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Obamacare - what is the problem?

(22 Posts)
Deadsouls Thu 03-Aug-17 00:05:30

I got to thinking what with all the drama across the pond, with Trump trying to repeal and replace Obamacare, what exactly are the problems that people have with it? I want to understand as genuinely don't know/don't have enough knowledge. Any Americans out there that can explain why there is such opposition (from some) to obamacare. Having been bought up with free healthcare, from cradle to grave, it seems normal to want to provide healthcare to as many people as possible regardless of wealth or lack of.

BubblesBuddy Thu 03-Aug-17 00:34:12

Obamacare was medical insurance that had to provide minimum cover firvthisecwhomsigned up to it. It was supposed to be resonsably priced with defined benefits for those who bought it. It was not free. It was an attempt to make health insurance attractive because minimum standards were imposed. There is a website Obsbacare Facts that explains it all! If you can wade through it.

Trump doesn't like it because Obama introduced it! It does appear to be a better system for poorer people but it was not universal healthcare as we would understand it. Don't forget that the USA has a very different attitude to socialist reform from us in the UK. There is a fairly big attitude there that says if you cannot afford it, or your company can't provide it, you don't have it.

squoosh Thu 03-Aug-17 00:41:15

1) A lot of Americans have a terror of what they see as the socialist state eg. state provided health care. They think at the most basic level that if you can't afford to pay for healthcare you don't deserve healthcare. They see poverty as a moral failing rather than an unavoidable fact of life for millions.

2) Many Republicans despise Obamacare purely because it was introduced by Obama and they have made it their main aim to erase his main presidential legacy.

3) They also want to repeal it in order to introduce a system that provides tax breaks to the super wealthy. Because the Republicans are all about looking after the super wealthy. They're remarkably gifted at persuading millions of poor and middle income Americans to vote against their best interests.

SonicBoomBoom Thu 03-Aug-17 00:46:49

Good thread OP. I, too, wondered what the issue was, assuming there had to be a good reason that the Republicans hate it so much.

Thanks Squoosh, although, I was really hoping that wasn't the answer!

Lweji Thu 03-Aug-17 00:47:51

In addition to the private insurance part, there was Medicare and Medicaid extensions that are at the discretion of each State.
Recent analyses suggest that these extensions are the main reason why there's more people with health care coverage.

Obama actually needed Republican votes to get Obamacare through, which is why (IMO) Obamacare isn't doing as well as it could be.

Health insurance was supposed to be mandatory, but the fine for not signing up doesn't seem to be high enough and many younger healthy people haven't signed up.
Add this to the mandate that insurance companies can't refuse insurance for a large list of what is considered "pre-existing" conditions. This includes pregnancy, for example.
So, it does drive prices up because not enough low risk people sign up.

Under Obamacare, adult children could be added to their parents' insurance too.

Many people don't realise that the Affordable Care Act that gives them health insurance IS Obamacare.
They just hate Obama.

Lweji Thu 03-Aug-17 00:48:59

BTW, Obamacare is still on. Republicans have failed to repeal it.

Kursk Thu 03-Aug-17 01:15:41

Obamacare was meant to be affordable healthcare, however if you refuse to buy a policy or still can't afford it) there is a fine. For some it's a cheaper to pay the fine.

Forcing people to afford something won't work.

The US population as a rule does not trust the Government, any government involvement in your life is viewed with suspicion.

Deadsouls Thu 03-Aug-17 09:23:05

So if I understand correctly from the generous info that ppl have given here:
1. Obamacare is not 'free' healthcare, as for example, the NHS. It is still medical insurance, albeit cheaper cover that provides minimum health coverage.

2. There is an incentive for signing up, albeit a fine, that is thought not to be high enough. But the thinking is that if there is cheaper medical insurance, more people who might not be able to afford it normally, would sign up; young people, those who have a lower income.

3. Obamacare obliges insurance companies to take on those with pre-existing medical conditions, and for children to be able to stay on parents insurance till age 26.

4. Prices for insurance for people who can afford more expensive health insurance go up because not enough lower risk people sign up, does that mean sign up to Obamacare?

Question; can you still sign up for different medical insurance or is Obamacare it?

It is interesting to consider the different cultural view to socialised medical care, and perhaps the fear of it. But it does strike me the Amercican system off healthcare makes health a commodity. It's quite hard to get my head around but is very interesting.

TheDowagerCuntess Thu 03-Aug-17 09:50:00

As previous poster have said, many Americans - especially Republicans - are terrified of the concept of socialism, and of helping out those disadvantaged and less able.

They then turn an utter blind eye to collusion with an ex-Communist state.

Kursk Thu 03-Aug-17 11:36:12

Deadsouls
There are lots of health insurance companies, however the majority of decent employers will offer insurance as part of the package and pay some or all of the monthly premiums.

Obamacare is really targeting unemployed and minimum wage people.

Lweji Thu 03-Aug-17 16:58:16

One big problem, and that Obamacare doesn't solve, is the cost of healthcare.
It's disproportionately high in relation to similarly developed countries. And the health indicators (longevity and child mortality) are much worse.
People can still die or get bankrupt for lack of free or affordable healthcare.

Mistigri Thu 03-Aug-17 17:54:32

Obamacare was always a compromise and a suboptimal solution to America's healthcare problems, because to get anything done, Obama had to get the healthcare industry and at least some republicans onboard.

