Were things better before Obamacare?

Chew Toy McCoy

macrumors regular
Original poster
May 13, 2016
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Or are all the haters taking a big dip in lake selfish and really don't care about the big picture and how it might benefit other people? I really don't know. I've had employer provided healthcare. It seems like the people who really want to keep it are acting like millions of people will drop dead within 6 months as a result of it being taken away. Does that mean tens of millions of people were dropping dead before it existed?

I come to this forum for all the answers.
 

darksithpro

macrumors 6502a
Oct 27, 2016
582
4,492
The federal Government is insufficient. Policies and laws are better at the state level, where the state knows what works and what doesn't for it's citizens. This is a conservative policy. The FEDERAL one size fits all ideology is flawed and the conservatives and liberals know it. Less Government is better for everyone.
 

Zenithal

macrumors G3
Sep 10, 2009
9,033
10,113
where the state knows what works and what doesn't for it's citizens.
Highly debatable. Indiana, Kansas, Connecticut, Arizona, etc. know nothing and ****ed up.

Indiana had and probably still has the worst outbreak of STDs and STIs in US history thanks to Pence. Kansas' tax experiment that Trump's plan is based on failed miserably. Connecticut raised taxes across the range, especially high networth individuals. These people moved out of state and Connecticut has been failing at its budget for years. Their public school system is a mess as a result. Arizona's immigration laws and that dumbass Arpaio caused major issues for the state and taxpayers within. It cost US taxpayers money for the government to go after Arizona.

States may believe they know what's best. Sometimes they're right. Sometimes they're wrong. They're rarely remembered for the right things. They are remembered for the bad things.

Poor red states screwed over their low income constituents by limiting ACA subsidies. Leading people to complain. These same politicians are on board with repealing ACA and making the insurance market far more hostile towards consumers than they were prior to the ACA, effectively allowing insurance companies to find any reason to deny a claim or deny the ability to purchase insurance.

It's all fine and dandy until something tragic happens. Of course, as I've said before, you could start a GoFundMe page like a freeloader instead of working to buy better insurance. Too bad. Enjoy the funeral.
 
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citizenzen

macrumors 65816
Mar 22, 2010
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The federal Government is insufficient. Policies and laws are better at the state level, where the state knows what works and what doesn't for it's citizens. This is a conservative policy. The FEDERAL one size fits all ideology is flawed and the conservatives and liberals know it. Less Government is better for everyone.
You must have hated the space program.

Had states developed their own programs according to their needs and means, Alabama’s would’ve consisted of firing bottle rockets out of empty beer cans.
 
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Zwopple

macrumors regular
Dec 27, 2008
118
494
Or are all the haters taking a big dip in lake selfish and really don't care about the big picture and how it might benefit other people? I really don't know. I've had employer provided healthcare. It seems like the people who really want to keep it are acting like millions of people will drop dead within 6 months as a result of it being taken away. Does that mean tens of millions of people were dropping dead before it existed?

I come to this forum for all the answers.
I'd say for people that had affordable insurance (not via employer) before and no pre-existing conditions yes things were probably better before the ACA.

Before the ACA it was common to hear about people going bankrupt due to illness, even insured people due to hitting lifetime limits or insurers finding some unrelated pre-existing condition to dump them.

It's hard to know exactly where the markets would have ended up w/o the ACA but my guess is they'd be roughly the same except the same ****** clauses that allowed insurers to screw you over when you finally had to lean on them.

The problem with the ACA is it did nothing to actually control the actual cost of care, and until that happens no healthcare plan is going to work because the system has too much fat being scraped by too many parties.
 

shinji

macrumors 65816
Mar 18, 2007
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Or are all the haters taking a big dip in lake selfish and really don't care about the big picture and how it might benefit other people? I really don't know. I've had employer provided healthcare. It seems like the people who really want to keep it are acting like millions of people will drop dead within 6 months as a result of it being taken away. Does that mean tens of millions of people were dropping dead before it existed?

I come to this forum for all the answers.
Things weren't better for people with pre-existing conditions who couldn't get coverage before.

It also helped millions of people in Medicaid expansion states and improved coverage in the individual market.

