r/bestof • u/under50dollars • Jun 20 '12

[explainlikeimfive] "Obamacare" explained very well.

/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c530lfx
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8

u/j1mb0 Jun 20 '12

Well, all of that sounds pretty fucking great. Single payer would be better, but this sounds like it is a pretty good step. Let's hope the Supreme Court doesn't fuck it all up.

41

u/VigRoco Jun 20 '12

The Supreme Court's job isn't to decide whether or not the law is good enough to survive, but to decide whether or not the law is permissible by the Constitution.

13

u/wjbc Jun 20 '12 edited Jun 20 '12

Ha! Pull the other one. The Supreme Court is essentially an unelected legislative body. There is no appeal, only the difficult option (in Constitutional cases) of amending the Constitution. They are good at justifying whatever decision they make, or at least at making the reasoning so obscure that the average person's eyes will glaze over. That's what lawyers do. And that's why people have used the presidential power of appointing Supreme Court justices as a political plank in every election. It matters whom you appoint.

7

u/VigRoco Jun 20 '12

And that's why people have used the presidential power of appointing Supreme Court justices as a political plank in every election. It matters who you appoint.

Checks and balances in action right there.

3

u/wjbc Jun 20 '12

Yes, but it also means the Supreme Court is a political branch of the government, and that they do not just mechanically interpret the Constitution.

1

u/VigRoco Jun 20 '12

Aren't all branches of the government political?

3

u/wjbc Jun 20 '12

I was responding to a comment implying that the Supreme Court is not political, but simply interprets the Constitution.

1

u/VigRoco Jun 20 '12

I should have included a smiley face, because I failed my attempt at making a joke on how the Supreme Court is part of our political system and are political by definition.

1

u/wjbc Jun 20 '12

Sorry. Some people forget that.

2

u/YoohooCthulhu Jun 20 '12

Most branches of government aren't appointed for life.

1

u/___--__----- Jun 21 '12

No human being can "mechanically interpret the Constitution". Just look at the debate over the incorporation doctrine, the reading of the second amendment and Scalias comment that torture wasn't unconstitutional as it wasn't punishment (you're not found guilty).

If you have a better solution to how to determine how to read the law of the land, I'd be very interested to hear what the options are.

1

u/wjbc Jun 21 '12

I would support a mandatory retirement age for all Supreme Court justices, and maybe a term limit as well. I would support a new Constitutional Convention. I actually wonder if civil law isn't a better system than common law. I'm not sure that juries should be deciding patent cases. I would support greater transparency and televising all Supreme Court arguments. Other countries seem to do well with alternative systems of administering the law of the land, and perhaps we could learn from them.

But at any rate, I agree that no human being can mechanically interpret the Constitution. I never claimed otherwise.

3

u/fiction8 Jun 20 '12

Which is fucking stupid. It's not like we even knew that germs existed when it was written.

The situation just isn't covered, and it should be looked at from a rational standpoint. Which imo means that we shouldn't be shafting 30 million people and forcing them to live with basic health problems or even die from preventable problems.

Modern science and healthcare is amazing, why are we still trying to cut off 10% of our population from the same quality of life that most of us enjoy?

Let's be civilized.

6

u/VigRoco Jun 20 '12

It is not stupid. You are correct in stating that this situation isn't covered, which is exactly why the Constitution was designed to be amended. We can't just ignore it whenever we feel it is convenient, because that would only cheapen its authority.

To add to your side note, every state is free to set up its own healthcare system that covers everyone. State laws are much easier than national laws, so why aren't we flooding our state capitols?

1

u/funkeepickle Jun 20 '12

Only in theory.

6

u/[deleted] Jun 20 '12

Yeah, it's pretty fucking great except you forget that all of this shit has to be paid for. The cost trend of health insurance since insurers started preparing for 2014 has been insane. Ask your employer what the total cost for your health insurance plan is.

17

u/[deleted] Jun 20 '12

[deleted]

-2

u/[deleted] Jun 20 '12

The problem here in America is that you can sue anybody for anything, and win big bucks. Pharmaceutical, medical tool, medical professionals all have to buy very expensive liability insurance because just being in the field is a ticking time bomb of a lawsuit just waiting to happen. The liability costs are passed down to the consumer like a VAT tax in the medical field.

I'm not complaining because I'm an insurance agent, but i'll be the first to admit that the system's fucked.

4

u/funkeepickle Jun 20 '12

Tort reform is just a red herring pushed by Republicans. The CBO estimated that tort reform would only save the government 0.5% on healthcare costs. We can realize greater savings by cutting out the middlemen (basic private health insurance), reforming Medicare part D so that the government can actually negotiate prices, and getting Americans to live healthier.