Many of the ideas behind the ACA were drawn from the healthcare policy developed by former Republican presidential candidate Mitt Romney. Obamacare as enacted was a cross-party solution to a longstanding problem, and this was its main strength (it enabled Obama to actually pass legislation and millions of uninsured people to obtain coverage) as well as its main weakness (the chosen solution is complex and it remains a private insurance system that is essentially run for the financial benefit of insurers, pharma and medical device companies, and healthcare providers).

Why do the Republicans hate it so much?

- Obama is black/muslim/not really American/all three (and it really is about Obama the person: in polling, the ACA tends to be viewed much more favorably than Obamacare by Republican voters, even though they are the same thing).
- for the libertarian and tea party republicans, the state shouldn't meddle with healthcare; being poor is a moral failing that can and should be punished by ill health and early death.

Fekko Thu 03-Aug-17 17:58:33

An American (nice old chap) I was seated next to at a dinner indicated that he thought obamacare cost everyone else a lot of money. Not sure if it's true and I didn't want to get into a fistfight with a client heated political debate.

Mistigri Thu 03-Aug-17 17:59:57

Forcing people to afford something won't work.

The people who don't buy health insurance are often those who need it least ie young and in good health.

But if these people don't participate, the cost of insuring everyone else goes up. To bring the cost of insurance down the risk needs to be spread across the widest pool possible.

Obviously it would be far more sensible to have an NHS style system or a "single payer" system like continental european state insurance systems, where everyone pays an obligatory, fixed percentage of earnings into the system.

obsessedwithCFNs Thu 03-Aug-17 18:07:04

I live in the States and have asked many people this question. The most common response was 'it costs too much'. It forced their premiums up and they simply don't want to pay for other people. One Republican told me healthcare is a privilege and not a right. 🙁

Thankfully I live in a liberal area and all my friends want a universal healthcare system introduced. It will never happen though

Lweji Thu 03-Aug-17 18:23:49

I think I saw a suggestion of making health care a state problem.
It's a nasty way to do things, but it might end up swaying conservative states if other states went single payer and ended up with lower health costs and better health indicators.

Lweji Thu 03-Aug-17 18:25:06

If you ask Democrats they'll agree it's not working well.
What they can't accept is a much worse system for the vulnerable and the poor.

Childrenofthestones Wed 06-Dec-17 21:54:12

I have just been given a GP appointment for three weeks time.
To Americans with health care this is intolerable and unbelievable.
To Americans without health care this would be a godsend.
There are millions more than happy with their cover and don't want to pay more.

MsAmerica Fri 02-Feb-18 23:33:29

It looks as if you received some excellent, astute answers, but as I quickly skimmed, I didn't see any mention of one of the original formal objections: If I understand this correctly, it can be considered unconstitutional for the federal government to force people to buy something.

Of course, the more driving force is just selfish rich Republicans who don't want any money going to anyone who actually needs help.

pallisers Fri 02-Feb-18 23:45:36

Many americans are opposed to government telling them what to do. Obamacare mandates that you have health insurance - you are "fined" by way of additional tax if you can't show you have coverage (this is the way they got around the constitutional issue MsAmerican mentioned).

Some people are paying more for care since obamacare came in and are annoyed.

Some people don't want coverage because they think normal rules of health don't apply to them - I'll never be sick!! so resent paying for it or paying the tax.

The reality is we all paid for the uninsured because if you present at a hospital with an emergency, you will be treated. That cost is spread onto those insured.

The other reality is that the majority of americans would prefer obamacare to stay in place. And the majority of Trump's base are probably on medicare or medicaid and have benefited from the expansion of those programs.

The third reality is that congress has one of the best healthcare packages around.

But Trump and the republicans are off on their merry dance of illogic. It is like lords of misrule or like landing in topsy-turvy land - today we saw the republican party, the right-wing party of Law and Order, go full -on attack against the FBI and the CIA in an effort to shut down an investigation into a totalitarian, ex-communist regime's interference in our democracy. Weird times.

Oh, and I live in Massachusetts where we already had a version of obamacare - organised and instituted by our republican Governor Romney, the republican presidential candidate who ran against Obama in 08 (actually a decent man in many ways). Sometimes I think you couldn't make this shit up.

IfyouseeRitaMoreno Fri 02-Feb-18 23:53:59

Obamacare is just a plaster on the problem of healthcare.

It makes healthcare more affordable for many but it doesn’t stop the real problem of inflated healthcare prices under a multipayer system.

My phone auto corrected to “multiplayer” which is actually right. Because each party is looking to play the system for maximum profit at the expense of the patient. This is the problem that Obamacare doesn’t address. It’s just another insurance scheme, not a single payer system.

pallisers Sat 03-Feb-18 00:01:06

I agree ifyouseeRita that it doesn't address the fundamental problems - but repealing it will just cause more misery for more people. Ultimately the US will have to face this issue head-on.

The link between healthcare and employment (insurance as a benefit) is accidental and wrong. It has all sorts of repercussions including giving employers a vested interest in only hiring healthy employees. Denver, Colorado, for example, often markets itself to companies as having a young healthy, outdoorsey workforce. Code for "won't cost you too much in healthcare"

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