Deadline Day, or Not...

[exedir]

It probably should not be named ObamaCare, and yes, now that isn't the preferred name either, and surely it could be more correctly named, FlexCare or Let's Fix It Care...or something.

And no, not a surprise that another hard fact about implementation is being changed, as the December 23rd, the must do date to have coverage on the January 1st has been extended to until Santa's arrival, tomorrow. And yes, if it makes the Affordable Care Act more viable, then its another rightful change in making it work.

But does it? Have all these changes in what was, to what is necessary, going to make it all better? Probably not, not without more changes.

This has been true along as the entire ACA at it was, and is, full of difficulties and assumptions that weren't and aren't going to happen. And yes, the design, much less the legislation, was a lot of wishful thinking, or maybe just wishful politics.

To say what we have here is a mess, doesn't have to wait until January 1st. And it is going to be, for the Republicans, a gift that keeps on giving as winter turns into spring and beyond. Not to say that there are any real alternatives to what the ACA is attempting to deal with, and repeal does not get us back to where we started.

Heath care financing is broken, and the impact is going to be felt in the delivery of medical services in that there is going to be trouble in getting access as providers have to make choices with a increase in demand that is baked into the ACA. Confusion and consternation is but the first wave of how the changes will be felt and portrayed, real care and treatment issues will follow.

Was any of this necessary? In the end, probably not, though change happens, it does not usually happen without difficulty, sometimes of one's own making.

[LoveLife&Laughter]

You do know there is a Rx pill for obsessive disorders?

Merry Christmas  :0)

[Ioruach]

I was working for the Social Security Administration (SSA) in Chicago when health care for the elderly was enacted into law. The term “Medicare” was coined by someone in the media and was not part of the law itself.  SSA was given the task of implementing and running the new program.

To do this, the Bureau of Health Insurance was created within SSA, a fancy new building was built next to the original SSA headquarters on Security Blvd in Baltimore, hundreds of SSA employees from around the country, including yours truly, were brought into Baltimore and many others were hired from private businesses, including insurance companies. 

As with the ACA, there were problems with the implementation.  Many of them.  But I don’t recall the degree of the rancor and bitterness that exists today from the Republicans. Of course, Republicans in office at the time had mostly voted against it, but after all was said and done, they generally accepted it and moved on.  We live in different times.   

[exedir]

Indeed, 1964 is now almost 50 years ago.  

It was President Johnson that whipped this expansion of Social Security through Congress, and did so with a new tax added to the FICA, and as a Kennedy legacy.  At the time the Republicans were moving from the east coast financial elites to the discover a new strategy on conservatism as envisioned by Goldwater and the John Birch society.  This morph into a southern strategy as the Democratic party diminished and expelled its traditional southern wing which was more in line with the old Copperhead Democrats, those against reconstruction and instituting and sustaining Jim Crow. 

As to implementation, Medicare made Ross Perot a wealthy man.

[ProblemAgain]

the term 'obamacare' is nowhere in the law...and was not coined by democrats but rather by some shrill republicans in an attempt to 'tar' the affordable care act with the uncle remus brush for their redneck constituents.....that's that socialist, commie atheistic, muslim nigger medicine...might end up being ironic that, once the kinks all get worked out, that obama is immortalized by the term meaning virtually universal medical care in our country at last, much to the teethgnashing and disgust of peckerwoods everywhere

[Ioruach]

Yes, I certainly hope that the term "Obamacare" doesn't stick around like "Medicare" has. 

But look at the good news today:  Putin has let the Pussy Riot gals out of the slammer.

[LoveLife&Laughter]

Let's hear it for Putin!

[ProblemAgain]

from the motley fool which has been against the affordable healthcare act

Read This Before You Judge Obamacare

By Patrick Morris | More Articles | Save For Later
December 21, 2013 | Comments (18)

The Patient Protection and Affordable Care Act, otherwise known as Obamacare, is one of the most hotly contested pieces of legislation perhaps ever, but there is one thing people need to know before they make a judgment of the controversial plan: The nightmarish financial path that was the status quo.

An unsustainable path
There is no denying that the cost of health care in the U.S. has been traveling on an unsustainable path for the better part of the last 50 years. Consider the U.S. government's spending on health care as shown in the chart below:

Source: Bureau of Economic Analysis.

While it's easy to think that because of inflation, it's obvious that chart would look odd, but when shown on a comparable scale to total federal government spending, you can see how dramatically the spending on health care has outpaced total spending:

Source: Bureau of Economic Analysis.