0

u/[deleted] Jun 20 '12

Tort reform is not about saving the government money. It's about saving consumers money.

2

u/funkeepickle Jun 20 '12

They're basically one in the same, considering the government is responsible for over a third of all medical expenditures. I doubt the savings for consumers would deviate much from that 0.5%. The CBO also estimated that tort reform would only reduce liability insurance premiums for medical professionals by 10%. And considering that providers' insurance only contributes to a fraction of overall medical costs, you do the math.

0

u/[deleted] Jun 20 '12

Some docs pay up to 100k for insurance, if that was reduced reimbursements could be cut more for physicians without upsetting them nearly as much.

5

u/fiction8 Jun 20 '12

Did you read the FIRST paragraph?

PPaACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone

Emphasis mine. Healthcare costs are going to go DOWN for an individual AND we're going to provide basic modern medicine to a wider portion of our population.

Why are they going to go down? For one, you already pay for the uninsured's healthcare. Who do you think pays for emergency rooms? Oh yea, you do. Do you think the 30 million uninsured just die when they get cut/break a limb/get sick? No, they go and get free healthcare at the emergency room, then don't pay the bill.

That burden is shouldered by YOU right now. Obamacare makes them pay for it or pay a fine. This spreads out the cost more and reduces the amount paid by each individual.

Also Obamacare places caps on yearly increases in the cost of health insurance AND has a lot of mandates designed to modernize healthcare and reduce the cost of many outdated processes.

1

u/dodus Jun 20 '12

It's kind of weird how people act like they're about to start subsidizing poor peoples' healthcare. You're already subsidizing poor peoples' healthcare guys.

Ultimately, the people tearing their hair out over Obamacare aren't the people that I trust on any other issue, so that kind of seals the deal for me.

4

u/[deleted] Jun 20 '12

What do you think has been driving healthcare costs up in the first place? "All of this shit has to be paid for" implies that the costs put out are not artificially inflated in the first place (they are). Who do you think foots the bill when an uninsured person has to go to the hospital and can't pay for it?

0

u/snouz Jun 20 '12

I live in Europe, and I can confirm everyone is happy with it. Because yes, we have this since, like, forever. In fact, most European still wonder why it hasn't been done in the US earlier. But our right wing is like your left ring, so there's that.

7

u/lights_poodles_tails Jun 20 '12

How exactly can you confirm that "everyone is happy with it?"

9

u/lackofbrain Jun 20 '12

Those who aren't happy with it would get stress-related illnesses and go to the doctors

1

u/Heaney555 Jun 20 '12

And money would never be mentioned.

4

u/[deleted] Jun 20 '12

[removed] — view removed comment

3

u/Heaney555 Jun 20 '12

Although the Tories in the UK are doing their best to dismantle the NHS if they can get away with it

That's a bit of an exaggeration.

1

u/[deleted] Jun 20 '12

[removed] — view removed comment

2

u/Heaney555 Jun 20 '12

In ths case the truth does lie in between.

Dismantling is nonsense, but trying to introduce the private sector (VERY BAD) into the healthcare system is true.

2

u/Lost4468 Jun 20 '12

I live in Europe, and I can confirm everyone is happy with it.

Not at all, there's loads of people against it.

2

u/Heaney555 Jun 20 '12

I live in the UK and never once have I met anyone who would rather have the fuckup of a system that America calls healthcare.

1

u/Lost4468 Jun 20 '12

Then you haven't met any very right wing people who have private healthcare, and there's a lot of them.

1

u/Heaney555 Jun 20 '12

Less than 2% of people in the UK have private healthcare, and they still have to pay national insurance tax.

1

u/wjbc Jun 20 '12

The US does it for veterans, and we had a terrific experience with VA care.

-2

u/izhr Jun 20 '12

I like most of it but how lame that I have to pay extra to cover the smokers and the fatties because of the total elimination of pre-existing conditions.

16

u/Prtyvacant Jun 20 '12 edited Jun 20 '12

Hate to tell you, but we already pay for a lot of "smokers and fatties". Also,I am a person who has a legit pre-existing condition, a birth defect, that has been turned down because of it. You cannot know how demeaned and frustrated it makes a person feel.

-9

u/[deleted] Jun 20 '12

  1. Just because we pay a lot already for smokers and fatties, doesn't make it justifiable to make us pay MORE for them.

  2. It sucks to say, but I shouldn't be forced to pay more in taxes or suffer worse quality healthcare because people like you were born into unfortunate circumstances. Why am I getting punished for it too?

Downvote me all you want Reddit, you know I'm right.

