Howdy,

I give sincere apologies to everyone already posted here when I say that these topics seem a wee bit boring so far.  They all relate to high school.  Life did continue after Niles West.  We all received our excellent Niles West education, so let's use it.

I pick something more current.  I would like to know what you think about Obamacare?  Pro or con and why?  I am intentionally not yet stating my opinion, as I do not wish to taint the question here(at least not yet).  If you are in favor of Obamacare, then why should we all not consider you a socialist dog?  If, however, you are against it and support its revocation, then I ask the simple question (as yet not answered by anyone), what do you then do with the 35 million or so Americans without insurance coverage who flood emergency rooms?

I figure that I can ask this without attracting rage, as Obamacare care has absolutely no impact upon me living here in Thailand.  FYI, Thailand, third world that it certainly is, provides healthcare for all Thai people.  Certainly not the best healthcare that I have ever seen, but it is better than nothing and essentially free to all Thais.

I also suggest that we all be nice to each other (assuming that anyone even bothers to make a post here).  Everybody gets to have their own opinion without harassment....is that not what America is about and what they taught us at Niles West?  Everybody, however, does not get their own set of facts, so let us also try to stick to the truth.

Anybody want to play?

s hirschtick, Indian from '64

Most people think the Patient Protection and Affordable Care Act (Affordable Care Act) aka Obama Care is only about providing health insurance to those individuals that don’t have coverage. It is far more than that. As a nation, we are transforming health care delivery into a system that is patient-centered and value-based. Existing Medicare and Medicaid programs and initiatives, as well as new programs authorized by the Affordable Care Act, focus on new service delivery and payment models that encourage and facilitate greater coordination of care and improved quality. These new initiatives include accountable care organizations (ACOs), bundled payments, health and medical homes, and reductions in payment for hospital readmissions. It is also moving the medical profession away from paper health records to electronic health records.

State-directed health insurance exchanges is the compromise made  to the insurance industry that has created the Frankenstein monster we have today for obtaining insurance coverage under the Act.  It was messed up further by the US Supreme Court when it ruled that states could opt out of the Medicaid expansion 

The Public Option Act, in contrast, would have allowed all citizens and permanent residents to buy into a public option by participating in the public Medicare program. While the United States House of Representatives passed a public option in their version of the bill, the public option was voted down in the Senate Finance Committee and the public option was never included in the final Senate bill.

It is my belief that a single payer healthcare system (Public Option for all) is the only sensible way to provide healthcare to our Nation. I wrote a paper on a single payer system in 2007 and is available for download at: https://dl.dropboxusercontent.com/u/24019420/singlepayer.doc

Here are some other helpful documents: (Cut & past URL in your browser)

Affordable care Act:

http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf

Reconciliation Act:

http://www.hhs.gov/healthcare/rights/law/reconciliation-law.pdf

Meaningful Use of Electronic Health records:

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html?gclid=CNzOsqbO2LoCFY0-MgodtH0A7A

The Supreme Court’s Decision on the Affordable Care Act:

http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

A thoughtful post Mr. Ditkowsky.  Lots of technical chatter, but I think that you are saying that Medicare for all would be best.  But, but, but is that not the government assuming control of all healthcare?  What about the insurance companies and their shareholders?  And most import, who pays for it all?  Do you mean to say that Mitt Romney's worthless 47% of the people (all the moochers according to Mitt) get free healthcare paid for by the 53% of Americans who are hard working folks?  Clearly you are not a Fox News viewer.  Explain yourself please Mr. D.

I explained myself in my 2007 paper written for one of my classes for my master's degree om medical informatics.  It is posted for download as mentioned in my last post. As for the insurance companies they can move on and out of healthcare. 

I still don't understand Obama care. I get it but don't understand  why insurance premiums are so high.

And yes Steve.......life for some ended in high school.  Miss u.

Hi Sharry,

Miss you too.  We'll see each other soon in either LA or Chicago.

Health insurance premiums are only that high in USA.  Far more reasonable outside.  Obamacare is complex because problem is complex and GOP have fought every step with many lies, so it makes for a most complex law.  There is no quick explanation of it that can be complete.  This law addresses many issues, but key focus is on 35-40 million Americans w/o health insurance so they avoid medical care until it becomes an emergency, then go to hospital emergency rooms.  These ERs by law must treat everybody, so States end-up paying, which means all taxpayers pay for the uninsured.  Obamacare offers FREE money (at least for 3 years) to States to expand health coverage for the poor (Medicaid).....but amazingly, many States controlled by GOP have turned down this FREE money because of GOP irrational hatred for Obama. 

Note, for example, that the Republicans running the US House of Representatives have voted over 40 times to totally repeal Obamacare…..yet they have NEVER offered any program to replace it or provide for the massive number of uninsured citizens.  They simply have been driven to irrationality caused for many by their hatred of having a Black man in the White House.