Some of the haters took a dip in Lake Selfish and/or Lake Nobama, but others do have a valid complaint that deductibles are insane for many plans now, something that wasn't always the case. It's possible for a plan's deductible to be so high now that it actually makes more sense for the patient to negotiate a cash price with the provider.
 

citizenzen

macrumors 65816
Mar 22, 2010
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... Does that mean tens of millions of people were dropping dead before it existed? ...
At least tens of thousands annually ...
... we calculated 27,424 deaths among Americans aged 25 to 64 years in 2000 associated with lack of health insurance. Applying this hazard ratio to census data from 2005 and including all persons aged 18 to 64 years yields an estimated 35,327 deaths annually among the nonelderly associated with lack of health insurance. ...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775760/
 

bradl

macrumors 601
Jun 16, 2008
4,006
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The federal Government is insufficient. Policies and laws are better at the state level, where the state knows what works and what doesn't for it's citizens. This is a conservative policy. The FEDERAL one size fits all ideology is flawed and the conservatives and liberals know it. Less Government is better for everyone.
Policies and laws are better at the state level? At the State level, the State National Guard was sent out to support segregationists and possibly shoot those who were supporting integration for nine black kids who were simply going to school. The governor of said state was also in violation of integration, per Brown v. Board of Education.

At the State Level, a white man and a black woman were both put in jail because they loved each other, but apparently, the State couldn't handle it, with its anti-miscegenation laws and race laws that they had.

At the State level, you had governors proclaiming "segregation today, segregation tomorrow, segregation forever!", as well as their own officials supporting the KKK.

Policies and laws are better at the state level? b*******.

Back on topic, as far as healthcare goes, I would also disagree that state laws are better. If a person on a state's Medicaid gets injured out of state, their insurance may not cover everything, as they are outside the jurisdiction of coverage of their state. Additionally, this wouldn't even be applicable under Article 4, Section 1 of the Constitution.

the only way for this to be done, without having 50 different implementations that would have to have 50 different variances of it to be honored by all 50 states, is to have it done at the federal level. That is why it works so well in other countries, instead of the spitwads, chewing gum, and tape being used to cobble together what we have now.

BL.
 

blackfox

macrumors 65816
Feb 18, 2003
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Policies and laws are better at the state level? At the State level, the State National Guard was sent out to support segregationists and possibly shoot those who were supporting integration for nine black kids who were simply going to school. The governor of said state was also in violation of integration, per Brown v. Board of Education.

At the State Level, a white man and a black woman were both put in jail because they loved each other, but apparently, the State couldn't handle it, with its anti-miscegenation laws and race laws that they had.

At the State level, you had governors proclaiming "segregation today, segregation tomorrow, segregation forever!", as well as their own officials supporting the KKK.

Policies and laws are better at the state level? b*******.

Back on topic, as far as healthcare goes, I would also disagree that state laws are better. If a person on a state's Medicaid gets injured out of state, their insurance may not cover everything, as they are outside the jurisdiction of coverage of their state. Additionally, this wouldn't even be applicable under Article 4, Section 1 of the Constitution.

the only way for this to be done, without having 50 different implementations that would have to have 50 different variances of it to be honored by all 50 states, is to have it done at the federal level. That is why it works so well in other countries, instead of the spitwads, chewing gum, and tape being used to cobble together what we have now.

BL.
Well said.
 

MadeTheSwitch

macrumors 6502a
Apr 20, 2009
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Or are all the haters taking a big dip in lake selfish and really don't care about the big picture and how it might benefit other people? I really don't know. I've had employer provided healthcare. It seems like the people who really want to keep it are acting like millions of people will drop dead within 6 months as a result of it being taken away. Does that mean tens of millions of people were dropping dead before it existed?

I come to this forum for all the answers.
Oh hell no things were not better. I have first hand knowledge. In between jobs with a preexisting condition? Sucks for you, pay through the nose when you have no income with little options. That makes sense. Low or no income? Good luck finding someone to see you where I live. Obamacare changed all that as the medicade expansion really did expand choices where I live. Major healthcare systems like Kaiser started taking patients. I can't tell you how much better it is to have all your records in one place and not have to resort to finding a hodgepodge of doctors out of a phonebook with no assurances that the labs etc. that they send you to will be covered. So very much better now than how it was.
 

bradl

macrumors 601
Jun 16, 2008
4,006
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Were they better before the ACA?