Health care expenditures of the federal government have risen on average by 12.4% per year since 1959, whereas total expenditures have only risen by 7.4% -- a 5% difference. But it isn't simply the government that's spending more on health care -- individual Americans are, too.

Consider that the personal spending on health care has risen from $1.2 trillion in 1999 all the way to $1.7 trillion in 2012, an increase of 50%. This is all while all other expenditures (excluding health care) have only grown by 33%:

Source: Bureau of Economic Analysis.

Yet it isn't as though the average American can easily keep up with this unsustainable growth in health care spending, as the median household income in the U.S. has actually fallen by almost 10% over the same time period:

Source: St. Louis Federal Reserve.

All of these trends led the bipartisan Congressional Budget Office (CBO) to estimate that while the U.S. currently spends 17% of its GDP on health care and related services, that number would balloon all the way to 40% by 2080. Even more troubling, it isn't even as though our health care system has led the to the best outcomes -- a healthier public -- as Bloomberg recently noted, "the U.S. spends the most on health care on a relative cost basis with the worst outcome."

No matter what you think of Obamacare, it's clear that something needs to be done about health care in the United States.

Moving forward
In all of this, we can see why President Obama and many politicians of both parties were so keen on attempting to change the health care system. There is no denying that the current rollout of Obamacare has seen problems, and it may in fact not even be the best solution. But there is also no denying that the health care system in America was (and still may be) spiraling out of control.

Many want to say that simply getting rid of Obamacare would fix all of our current problems, but the previously mentioned CBO also noted that repealing the Affordable Care Act -- as proposed in 2012 by John Boehner -- would actually increase the Federal Deficit by $109 billion between 2013 and 2022.

A June 2011 paper from the National Bureau of Economic Research, Jonathan Gruber, a former Mitt Romney advisory, noted simply when discussing the Affordable Care Act; "[w]hether these policies by themselves can fully solve the long run health care cost problem in the United States is doubtful. They may, however, provide a first step toward controlling costs -- and understanding what does and does not work to do so more broadly."

The reality remains that it is entirely too early to tell what the ultimate impact of Obamacare will be and whether or not it will be a success or a failure. But what we all must know is that health care in the U.S. needed to change, radically, as it was leading our country down an unstable path.

[exedir]

The issue is unsustainability, how we finance medical services.  We have used the insurance model as the under pinning of the whole scheme and then making payments on a fee-for-service basis making what we buy and what we get as to medical services the most expensive in the world.

There are a lot of reasons why we have what we have, but the point is that it can't continue, that you can't keep your health insurance plan based on fee-for-service, and you can't have unlimited choice as to what and who provides services. 

Affordable Care Act nee ObamaCare or whatever it gets called, is probably a bridge to no where in that as it is currently setup it does not change the problem or even treat the symptoms of what ails us, so to speak. What it is, is a political solution to an intractable problem of limited resources, unlimited demand and in the end the same result, postponed at best. 

[ProblemAgain]

the problem at the time was getting ANYTHING thru congress as the 'campaign donations' from lobbyists and corporations involved in insurance and providing healthcare and related goods and services poured into the chests of senators and representatives in order to keep the cow on the milking machine ...there was NO WAY the for-profit corporations were going to take this lying down...at least not without getting paid for lying down

[LoveLife&Laughter]

Not true Ex.  Fact is we couldn't have continued the old way -- something had to change.

The ACA does that.  

[LoveLife&Laughter]

"Affordable Care Act nee ObamaCare or whatever it gets called, is probably a bridge to no where in that as it is currently setup it does not change the problem or even treat the symptoms of what ails us, so to speak"

Baloney, "so to speak."

I know Conservative are not allowed to admit it, BUT that's exactly what it does do.

[exedir]

In the Christmas spirit and as a gift that keeps on giving, what deadline?  

Nope, if you were attempting to sign up and some how got screwed up, you can run the process until the 31st, more or less.

As implementation is concerned, it is and remains a mess, and the mess will be worse in that as of the supposed date of coverage, there is no way those policies can be issued and the payments confirmed to validate the plan chosen.  And the blame for this Grinch act in Whoville?, the insurance companies, of course, in that their back offices can't cope with the demand or provide a level of customer service to match expectations much less demand for payments.

Actually, it will all fall on the providers and patients to sort this all out, including the frustration that is going to be a part of what will happen as it all unwinds in the media klieg lights with the blathering talking heads tsk-tsking, and yes, it was all avoidable, but then again, that is politics of health care, a promise with a hope you will feel better in the morning.