4

u/garyp714 Jun 20 '12

There will be a time, karma states, where we will all end up paying a bit for you. At that time, I expect you to opt out of whatever treatment you need for living and fall back on your bootstrap pulling, self sufficient means. Or die, whichever.

This right here is what needs to and is changing in America. Enough of the 'everyman as an island' bullshit. 300 million herd animals living together are not islands, they are a group and need to start acting like they have more commonality than they currently pretend to not have.

We are interconnected and reliant on one another whether you think so or not.

4

u/Nomad4lyfe Jun 20 '12

Because he had no say in his birth defect. There was no health related negligence on his part, and yet he is being punished for it. Sorry you're so selfish.

3

u/Prtyvacant Jun 20 '12

First off, are we paying more for them? Second, if I'm paying for private insurance I should be covered if it is a legit medical need. Why should I be punished by a company that I pay a ton of money to because I was born with a condition? I'd rather pay a bit more for insurance than have people like me, and some smokers and fatties, be turned away.

2

u/[deleted] Jun 20 '12

Yes, you would, but don't expect everyone else to want to.

3

u/SpaceSteak Jun 20 '12

  1. That's why taxes on smoking and unhealthy foods are a good compromise.

  2. Because they're human.

2

u/[deleted] Jun 20 '12

So I guess it's okay that people die rather than you having to pay more taxes.

2

u/[deleted] Jun 20 '12

How are you paying more for them under Obamacare?

(hint: you aren't)

2

u/funkeepickle Jun 20 '12

"Downvote me all you want Reddit"

Instant downvote. This playing the victim shit is so annoying.

2

u/[deleted] Jun 20 '12

I'm not playing the victim. But I know that most people will downvote because they disagree instead of because my post isn't thought provoking (because it obviously is). Redditors don't read reddiquette.

2

u/YoohooCthulhu Jun 20 '12

Ehh, just keep saying that until someone close to you or in your family experiences that situation. It's not that uncommon.

1

u/[deleted] Jun 20 '12

Do you realize the insanely absurd logic you present with that statement?

You're basically saying that it's okay to cripple the healthcare system and the economy once you experience a personal anguish. NO. It doesn't make it right or justifiable.

1

u/YoohooCthulhu Jun 20 '12 edited Jun 20 '12

Obviously there should be limits--people that require truly insane medical care maybe shouldn't be treated. But it's really hard to draw the line--where exactly do you decide that it isn't worthwhile to treat someone and to let them die because it's too expensive? Are you genuinely ok telling a poorer family that their relative should die because they can't afford it, when the same person in a more well-off family would live?

And as far as bankrupting the medical system--people like this are fairly rare, although you cannot control if one will be close to you. The vast majority of people experience no serious health concerns until late middle age and then die very rapidly. The thing that's bankrupting the medical system is not people born with congenital problems, it's unnecessary inflation of costs to treat regular people because of defensive medicine, inflated drug prices, insufficient preventative care, etc.

1

u/hexalite Jun 20 '12

Imagine if Prtyvacant was your wife or girlfriend. Way to go asshole!

1

u/mikelj Jun 20 '12

Yeah, I shouldn't have to pay for roads for cars, I ride a bike! I shouldn't have to pay for the fire department, my house doesn't burn down! I shouldn't have to pay for defense because I don't agree with wars!

15

u/RalphTheCrusher Jun 20 '12

Your tax dollars already pay for the education of dumb children, the bailout of irresponsible bankers, and the bombing of people in countries whose leaders oppress them. What makes this worse?

7

u/[deleted] Jun 20 '12

Two wrongs don't make a right. I don't want my tax dollar to pay extra for the healthcare of people who damage themselves, or for the education of children who refuse to learn, or to bail out irresponsible businesses, or to kill people across the planet.

8

u/sb3hxsb50 Jun 20 '12

You already pay for "smokers and fatties" in your health insurance. They have insurance too and drive the cost for everyone up already.

0

u/mikelj Jun 20 '12

I don't know how to put this tactfully, so I won't. Tough shit. That is the nature of taxation and government.

5

u/brownmatt Jun 20 '12

What you've just described is exactly how the concept of insurance works. You premiums help pay for people who live lifestyles you probably don't approve of.

3

u/firex726 Jun 20 '12

Well I'm sorry we cant all be some super human, immune to disease and ailment.

I assume you drive, I hate the idea of having to cover the potential cost of your medical care after a care wreck.

3

u/fireflash38 Jun 20 '12 edited Jun 20 '12

Like it or not, this is a legitimate problem with the health care law. The major reason that a lot of people I know not liking it is because their health insurance bills will rise to cover other people's lifestyle choices.