Let's take a trip back in time.. 19 years ago, in 1998, when this was aired on live TV. In fact, afternoon cartoons were interrupted for this, as it happened between 3pm and 4pm PT in Los Angeles.

https://en.wikipedia.org/wiki/Daniel_V._Jones

Daniel Victor Jones (April 15, 1958 – April 30, 1998)[1] was an American man who committed suicide on a Los Angeles freeway in 1998. The incident is well known, as his suicide was broadcast on live television by news helicopters. Jones committed suicide as a form of protest towards HMOs, after being diagnosed as HIV-positive. Footage of his suicide was shown in the 2002 documentary film, Bowling for Columbine.
IIRC, this came on, pre-empting Pokemon and Power Rangers, so you know all of the kids at the time were home watching this. And yes, the cameras didn't turn away from this at all, showing the whole entire incident, up until he literally blew his head off.

There is video of this; in fact, amazingly, it is still around, as this predates YouTube, and barely comes in at the time of RealPlayer. Again, not for the faint of heart, so watch with care.

Link to the video

Again, this is all in response to how HMOs were treating their patients (not just him in particular), which had been systemic for at least 4 years prior to this. For those reasons, and the fact that HMOs require you to see them before seeing any specialist (read: must have a referral), I have always chosen PPOs. However, even with that choice, service hasn't been on par with what I have seen and had outside the US.

And I haven't even started on Medicare Part D, and how that has driven up costs.

BL.
 
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LIVEFRMNYC

macrumors 604
Oct 27, 2009
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It's way too early to tell. But from what Trump is trying desperately to push, the near future doesn't look bright.

On a social level, Trump is further aggravating issues that's already been aggravated for the past decade. Not a good look on his part.
 
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VulchR

macrumors 68020
Jun 8, 2009
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The federal Government is insufficient.
Agreed. That doesn't mean it is unnecessary though.

Policies and laws are better at the state level, where the state knows what works and what doesn't for it's citizens. ...
Prove it. Why does local equal better? I think local governments can be very effective, but that local governments can be more easily corrupted, more easily influenced by special interests, and can perpetuate what is in essence a class system in the US. In poor areas, local governments cannot raise enough funds to be as effective as they should be. Finally, some issues, e.g. infectious disease, must be handled on a national level.

If local government were optimal in issues like health, you would expect that there would be little variation across localities. The opposite is true in the US. Life expectancy can vary by up to 20 years depending on the county in which one lives and in some counties life expectancy has fallen between 1980 and 2014 (see link for summary of study that can be found at this link; map of the change in life expectancy from 1980 to 2014 below).




According to the original source cited in the link, about 27% of the variability in life expectancy across counties can be accounted for by variation in local health health care factors (albeit other factors such as wealth, ethnicity and lifestyle play dominant roles). Note that health inequality across counties has increased over time in the US according to the study.

One of the functions of the federal government should be to help even out disparities so that the playing field is even. Health shouldn't be a lottery based on where you live. Even if you blame adults for the health consequences of their lifestyle choices, you cannot blame newborns...
 
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samcraig

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Jun 22, 2009
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The thing many "against" or think the ACA is a disaster, broken, etc seem to forget is that it's a LOT of various elements. So it's hard to say better/worse before because it was more like - "different." There are a lot of things and protections within the ACA that are unequivocally better and somethings that are not. This is why a full repeal is dangerous. And why those against repeal/replace have their justified concerns. Especially with what has so far been presented.

Trump "talked" a good game to his base, but soon learned when taking office that Healthcare is not easy. Simply saying repeal and replace with something more affordable and better is lip service. Especially since the R's had sat down on the job for 7 years without really coming up with a plan.

It's easy to be an armchair critic (for us and definitely for Republican congresspeople) - doing the work is a lot harder.
 
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Herdfan

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Apr 11, 2011
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I'd say for people that had affordable insurance (not via employer) before and no pre-existing conditions yes things were probably better before the ACA.

Before the ACA it was common to hear about people going bankrupt due to illness, even insured people due to hitting lifetime limits or insurers finding some unrelated pre-existing condition to dump them.
So yes, for me they were better.

I had a policy I liked with the coverage I wanted, not what some government bureaucrat thought I should have. Premiums were mostly stable and increased 3-7% per year.

That said, there are some good things the ACA did such as remove the pre-existing condition limitation.

But overall it was an extremely complex solution to a complex problem. Perhaps a simpler solution would have been better. There was no reason to create the exchanges. The individual markets should have been left alone albeit with some of the consumer protections.

