What do you think of Obamacare?
Having worked in the Canadian single payer system and our own for profit hospitals, I greatly admire and prefer the Canadian. From the point of view as a critical care nurse, I loved being focussed on treatment first. The second the patient hit the triage desk we were about treatment only. The bureaucracy came later. In the USA nurses and doctors are expected to count each individual gauze, every tube of lotion, and every second spent on billing is time spent away from providing care. In Canada we just do our nursing duties and let stores and accounting count the costs. Accounting is a place a single payer system saves Canadians a fortune. In the USA we have entire towers filled with bookkeepers and accountants, not to mention the required collections department. Canadian hospitals have accounting departments that take up less room than most nursing units, which leaves the towers available for more patient beds. Fewer accountants means more nurses. People who argue that their system costs more fail to take this efficiency into account. Obamacare is a small step towards that superior Canadian system, where every citizen is covered through the general revenues of the tax system. In Canada there has not been a medical bankruptcy in the last half century, and no person has been denied treatment because of a pre existing condition. I never worked in Europe, but nurses and doctors have assured me that this is true in every industrialized democracy but ours. In terms of access to health care we are number thirty seven! The Canadian system is great for doctors as well, although the younger ones do not realize it because they do not remember how they used to need five clerks for the single one they employ today. They also do not need bill collection agencies and lawyers to track down their patients. Seriously, the Canadian system save so much on bureaucracy that can then be spent on parient care! I admit this is more about private care, including the Obama version, versus single payer universal coverage, but my point is that I think Obamacare is a very small but significant step towards equality with Canada and the European Union. That's why I will vote for a Democrat who supports single payer before any other candidate in the upcoming primaries. We deserve to be at least as good as Portugal, don't we?
What do you think of Obamacare?
“The Obamacare”, really Affordable Care Act, has two parts. One extended Medicaid, the program for the poor, to more people, particularly single people without children, who were not previously eligible. Unfortunately this became optional for states, so many people were STILL not covered.The second part set up a “marketplace” for individuals not poor enough for Medicaid and not covered by a health insurance plan from their employer. An attempt was made to keep it affordable by subsidizing the premiums. It still did not provide health care, just some sort of access to health insurance. It had several useful rules: children could remain on the parents’ insurance until age 26; insurance could not be denied because of pre-existing conditions; and there were minimum standards of coverage. These rules also applied to the insurance obtained through the employer.These did not provide insurance to ALL AMERICAN CITIZENS. There were big holes left. The states that did not extend Medicaid, of course. And there were people who could not afford the offerings of the “marketplace” no matter how they were subsidized. They were allowed to go without and not pay a penalty.Yes, it is a KLUGE. But the “public option” was not allowed. And the implementation was not entirely in good faith. And anything that is not national is going to be subject to the vagaries of the states’ politicians. It was a good start, considering what existed before.The original question has changed; the premise was that insurance was provided to all Americans, which is false.
What do you think of Obamacare?
I don't like Romneycare (let's call it by it's correct name, okay?). It is flawed. But it has one virtue that outweighs its flaws. For 3 decades it has been obvious we need to change the way we deliver and pay for health care in America. The ACA a least gets us off the starting block. That makes it worthwhile. As for suggestions: first, prohibit insurance companies from making medical decisions. Second (you touched on this): preventative care. You mentioned lifestyle diseases. However, most medical problems are far less expensive to treat if you catch them early. Shifting insurance and treatment policy toward preventative care works. It saves huge amounts in the long run. Another point: we are wasting $50-$100 billion per year (or more) by incarcerating people in nursing homes who could live independently with some assistance. Plus, they would get a better quality of life. But Medicare won't pay for it. You are wrong about eating and exercise -- you left out smoking. The sick thing about this is there is are viable solutions. For example, electronic cigarettes do not have ANY of the tars and carcinogens that kill people. Yet the FDA continues to ignore studies (by institutions like Boston University, not fringe groups or commercial producers) that show this particular approach works -- extremely well. Instead the government continues to attack a proven alternative to killing people with tobacco. That policy has to change. Those are just a few things to think about. Three are a lot more. But look at them closely: EVERY ONE implies some unethical businesses getting their dishonest and exploitative business methods curtailed.
What do you think about Obamacare?
There are mixed opinions about it. Some think it is ruining the country. Others think it shows how much Obamacares about us. Thanks to Obamacare insurance companies can't deny you coverage for whatever reason. Everyone can now have health insurance. So do you think Obamacare is a good or bad thing? And why?
What do doctors think of Obamacare?