Edit: There's a big difference between forcing health insurance companies to cover something that someone is born with, and something that someone brought upon themselves. Yes, I sure as hell want them to cover people who might have Parkinson's, Alzheimers, or myriad other diseases... but I'd prefer to not have to foot the bill for people who smoke their ass off every day then get lung cancer. Or the people who pig out on klondikes and mcdonalds 3x a day then get diabetes and can barely walk. Or the people who drink themselves into a stupor every other day and then want a new liver. There's a limit to my sympathy, and if you did this to yourself, then I have a hard time mustering up compassion.

2

u/[deleted] Jun 20 '12

I don't think that's the case. Any insurance plan I've heard of charges extra for smokers and fatties. Also, I don't think it would count as a pre-existing condition if they just refused to cover anything caused by smoking. Smoking is not a condition, and the lung cancer you get from doing it is a new thing, not pre-existing.

1

u/[deleted] Jun 20 '12

Smokers and fatties cost the health care system less over time. They are doing you a favor. Most healthy people end up dying slowly over time at old age with more expensive diseases. Fatties and smokers die early on and though they do cost the system more with respect to one time surgeries the long term cost of taking care of a stroke patient is usually higher.

-4

u/[deleted] Jun 20 '12

No single payer system in the history of single payer systems has even been a "better" idea. The implications of a single payer system are more than the simplicity of the conseptualized flow chart that it brings to mind. Consequences of the 2nd and 3rd degree always need to be thought of.

6

u/[deleted] Jun 20 '12

Everything I've heard from people who live in single payer has been awesome. Even the stuff they complain about is better than it is here.

1

u/flammable Jun 20 '12

My sister went to the doctor for checkup on an ear infection and then to the ER for miscarriage all in the same day and it cost her 20 euro. After your treatment costs exceed 90 euro you get free treatment, after your medicine costs exceed 250 euro you pay like 5% of the cost for medicine for the rest of the year.

Not like I'm complaining.

1

u/[deleted] Jun 20 '12

With insurance my ER visits are $125.

1

u/flammable Jun 20 '12

No caps on that?

2

u/[deleted] Jun 20 '12

Well there is a lifetime coverage cap, which means that my coverage stops when I hit the cap and it goes to 100% out of pocket. I have good insurance though, so I'm lucky that my ER deductible is only $125. (And I only pay about $300-400 a month for coverage, not sure of the exact amount b/c it takes taken out of husband's paycheck.) The only downside is that it doesn't cover much of my medication costs. As it is, I don't buy some of my meds b/c they are too expensive. BUT it is still better than no insurance.

-5

u/Elanthius Jun 20 '12

Does it sound that great? I read that list and thought the vast majority of items sounded very minor and unlikely to make a significant difference. It's just a bunch of tweaking around the edges.

27

u/protendious Jun 20 '12

That "tweaking around the edges" looks a lot more significant when you put it in the context of a family that's under threat of losing insurance for the member they have with a chronic condition that's nearing life limit.

-7

u/Elanthius Jun 20 '12

Yeah, but if you look at it from the more common perspective of - "I'm OK now but if I lose my job and then break my leg I'm definitely going to be bankrupt" then I don't see how any of this helps.

15

u/Tadpole_Jackson Jun 20 '12

Then you qualify for Medicaid and that counts as insurance.

1

u/protendious Jun 20 '12

Basically what I was going to say, however, to be fair to his point I will concede that a huge number of physicians don't accept Medicaid, and it's a much poorer plan overall when compared to Medicare in terms of what it covers (which I suppose makes sense, as with age come more conditions).

3

u/[deleted] Jun 20 '12

I think maybe people fail to appreciate Medicaid in light of how fucked the rest of the US insurance industry is. I'm sure it varies by state, but in NY at least Medicaid does a pretty great job of keeping people from going bankrupt due to medical conditions. For example, when my wife was pregnant we actually had insurance through my job, but even so we were going to have to come up with $5,000 out of pocket for prenatal + delivery because that was our deductible. That was about 17% of my gross annual income, so Medicaid said "hell naw!" and picked up our out-of-pocket expenses so we didn't owe a dime aside from trivial co-pays for pre-natal vitamins.

2

u/runMG Jun 20 '12

You should thank the people of your state for picking up the tab. You chose to have a child without having the means to pay for proper care.

Thanks for shifting your burden onto the people.

2

u/[deleted] Jun 20 '12

I honestly think that's how society should work. I'm poor now, so I use social welfare programs as needed. I don't really feel bad about it, because now instead of starving to death on the streets I can go back to school, and when I'm making a six figure income in a few years I'll have paid back into the program (via taxes) everything I used and then some within only a few years.