The create a public option. Let those who could not afford coverage in the individual markets buy into Medicare (or call it something else if you wish) and have them pay similar to what they are paying on the exchanges. Keep deductibles low so that it can actually be useful. (do any ACA supporters really think someone who makes $40-50K a year can afford a family deductible of $12K+?)

This would do a couple of things. It would have kept the markets stable. It would have given the citizens a taste of government health insurance, so if it was good and people liked it, they could sign up for it voluntarily. If it was not good, then, well hate to be a bit gruff here, but beggars can't be choosers.

Over time IF people liked the government run program, all the individual markets could move to it and employer provided market could have stay the way it was. A new market would emerge for additional coverage (like what my mom has for Medicare) that could be purchased optionally.

Just my thoughts.
[doublepost=1509032394][/doublepost]
Tell that to the people in Somalia who have a very small government, or those in any number of third world countries that have very few government services.
There is a balance point. I think we have gone a bit too far in this country with the government meddling in our lives. More money should be spent on infrastructure and less on non-essential stuff.
[doublepost=1509033114][/doublepost]
According to the original source cited in the link, about 27% of the variability in life expectancy across counties can be accounted for by variation in local health health care factors (albeit other factors such as wealth, ethnicity and lifestyle play dominant roles). Note that health inequality across counties has increased over time in the US according to the study.

One of the functions of the federal government should be to help even out disparities so that the playing field is even. Health shouldn't be a lottery based on where you live. Even if you blame adults for the health consequences of their lifestyle choices, you cannot blame newborns...
So you think the government should do something to change lifestyles? Should it ban fast food in areas of higher heart disease? Should it look into your kitchen to see what you are feeding your kids at home? Is that how you want to live?

While I agree that information can be made available by the government, you can't make stupid people smart. (I do expect this to be one of the next SJW causes) So if J6P wants to eat McDonald's 3 meals a day, what can you do to stop him? I live in a wealthier area in the middle of a depressed state. I have access to healthier dining options and stores that carry better foods. But for some people who live 20-30 miles away, healthy for them means Subway. Food is purchased from a local market that sells gas (think large c-store). Choices are limit to mainly processed foods.

How does a government fix this? And do the citizens want it fixed? Some probably like eating McDonald's every day. Propose limiting what food stamps can buy and you are a terrible person.
[doublepost=1509033284][/doublepost]
The thing many "against" or think the ACA is a disaster, broken, etc seem to forget is that it's a LOT of various elements. So it's hard to say better/worse before because it was more like - "different."
For me I say it is worse because my premiums have doubled in the last 5 years. They went up about 40% the previous 5. And my deductible has tripled. And I have coverage I don't want or need.
 

VulchR

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Jun 8, 2009
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...So you think the government should do something to change lifestyles?
The federal government already has, for instance with smoking and drinking. Good luck getting that kind of effectiveness with local government...

Should it ban fast food in areas of higher heart disease? Should it look into your kitchen to see what you are feeding your kids at home? Is that how you want to live?
Like you, I think that the government has a role to play in education. Indeed, education adds years to life expectancy more than many medical treatments. I don't think he government should determine what you feed yourself or your kids. However, it can control the availability of 'foods' that cause problems (or at least label these foods), such as those that have high sugar and fat content.

While I agree that information can be made available by the government, you can't make stupid people smart. (I do expect this to be one of the next SJW causes) So if J6P wants to eat McDonald's 3 meals a day, what can you do to stop him? I live in a wealthier area in the middle of a depressed state. I have access to healthier dining options and stores that carry better foods. But for some people who live 20-30 miles away, healthy for them means Subway. Food is purchased from a local market that sells gas (think large c-store). Choices are limit to mainly processed foods.
Government could give tax breaks to firms that offer healthy foods in poorer or rural areas. It also has a general role to play in enhancing the quality of life in these areas. And again, one of the points I made in my post above is that the federal government can target poor areas with financial assistance in a way that impoverished state and impoverished county governments cannot. It sounds like you see the federal government as a bloated ineffective behemoth*, and I have sympathy for that view to some extent, but that does not mean that reducing all federal programmes will do more good than harm.

How does a government fix this? And do the citizens want it fixed? Some probably like eating McDonald's every day. Propose limiting what food stamps can buy and you are a terrible person.
I do not believe that government can fix everything, but government can reduce the harm to society and to the individual. It can, for instance, provide medical care, and if that medical care is preventative, it can reduce the costs over the current unsustainable situation.