Obamacare is certainly NOT perfect and there are better solutions to the problem (see Vermont experiment in progress now)….but GOP irrational resistance prevented passage is better law.  Nor am I saying that Obama is perfect.....as he certainly is not.  But GOP hatred is extreme to point of resisting everything he proposes.  For example, Obamacare is a GOP concept (really!!)....but as soon as he adopted it, GOP began fight.  Some of this resistance is certainly genuine and sincere....but some of it from some folks is clearly racist.  Anyone getting their news from any place other than Fox, Limbaugh or Drudge will most probably agree.

From my vantage point, this seems like number 1 issue in US now…..so I made this topic post.  I knew Jimmy D would comment….and am happy that you joined us.  But absence of any other comments does seem to indicate many folks stopped thinking.  As you know, I am not planning to attend reunion, primarily because of the distance involved…….but even if I lived closer, the concept of many folks standing around and misrepresenting how they have spent the last 50 years w/o any discussions of anything topical simply indicates an evening of no fun, at least for me.  I look forward much more to our possible mini-reunion in late August.

steve

You crack me up, Hirschtick!  You love to play advocate.  During a discussion we had on this subject, I distinctly remember you indicating universal Medicare would be the perfect solution, albeit hard or impossible to implement.  (Think that proving true of Obamacare, as well.).

You pose a good question..."Who would pay for it?"  Well, who the heck is paying for Obamacare??

Me again.  Hey, you lamented about not projecting interest...And you know I aim to please. :o)

Alright, I know you do extensive "homework" when forming and before stating opinions ("opinions" being the key word here, as research doesn't ensure your encyclopedia has all the correct facts), but I'm most interested in hearing your source for a couple of your statements... That the Republicans running the House "simply have been driven to irrationality caused for many by their hatred of having a black man in the White House" (in fact, you bandied about the term "irrational" three times in referring to the Republican viewpoint) and "...but some of it from folks is clearly racist."  And Oprah doesn't count! ;)

You also refer to the FREE money Obama is offering to the states for three years.  Pray tell, is there such a thing?  And where does that FREE money come from??  Last I knew, our country can't pay its current, extensive debt.

I agree that the Republicans haven't come up with a better alternative, but I don't know that I agree that a bad alternative is better than none at all.

Yep, no question about it.  I like a good debate.

To answer your question, ultimately the same people who are now paying for the emergency room healthcare of all the uninsured folks who show up in the ERs will also pay for Obamacare.  That be us, the taxpayers.  So we the people should want the most efficient/effective healthcare delivery system.  Medicare for all would be better than Obamacare, but it never would have gotten through Congress, then or now.  In early Obamacare (before it became law), there was consideration of something called the "Public Option", which was a small step in that direction of Medicare for all, but it was killed by political bullets. 

While Obamacare is not best method in my view, in is much better than pre-Obamacare, which was no method at all.  It is clearly documented that Obamacare has already saved lots of healthcare costs...plus the other significant benefits (none of which seem to get much coverage on Fox or Limbaugh), to name just a few: Children up to age 26 can remain on parents plans; health insurance cannot be denied because of pre-existing conditions; insurance companies which spend too much on non-healthcare expenses (like executive bonuses) must refund a set portion of premiums to the policy holders; lots of money directed to installing electronic medical records, which will greatly improve patient care and prevent many screw-ups (Jimmy D knows far more about this than I do)........just to name a few of the benefits already in place, but not getting much press.

Vermont is trying Medicare for all, so we will soon have some actual real-world feedback on it.

In a high school class of our size there are undoubtedly many who have grown-up into folks who do not care for Obamacare.  Some I suspect passionately hate it.  They absolutely have the right to that opinion, and they should vote in that direction whenever possible.  I would really enjoy hearing from anybody what they think is a better path remedy a huge problem.  I see, however, that very few have even read this and our little group is you, me, Jimmy D and Sharry. 

s.

Thank you, "Mr. Ditkowsky," for posting some sources.  I'm going to take the time to read them, as will I do the same when Mr. Hirschtick adds his. 

You know that I don't feel I'm necessarily adept at participating in a "good debate," but you also know I love the way you make me think, so I just couldn't resist.

Hello Ms. K,

Let me be specific.

1. GOP as irrational....simply look at the record in the House of Representatives (the body they control with a majority).  They have voted over 40 times to stop Obamacare knowing very well that Senate will not agree and Obama would veto their attempt.  Best evidence of GOP irrationality is the just past government shutdown.  All GOP done by Cruz from Senate and the sheep who followed him in House.  And let us not forget that Obamacare was a GOP idea and has been implemented by GOP governor Romney in Mass.  I can go on here for pages....but this is plenty.

2. Free money.  Obamacare mandated that all States must provide healthcare (Medicaid) to poor folks and expanded the definition of poor folks.  Supreme Court changed this to optional for the States. States that accept this increased coverage will spend some big bucks.  But US government is giving each State 100% of increased costs for 3 years than 90% after that.  The 10% remaining that States will pay is far less than what States today pay for all the uninsured folks who use the emergency rooms.  No question....free money to each State that participates.  And my definition of "irrational" includes any State which turns down this free money to provide healthcare to the poor just because of politics.....and the State pays anyway at the ER.  Clear best example of this madness is Texas, which has greatest number of uninsured people of any State and turned down this free money.  This is in my view, both irrational and heartless.