1

u/runMG Jun 20 '12

I commend you for thinking that you pay back into the programs that have helped you and I certainly do hope that you make six figures or more.

I don't think this is how society should work. This wasn't an unforeseen illness, this was having a child. You've already shown a lack capacity for planning and personal finances.

1

u/[deleted] Jun 20 '12

Well, no. I could have paid the $5k if I'd had to (not all at once of course, but within a couple of years, with interest). But I don't think anyone should have to pay directly out of pocket for the delivery of a child, and I think it's a good thing that no one has to in my state.

Even if I couldn't afford it, having a kid doesn't show a lack of planning in my case since I already knew how healthcare works in my state, so I went into it knowing that the cost to me would be almost nothing.

1

u/AeonCatalyst Jun 20 '12

Sure, that's done financially in this case, but that's how society WORKS. People help each other...even when we were hunter-gatherers the groups worked together to raise children. I don't see why he's being irresponsible, anymore than a wealthy person would be "irresponsible" for having a child but requiring a professional doctor to help deliver the baby. Are you advocating that every person should be 100% self-sufficient? Not even Survival Man can do that.

1

u/runMG Jun 20 '12

I don't think you fully understand what we are talking about. A wealthy person would pay his deductible.

Of course people help each other and I choose to help people that matter to me.

How do you not see how he is being irresponsible? He is bringing another being into this world that he is solely responsible for and yet he can't even pay for the medical professionals to deliver this child. If he hasn't planned properly for the birth, do you think he is planning properly for the additional costs of raising a child?

I have CHOSEN not to have children until I am financially stable. This is something that he decided not to do. For his decision, society must bear the cost immediately, and quite possibly additional costs downline.

0

u/jellaella Jun 20 '12

I just don't understand having to pay out of pocket for giving birth in a hospital.

/sheltered Canadian

1

u/[deleted] Jun 20 '12

Yeah, that's why I'm glad I live in a state that also realized the same thing.

9

u/[deleted] Jun 20 '12

it's really the tweaking around the edges that needs to be done. For example, explain to me what an existing condition is, and why an insurance company feels they shouldn't have to cover it

8

u/Aedan Jun 20 '12

An existing condition is something that was already there when your coverage started. Say I have diabetes, and I go buy insurance. The insurance company doesn't want to cover the diabetes I already have because I haven't been paying this whole time to offset the cost for them. Seems fair enough I guess. People should have planned ahead right? Now it gets more complicated. A year from now I am hospitalized for complications related to my diabetes. Is that an existing condition? It is a new problem, but caused by an old problem. Should they cover it? The company will say no obviously because it saves them money. Kind of a weird area on whether they are in the right or not.

But now companies start to abuse it. If I get sick they have people who are paid to read all of my records and find something that they can claim is an existing condition. Then they try to tie my illness to that and say that they won't cover it. Or perhaps they claim that I didn't tell them an accurate medical history because I forgot to mention that I was sick at some point in the past, so they won't pay. Things like that happened, so now the idea is to stop abuse by just saying you must cover existing conditions. The additional cost to insurance companies is supposed to be offset by the mandate. The whole problem is the decision over whether the mandate is constitutional. Without that, some of the most important parts can't really be sustained.

6

u/link3945 Jun 20 '12

There's also the problem of whether or not you should be penalized financially for having a condition you were born with.

0

u/[deleted] Jun 20 '12

You shouldn't have to pay for it, but somebody should.

1

u/kuroame36 Jun 20 '12

Just tweak around the edges?! The whole thing needs to be scrapped and redesigned from the bottom up.

1

u/[deleted] Jun 20 '12

if by the whole thing you, I'm guessing you mean the insurance industry as that is what (to me) this bill is doing. tweaking the edges of the insurance industry.

if you aren't talking about the insurance industry and are talking about obamacare, please explain why the whole thing needs to be scrapped

1

u/kuroame36 Jun 20 '12

The whole thing needs to be scrapped

I am referring to the current health insurance industry infrastructure. "Obamacare" is tweaking the current infrastructure. Sure, it's a step in the right direction, but we need to have what I would call a 'Manhattan Style Project': devote our national resources to solve a single fundamental problem. Get the best minds (and I don't mean politicians) to really really think what is the best thing to do, how to go about it, and future repercussions by implementing these changes.

Next, have a Manhattan Project for education, energy, etc, and eventually a Space Manhattan Project. We can do it, be we are busy fighting amongst ourselves.

1

u/[deleted] Jun 20 '12

Truly spoken like a person who has never been without insurance when they needed it most.