but it is essential for a healthy society to provide for its citizens. A sick and under educated population cannot stay competitive for long.

 

[ziggy29]

I'd like to see significant pieces of it blown up and reworked, but I don't consider repealing it to leave the status quo in place as remotely acceptable.

 

[dgoldenz]

It will all blow up when people find out they have to pay $1500/month for coverage.

 

[M Paquette]

It will all blow up when people find out they have to pay $1500/month for coverage.

What's the copay for leeches? Are brand name poultices covered, or only generics? If a person with prior evidence of possession applies, will future trephinations be covered?

 

[ERD50]

1) Overturn Obamacare returning us to the status quo and then start over

I'm glad the 'start over' phrase was part of the poll wording, since the thread title sounds like just 'return' to status quo (I realize titles need to be short).

Yep, I think the current bill is such a mess that a complete start over is called for.

But I am interested in seeing how people feel about going back or moving forward.

I don't see that as "either/or", I see it as we need to move backward so we can move forward. Of course I want to move "forward". I've worked on plenty of projects that after a hard, cold review, you just suck it up and realize it would be better to start over from scratch than to try to fix what you've got. If you don't have a good foundation, the fixes just become complications on top of complications and are never as good as building it right from the get-go.

So move forward, even it means taking one step back to get there.

-ERD50

 

[ziggy29]

I don't see that as "either/or", I see it as we need to move backward so we can move forward. Of course I want to move "forward". I've worked on plenty of projects that after a hard, cold review, you just suck it up and realize it would be better to start over from scratch than to try to fix what you've got. If you don't have a good foundation, the fixes just become complications on top of complications and are never as good as building it right from the get-go.

I would support a "reform" of the reform to change some of the things I don't like. I could not support a complete repeal of the package because there's no assurance that (a) a different reform bill would ever be passed, leaving us with the status quo or (b) that a reform bill WILL pass -- and could actually be worse.


In other words, I'm okay with going one step backward after TWO steps forward -- but not going the full two steps back to square one.

 

[chinaco]

I like the idea of health exchanges. I wish they were not restricted to a state boundary.


But there are several provisions I have problems with.

I think the tax credit (if it stays) should only be based on a very basic plan.... the basic plan would have some form of rationing! They could offer multiple plan levels.... but an upgrade premium comes 100% out of the insureds pocket.

The mandatory coverage provision was the part of the bill that was attacked... But the tax credit is what most people do not like... it is the major cost component.


The no limit clause should be removed. Yes, the plan should have a limit that covers most catastrophic situations. But unlimited is no realistic.

 

[ziggy29]

I like the idea of health exchanges. I wish they were not restricted to a state boundary.

Had they made it an interstate thing, one of the main legal objections to the law would largely go away. Had they created exchanges that crossed state lines, it would *very* clearly constitute "interstate commerce" as defined by the Constitution, and completely appropriate for Congress to create and regulate.

 

[Texas Proud]

Going back to the previous system is not a choice. Our healthcare system was already broken before the reform. We must go forward and expand on the current system. There are many flaws with the reform but its main purpose to get everyone covered is the right thing to do. Like education, healthcare is not a right but it is essential for a healthy society to provide for its citizens. A sick and under educated population cannot stay competitive for long.

I think India is proving your last statement to be wrong...

 

[ERD50]

I would support a "reform" of the reform to change some of the things I don't like. I could not support a complete repeal of the package because there's no assurance that (a) a different reform bill would ever be passed, leaving us with the status quo or (b) that a reform bill WILL pass -- and could actually be worse.


In other words, I'm okay with going one step backward after TWO steps forward -- but not going the full two steps back to square one.

Pretty much agreed, but I took the viewpoint of the hypothetical, since donheff said:

Note: I realize that in real life the President would veto and overturn. But I am interested in seeing how people feel about going back or moving forward.

So I took it more as 'how you feel' rather than what is practical/possible/likely.

Heck, we are all just anonymous posters on a forum, it's ALL hypothetical


-ERD50

 

[samclem]

Here's what John Q. Public thinks (as of Dec 20, 2010):

Fifty-five percent (55%) of voters now favor repeal of the health care law, including 40% who Strongly Favor it. Forty-one percent (41%) are opposed to repeal, with 31% Strongly Opposed. Support for repeal has ranged from 50% to 63% in weekly tracking since the bill became law in late March. Last week, support for repeal was at 60%.

A majority of those polled believe it is at least somewhat likely the law will be repealed.

According to Scott Rasmussen, one of things that would most brighten President Obama's chance for re-election is for the new law to be struck down by the Supreme Court.

 

[FreqFlyer]

Had they made it an interstate thing, one of the main legal objections to the law would largely go away. Had they created exchanges that crossed state lines, it would *very* clearly constitute "interstate commerce" as defined by the Constitution, and completely appropriate for Congress to create and regulate.

What prevents health insurance from being purchased across state borders? Is this a restriction by federal law?

 

[kyounge1956]

(snip) According to Scott Rasmussen, one of things that would most brighten President Obama's chance for re-election is for the new law to be struck down by the Supreme Court.