3. Reality is making the best arguments here.  Simply look at California, where the State is co-operating and Obamacare is HUGE success already....and it will get better.  How does Texas government explain to its citizens how they are deny healthcare to so very many??

OOXX,

s

My dear Mr. H,

1. 

"Call me irresponsible, call me unreliable
Throw in undependable too
Do my foolish alibis bore you
Well, I'm not too clever,..

Call me unpredictable, tell me I'm impractical
Rainbows, I'm inclined to pursue
Call me irresponsible...(and I do adore you)"

But please don't call me Irrational.

Yes, Governor Romney did implement a healthcare plan in Mass which, as simple me understands, has worked quite well.  How did that happen without all the free federal money and intervention?

2.  Free Money.  I have this visual image of our President with fistfulls of money, passing it out to the 47%, while the US Treasury is frantically busy printing up more and the House and Senate must keep voting to raise the debt ceiling to keep up...All while the ceiling of our credibility as the world's financial leader keep lowering.  That's what I call madness.

3.  Time will tell.

Enough fun for a while.  I've done my job (and well, I might add).  I've got your blood stirring, your brain ticking (well, not really--That brain's always ticking) and have offered myself up as a whipping post for your frustrations. 

I'm just a simple, emotionally driven gal.  Now I've got to do some real homework so I can return with some actual intelligent arguments for debate.  One last thing...You accuse the Republicans of tunnel vision and withholding positive facts about Obamacare.  Might I be I so bold as to question whether you use some of the same tactics in defending it?

ooxx backatcha

My gosh... don't ya get it?  Obama care is about CONTROL. Control of your (and my) life, thru healthcare. It is over 20% of our economy. When the Socialists control you , they will, of course, control your vote.

Hi Carol,

You clearly enjoy typing more than I do. 

Point by point reply:

1.  Romneycare (Mass) is a State program, so clearly there was no federal money.  The State paid to assist those who needed help paying for insurance.  Tough to have free money when only one party involved.  Money paid by Feds to States under Obamacare covers 100% of expanded Medicaid cost for 3 years than 90%.  That is as free as can be for 3 years for the State recipient.  As I have already said (and to which you do not respond....because there is no acceptable response), ultimately the taxpayers pay for it all under Obamacare AND as they did pre-Obamacare (through the emergencies rooms).  Don’t the taxpayers really want the least expensive system that delivers the best possible healthcare?  Sure they do.  That absolutely was not the state of affairs before Obamacare.  And I say again, we can do much better than Obamacare if politics and racism were not factors, but they are (certainly not for everybody in Tea Party, but with many......just look at their rally signs!).

2. Sorry, Obamacare has already and will overall continue to save money.  I include here the dramatically increasing costs of healthcare in USA....which Obamacare has already reduced significantly.

Ms. K, I am happy to be wrong, as I can learn from it.  But that takes facts and logic.  With great respect, some of your facts are incorrect.  I will send you information from objective sources as I come across it in the future.  Also, you fail to address to key problem, which is 35-40 million US citizens who did not have health insurance (and many more with just plain shitty health insurance) in a system of spiraling costs and private profits.  There is lots wrong with Obamacare and I am happy to talk about that also......but I will return over and over again to the key question that I have never heard answered by any Republican in Congress: what is the alternative to solving the health insurance/cost problem in the USA?  Americans have this delusion that US healthcare is best around.  Well, check any worldwide statistics to see how wrong that is, AND what the hell difference does it make to all those who cannot (or could not) afford access to that system?

---finis---

000XXX

Hi Jack,

Welcome to the chat and thanks for contributing. 

I have a few questions.  Apparently I do not get it.  Who is controlling us and how?  I thought that everybody was free to choose his or her own insurance company.  How is that control?  You can even choose no insurance if you think that wise.  The so-called penalty has no teeth as you can ignore it and nothing will happen.  So, what am I missing, as you clearly see things differently.

You are over 66 and worked for Wells Fargo so I think you are now enjoying Medicare and Social Security.  Do you feel the same about these two programs?  If not, why not?

Thanks again for showing up.  Living here I so rarely get to chat about these topics.

steve

Jack, if you are worried about someone controlling your life through healthcare; I would focus on health insurance companies that are have historically been putting their bottom line profit ahead of the American Public's healthcare needs.  Especially if you are less well off than most of our classmates. 

I know Mr. Hirschtick said "finis" relative to my contributions here, so accordingly he need not read or respond.  And while  I am doing some research before adding any more Obamacare comments or opinions, in response to our enjoyment of Medicare and Social Security:

They are programs which we paid for WHILE we were paying for our own health insurance, thus not a source of government entitlement.

Nope.......I said "finis" solely because I was finished with my entry.  It had zero to do with your entries.  I have no ability whatsoever to effectively tell you when to make entries or when to cease. 

s.

Please check facts.  Social Security and Medicare are indeed government entitlement programs, as many recipients receive more than they contributed.  Similarly, many beneficiaries of Obamacare receive zero money from government.  All they get is the opportunity to purchase and pay for health insurance.

I welcome yours and anyone else's comments.....and what different does it make if I don’t?  We are each our own bosses.

s.