Obamacare is "imploding", "collapsing under its own weight" etc. That is, and has been, the Republican drum beat, but is it true? I would argue that the answer is a flat out "No." But, but, but, what about those 130% premium increases, providers bailing on the Exchanges, etc. Yes, there are those issues ... in states who failed to implement the ACA (Affordable Care Act) the way it was crafted to function.
It is a bit like buying a storage cabinet in a box. There are all the pieces "A" through "qq", all the various screws and self-locking bolts, 3 special drivers, and detailed instructions for assembling the cabinet. You start putting it together and decide that there are just way more self-locking bolts, and you only want 2 shelves instead of 5, and you want the drawers on the right rather than the left. You finally get the thing put together, cussing included, get it all loaded up, and you open the drawer (now on the right), and the whole damn thing collapses, taking your special $5,000 vase with it.
Now, you can make the argument that the cabinet was "faulty" and just "imploded" after you put it together. And, you can try suing the manufacturer for selling this lousy cabinet, and they should pay you not only for the cabinet, but your time, and the $5,000 vase that got broken when it fell apart. And, when it c0mes out how you "modified" the construction you are likely to get hit with a counter suit.
The same is true of many of the issues the Republicans are carping about in regards to "Obamacare." Half of the states have chosen to either not participate or to only partially implement the program. Thereby undercutting important components. If they chose to not participate, then those folks within their state choosing to exercise their rights to healthcare, may find that the Exchange in their area has shrunk and costs are climbing.
That is ONE way to look at the lie, and Johnathan Gruber explains this further in the audio file below from his interview on NPR.
- There should be coverage for all - medicare for all. Medicare is a plan that works fairly well, though improvements could be made - the first being that you should NOT be virtually forced to get a third party plan in order to actually use your benefits.
- Standard medical coverage (excluding optional and unnecessary procedures - and I know this is a tricky component) should be NON_PROFIT. The health of the nation should not be a for-profit environment.
- Pharmaceutical companies should be controlled more closely, and bidding and contracts to control costs (and quality) should be implemented.
- Developing and implementing a good PUBLIC health system that includes both urban and rural areas, and that may mean instituting both clinics and hospitals.
- Mental healthcare and dental care should not be treated differently than physical healthcare.
- Bag the taxing of "Cadillac" plans. I was lucky enough to work for an employer, in a UNION position, with a good insurance plan. While it would count as a "Cadillac" plan as identified under the ACA, it was NOT. It was a plan that AT A MINIMUM everyone should have (reasonable premiums, co-pays, and out-of-pocket to cover standard, emergency, and catastrophic care), but there are far better oout there and the corporate executives have them.
I am sure that we could add to the list. The problem in trying to implement a full coverage system in the U.S. is trying to make sure that everyone gets their piece of profit along the way - the pharmaceuticals, the insurance companies, the care providers and their administrators, the equipment providers, etc. These things don't only screw up healthcare policy, they screw up healthcare costs - higher and higher each year.
Medicare administration is consistently under 10%, and the "paperwork" would be radically reduced if it was one system. This is far better than the costs of insurance companies. My Medicare payments are about $125 a month - taken out of my Social Security. My third party costs are far higher than that. I firmly believe that we could craft an exceptional healthcare system for everyone at relatively low cost IF we quit trying to keep all the private interests not only afloat, but coming up roses.
There is nothing to stop the existence of a collateral for-profit health system, including a number of insurance possibilities for accessing it, or even bridging between it and the nonprofit system.
I think it is important to remember that we once had a pretty good public health system (I was born in a public hospital), and a private system that was covered though employers. Employers began cutting benefits , and then locking down wages, to improve their profits. Reagan killed the public health system and opened up for-profit medical care. As employers cut benefits employees were forced into an environment with no insurance or paying out of pocket (something most people and families could not afford). For those employers who not only cut benefits, but also forced low wages or non-full time employment (like WalMart) they shifted the burden of not just healthcare (via medicaid), but food costs (via food stamps) and other subsidies (via welfare programs) onto the "government" (tax payers). Meanwhile the effective tax share of corporations decreased as the middle and working class effective tax rates increased. In other words, the tax payers (which includes the exploited workforce) picked up the tab on benefits (plus) to improve the profits of an array of corporations. I will restrain myself from going on about the ever-expanding quest for corporate profits and what it has cost the people, the nation, and the world.
So fix healthcare for the PEOPLE, and not the for-profit arena and those with way more than their fair share of wealth.
On March 9, 2017, MSNBC's Ali Velshi did a bang up job challenging the lies an memes about collapsing Obamacare, the wonders of the Republican plan, and the "problems" of single payer systems. He did what the Democrats SHOULD have been doing for the last 9 years - at least. You have to repeatedly challenge lies or the lies "win" in that many will think they are true.