Finally, I have a question for you: If not the government, then how does the private sector fix this? My belief is that it doesn't. I believe it makes it worse.

*Not specifically referring to Trump.... :p
 
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tpham5919

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Mar 21, 2016
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It was better for me before ACA. Post-ACA, my premium doubles and deductible goes up 6X so of course I'm in the camp that think ACA is a disaster. Instead of addressing or at least attempt to address the causes for sky high health care cost, ACA just spreads the cost around to lower the premium for some at the expense of others (such as my family). I don't mind assisting others one bit but my family's needs always come fist and ACA certainly does not help me in that regard.
My concern now is that the new health care changes (if they pass) will mess ACA up even more. Everyone loses in the end except for the insurance and pharmaceutical companies!
 

R.Perez

macrumors 6502
Feb 16, 2010
386
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Philadelphia, PA
It was better for me before ACA. Post-ACA, my premium doubles and deductible goes up 6X so of course I'm in the camp that think ACA is a disaster. Instead of addressing or at least attempt to address the causes for sky high health care cost, ACA just spreads the cost around to lower the premium for some at the expense of others (such as my family). I don't mind assisting others one bit but my family's needs always come fist and ACA certainly does not help me in that regard.
My concern now is that the new health care changes (if they pass) will mess ACA up even more. Everyone loses in the end except for the insurance and pharmaceutical companies!

I understand the extra burden of increased premiums and how hard that can be on a family. That said, spreading costs around is literally how insurance works.
 

hmmfe

macrumors regular
Feb 28, 2003
239
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I've definitely seen (edit: saw) rates increase faster since the ACA for my company. However, how much of that was directly a result of the ACA vs. the insurance companies seeing an opportunity? I'm not sure. In the end, I feel it is very short-sighted to judge national health care policy by the current cost of my specific health care premiums. So, I think it's overall been a very good thing.

I did not like it too much at the time since it ended up being health care insurance reform, rather than health care reform. But, a step in the right direction nonetheless.
 
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bradl

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Jun 16, 2008
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It was better for me before ACA. Post-ACA, my premium doubles and deductible goes up 6X so of course I'm in the camp that think ACA is a disaster. Instead of addressing or at least attempt to address the causes for sky high health care cost, ACA just spreads the cost around to lower the premium for some at the expense of others (such as my family). I don't mind assisting others one bit but my family's needs always come fist and ACA certainly does not help me in that regard.
My concern now is that the new health care changes (if they pass) will mess ACA up even more. Everyone loses in the end except for the insurance and pharmaceutical companies!
I understand the extra burden of increased premiums and how hard that can be on a family. That said, spreading costs around is literally how insurance works.
Agreed. and let's put that into perspective and contrast.

By that, let's compare the ACA to how Medicare Part D was funded. Instead of taking the surplus that was handed to him by Clinton, George W. Bush decided to hand all of that back to the people, instead of putting that towards Medicare Part D, which would have buffeted everyone against the cost of supporting that bohemoth, in which now all of us bear the cost of that. The surplus could have taken care of that with no cost to us. Now, because of no surplus or funds allocated for it, Medicare Part D was not paid for, and we all are bearing the cost of that. If that surplus were spread around as it was supposed to, part of the issues we have with health care would not exist.

Additionally, it's only the seniors who are eligible for Part D, so the bulk of the population in the US won't even qualify for that, let alone see it to use, because it won't be sustainable by the time we reach 60 or 65, depending on the age qualification by state.

BL.
 

iMi

macrumors 65816
Sep 13, 2014
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I can only share personal experience. ACA made it possible for me to leave a corporate job, start my own business and still be able to obtain reasonable healthcare coverage for our family. At the time, my wife was working part time and we were about to have a child, so that healthcare piece of being employed was really important.

We now have health insurance through her job, so I don't know what the markets look like right now. But back then, without subsidies, we were able to obtain coverage that was very good at a relatively low cost. Deductible was a little high. That was the only downside, but now preventative care was almost always covered 100%, so there's a trade off. In taking to others who are self employed, buying coverage was a problem before. One had to submit to health exams and ended up with the many exclusions and lack of coverage for preexisting conditions.

Basically getting insurance through corporation and getting one on your own was a very different experience prior to Obamacare. After the law was passed, you'd get the same deal. No exclusions, relatively low cost, similar to that group coverage you'd get when working for a large company.
 
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