I have to admit, I was disappointed with the compromise the ACA ended up being. I’m someone who has been lucky enough to have had insurance for decades, so aside from the free physical every year, it really hasn’t affected me. If the noises Trump has been making about a universal plan are more than smoke and mirrors, (I know. Trump.) I could be willing to get behind him on this one. But I don’t think a Republican Congress has any desire to go down that road.
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Tell me about it. The lab I came from in the US has a football-field sized-room packed with customer service agents in cubes elbow to elbow who spend their entire days talking to unhappy patients and asshole insurance companies getting past initial denials. They are necessary to get claims paid, but add nothing to the quality of healthcare we provide. Maybe 300 people, and that’s just for southern California-- all our other regional labs have as many or more. My lab here has… zero.
And I pay $800/month for excellent coverage for my entire family, vs. $2000/mo I was paying in the US. And if/when we are accepted for political asylum and/or permanent residency, it’ll be half that.
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I just did a quick search on Gofundme.com for “medical” and got a mind-boggling 1,242,814 results.
What the hell is wrong with you America?
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"Even if you think you have good insurance, "
I don’t know of anyone who feels they have “good” insurance, except for maybe someone who works for he Federal Government.
Personally my deductible is so high, I just pay the cash price on visits for the most part.
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Me too, but if that compromise had existed a few years earlier then my mother-in-law might have lived long enough to meet her grandchildren.
There are plenty of reasonable arguments for improving on the ACA but I’ve yet to see one for repealing it before we have something better in place.
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It’s actually very simple…insurance companies make tons of money when they receive lots of premiums from young, healthy people who don’t need much health care and they lose money on old, sick people who actually file claims. They love that the ACA mandates coverage but hate that they can’t control who they sign up.
The risk pools is what makes the ACA work in actual practice - requiring young, healthy people to have coverage (or otherwise pay a penalty) subsidizes the old and sick. This is the part that pisses off Republicans the most. Take away the mandate and the whole thing collapses into the so-called “death spiral”.
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so, what you’re saying is that the insurance company’s are actually [halo]Job Creators[/halo]?
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They sure are! Especially if you consider the additional staff required by providers to deal with the insurance companies. They’re not exactly good jobs, though-- mostly they’re entry-level call center jobs. Anything interesting gets kicked up to a more experienced billing analyst.
It’s not unusual to see medical practices in the US that have more billing and insurance people than they do medical staff.
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And you want to destroy all that? That’s … that’s … why that’s just un-American! Are you a traitor!?
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Not every country. Switzerland and, I think, Germany have systems of compulsory insurance that are in some ways similar to the ACA except that they cover everyone.
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Some would say so. My family and I live in Belgium now, and have applied for political asylum in the EU. We’re sitting this one out. America right now feels like 1933 Germany. (Though if Trump kills NATO and Russian tanks come rolling down my street, I shall wrap myself in an American flag and explain that it was all a mistake.) 
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The main issue the insurance companies have is that they’re forced to cover people with pre-existing conditions. They’re not really happy about having to cover preventative care, either, since that’s paying out to healthy people.
The real organised opposition comes from corporate America, who had gotten used to making health insurance a way to chain down their employees.
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I have an individual policy, bought off the exchanges. Insurance was simply unaffordable prior to Obamacare, given my preexisting conditions, if it was available at all. For me, the ACA has been pure win (i.e., I get to treat my conditions), and also in line with how I think the world should be.
But I have a friend who gets employer-based healthcare, and according to him his employer-based plan is now taxed as a benefit, meaning his taxes have gone up without any additional benefit. I don’t know all the details of his circumstance – like, are there off-setting deductions – but he’s screaming about this when he hates on Obamacare.
Is this a known fact about the ACA for people with employer-based plans? Is the taxing of these plans part of the ACA at all, or was that separate?
I say “for no additional benefit”, but actually he benefits by, should he change jobs or go without work for a time, being able to get coverage without regard to preexisting conditions, and at rates much more reasonable than before the ACA if he picks up an individual/family plan.
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How is a colonoscopy expensive? It’s not as if it takes very much time and it doesn’t require anaesthesia. A couple of hundred dollars should surely be more than enough. Or is that counted as expensive for an insurance company. If it is too expensive then it’s about time that some of this sort of procedure was standardized and industrialized.
I’ve had one, in Norway, not the US so it only cost me about USD30 for the egenandel (literally own share), similar to the copay idea.
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Proving, of course, that they are mind bendingly stupid in addition to being profoundly evil.
Because 'Murica, fuck yeah!
(seriously, it’s expensive because it’s not a free market and they can make it expensive)
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[quote=“JonS, post:35, topic:93013, full:true”]
Proving, of course, that they are mind bendingly stupid in addition to being profoundly evil.[/quote]
Just short-sighted. That’s what happens when American-trained MBAs take over a business.
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There’s a difference?
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It’s generally done under anesthesia in the US. Usually propofol and fentanyl, and it’s done in an outpatient facility. Turning the corner from the transverse colon to the ascending colon can be quite painful. Are you thinking of sigmoidoscopy, where they only look at the rectum and descending colon, not further up the line?
As for the cost, you’re thinking sensibly, which does not apply in US healthcare. More info:
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Sounds like the complaint that people from the US side often make about socialism.
What happened to the market solving all the ills of the world? 
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Employer sponsored health insurance plans are not income and therefore not taxable by the IRS so your friend is full of shit*. The ACA does require employers to report the cost of coverage but not to tax it. Now companies can always adjust the amount of coverage offered so he may be paying more out of pocket now than before - but that was happening pre-ACA as well (and at an accelerated rate too).
Does the cost of an employee’s health care benefits shown on the Form W-2 mean that the benefits are taxable to the employee?
A. No. There is nothing about the reporting requirement that causes or will cause excludable employer-provided health coverage to become taxable. The purpose of the reporting requirement is to provide employees useful and comparable consumer information on the cost of their health care coverage.
*however, the actual benefits paid out on claims may be taxable depending on things like income limits and who pays the premiums. Doesn’t mean the value of the plans themselves are taxed as a benefit like Medicare or FICA.
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