I think that it's a step in the right direction. It's far from perfect, and fails to address some of the basic reasons for health care inequity. I think we need to adopt some of the strategies used in high quality manufacturing: identify opportunities for improvement, measure, develop ideas for implementation. Implement. Measure. Repeat.Doctors and medicine on the whole are used to a craft model of healthcare, and since we lacked any means of effective population health interventions until recently, we went with what we had.Now, while I firmly believe that medicine needs a personal touch, not everyone with a sore throat needs a 45 minute evaluation. Most just need a basic history, a set of vital signs, a basic exam, and maybe a strep test.Most diabetics need brief, but frequent "touch ups" to keep them on track with their medications and behavior regimens.ACA/ OBAMACARE doesn't really address the problems with the fee for service model, that gives a "churn to earn" incentive for health care executives to push onto their providers.There are some changes though which are promising. One of these is the accountable care system, where an insurer/ payor like Medicare pays a certain amount of money per individual per year, and sets standards of care that need to be met during the year. If the provider system is thrifty, they keep the extra. If the system is wasteful, they get soaked.The important thing is to take care of the patient. Any system that sacrifices that tenet will fail. Quality can be had along with efficiency, but many approaches may need to be tried before an optimal one is found for most people.Systems need to be designed so that it is in everyone's best interest- payors, providers, and patients - when patients are healthiest, and conflicts of interest need to be avoided, especially with payors.ACA was a step in the right direction, but it needs to be the first of many steps along a path of continuous improvement.
What do you think about the Obamacare Repeal Bill?
Obamacare or ACA as it is actually named wasn't repealed. Congress tried 70 times and wasn't successful. There are problems with the law but instead of fixing them the Republicans just want to end it. Going back to junk insurance policies that covered nothing isn't helping the American people. Stopping coverage for pre-existing conditions isn't helping the American people. Cutting out mandatory covered services such as cancer screening, mammogram, etc isn't helping the American people. Stopping kids from staying on their parents policies isn't helping the American people. Cutting assistance to low income families who need the subsidies isn't helping the American people.Fix the problem with this law. But turning us back to millions of people not able to get coverage or see a health care provider isn't helping the American people. Creating situations where one illness or injury can cause bankruptcy isn't helping the American people.
Do You Think Obamacare Will Work Or Fail!?
Its already a failure and will continue to remain so. The obamacare supporters here can point to its wonderful sounding regulations all they want, the outcome of those regulations have proved to be disastrous. Thats the one thing they cant and wont do: admit to the terrible consequences of this law. Way back before it was signed into law, they were promising that this law was the answer to all our problems. This would be the legislation that would deliver all sorts of miracles and fixes. Instead the exact opposite has happened. And it has added way more problems on top of the old ones. Now the same people who pushed this garbage on to us with all their phony promises, are now pushing single payer, along with making the same promises all over again! I think they should fulfill all their promises regarding obamacare before they even talk about changing our health care system yet again.
Do You Think ObamaCare Is A Good Or Bad Idea?
How's it working out for everyone? Not too good sofar. I think down the road, it will get worse. After all, Obama has threatened the America people that if they don't sign up, they will be fined,. That's not how American presidents are supposed to do business.
Why do many liberals think Obamacare is a success?
Let me add one more success story.. I have a heart condition, I’ve had it all my adult life and I’ve had 4 heart surgeries - 3 open heart surgeries and one minimally invasive surgery. 15 years before the ACA came into existence, my health insurance was cancelled by my provider after my last heart surgery and since that day getting health insurance has either been incredibly expensive or just impossible. When the ACA went into effect, I got health insurance for the first time at the same rate as other people, through my employer. It was, to me, an absolute miracle. I was able to afford the preventative care necessary for my condition (which, by the way, was mostly corrected through the last heart surgery and I was no longer a huge insurance risk….but that’s a different story) and felt, for the very first time, safe. That year, I also needed a hysterectomy due to a cancer scare and didn’t worry about the costs, which, after surgery, were about $500 in co-pays.But that wasn’t the biggest benefit for me. I was laid off in 2016 and received information on COBRA. It was $400 per month! Generally, if I did receive a COBRA letter after getting laid off or when a company went under (which was rare), it was for $1800-$3000 per month. $400 was incredible! But, I didn’t have to do it. NYS embraced the Medicaid expansion and while on unemployment, I received Medicaid. First time in my life I had health insurance while unemployed and I didn’t have to worry about using my pittance of unemployment dollars to pay for it. During that time period, I had emergency gall bladder surgery for a blockage and paid NOTHING. (Some may say I am living off of the welfare of others while on Medicaid and I say, bite me. I have worked and paid my taxes for more than 25 years and didn’t have health insurance for many of those years. I think I earned a year on Medicaid.)The ACA truly did save me. It saved my life when I had the cancer scare - I got the surgery I needed without constant stress of bills and debt. It saved my life when I had emergency gall bladder surgery. And when I go back to work this month, I will be eligible, once again, for employer provided health insurance. Does it have problems? Sure, but I would rather have it and push our government to fix those problems than have nothing again. And, I think, so would most of us.