I would think the president is too strongly identified with the bill for repeal to increase his chances of re-election. I googled and found the article at the Rasmussen Report. An interesting point is raised:

As Rasmussen Reports has documented, many individual components of the plan are popular, but the overall legislation remains unpopular. The unpopularity stems from the cost of the legislation in an era when voters would like to see federal spending go down rather than up.
One little-noted aspect of the debate was a disagreement over the purpose of the legislation. Most voters identified cost as the biggest problem with health care in America today, but about one-in-four said the lack of universal coverage was the top issue. Among those who see the lack of universal coverage as the biggest problem, 86% favored the legislation. However, among the majority who see cost as the biggest issue, 68% opposed the health care bill.

 

[TromboneAl]

What's the copay for leeches?

It depends on whether the leech is in your network.

 

[huusom]

I think India is proving your last statement to be wrong...

I don't think India is competitive at all. They are definitely getting better but would you want to live there? Selling cheap products at the expenses of the poor majority to enrich a small number of rich is not competitive by any means. This is the reason why India is called a developing nation and we're not.

 

[huusom]

Here's what John Q. Public thinks (as of Dec 20, 2010):

A majority of those polled believe it is at least somewhat likely the law will be repealed.

According to Scott Rasmussen, one of things that would most brighten President Obama's chance for re-election is for the new law to be struck down by the Supreme Court.

The poll results are suspect in my opinion. I've seen polls with total opposite results. In the end, it will depend of how much we can afford to pay as a society. The health care cost just can't keep going higher out pacing income and inflation. Those who are lucky enough to have group rate insurance think reform are not needed and those who are left to fend for themselves will say reform is needed or they will try to game to system to avoid having to pay anything at all by hiding assets, etc..

 

[donheff]

So we are running about 70% fix Obamacare vs 30% start over. Based on this thread and the other poll, it seems virtually everyone wants to fix the current system one way or another. I suspect most would agree that what we got last year was a slight modification of the current system with mandatory coverage, no denials, and weak competition. Seems a shame that the Republicans didn't cooperate to steer the plan in a sensible (from their perspective) direction instead of demonizing any change whatsoever as socialism and death panels. But we got what we got. So what happens now?

The Supreme Court will eventually rule on mandatory coverage. Any law scholars have an opinion on what will result if they find the mandate unconstitutional? My hope is that would simply strike down that single portion of the law leaving no denials for pre-existing coverage and other aspects in place. That would be a disaster for the insurance companies and, in my opinion, could be a positive outcome. Could there be a constitutional (commerce clause) approach based on nationwide exchanges - maybe even a national public option? If so, there would be tremendous pressure to accept something like that if the most likely alternative result would be Obamacare without a mandate.

 

[GregLee]

Some think that the greatest problem of our healthcare system is that it is not universal. That includes me but, I gather from comments in the other thread, none of you. At any rate, to fix that problem requires wealth redistribution, which in turn requires government involvement. Increasing competition, rationalizing prices, tort reform, and similar ideas bandied about here are not relevant.

 

[samclem]

I would think the president is too strongly identified with the bill for repeal to increase his chances of re-election. I googled and found the article at the Rasmussen Report. An interesting point is raised:

As Rasmussen Reports has documented, many individual components of the plan are popular, but the overall legislation remains unpopular. The unpopularity stems from the cost of the legislation in an era when voters would like to see federal spending go down rather than up.
One little-noted aspect of the debate was a disagreement over the purpose of the legislation. Most voters identified cost as the biggest problem with health care in America today, but about one-in-four said the lack of universal coverage was the top issue. Among those who see the lack of universal coverage as the biggest problem, 86% favored the legislation. However, among the majority who see cost as the biggest issue, 68% opposed the health care bill.

I think this indicates the public has a good understanding of the major attributes of the new law. The law does achieve universal coverage (eventually) and does very little to control costs.

Originally Posted by hussong
The poll results are suspect in my opinion. I've seen polls with total opposite results.

This poll is entirely consistent with other polls I've seen.
Here's a wrap up of many reputable polls, including some with historical tracking of the same questions over time.

The law is not supported by a majority of Americans, and support is not growing as some politicians had hoped it would.

 

[ERD50]

The poll results are suspect in my opinion.

...

Those who are lucky enough to have group rate insurance think reform are not needed...

I'd say your assumptions are suspect. I have a group rate insurance plan and feel very strongly that reforms are needed. But this bill is a mess. I'm sure I'm not alone.

Seems a shame that the Republicans didn't cooperate to steer the plan in a sensible (from their perspective) direction...

Seems a shame to me that with a majority in Congress and holding the Executive office that the Democrats couldn't get their act together to pass a bill that didn't require special favors to certain segments, and that didn't have more support from the public. Why blame the R's when the D's were holding all the cards?

I say that as an independent, just observing the facts.

-ERD50

 

[kyounge1956]

(snip)Seems a shame to me that with a majority in Congress and holding the Executive office that the Democrats couldn't get their act together to pass a bill that didn't require special favors to certain segments, and that didn't have more support from the public.(snip)
-ERD50

I don't understand how that happened. I don't follow politics closely at all but I thought the Dems had something like 2/3 of the seats in both House and Senate after the 2008 elections. With that kind of majority they should have been able to pass whatever they wanted to, even a single-payer plan, regardless of what the Republicans thought about it. What kept that from happening? How did we end up with this big complicated Act that nobody is really satisfied with?