is it really possible that Donald trump could be president????? [Part 2]

[claig]

From now on the race becomes winner take all. If Trump wins Florida on March 15, it is probably all over.

'The Republican Party now has 14 days to stop Trump'

www.vox.com/2016/3/2/11144812/super-tuesday-results-donald-trump-wins

I don't understand it fully, but according to the real conservatives in the Republican Party, i.e. not the RINOs, Obamacare was first developed by the RINO Republicans like Mitt Romney and Obamacare is an extension of Romneycare started by Mitt Romney in Masachussets.

According to Cruz, Carson, Rubio and Trump, under Obamacare premiums have increased dramatically and service has decreased. Carson sees it as a Saul Alinsky type Cloward Piven style way of overwhelming the system and destroying the middle class. It passed through the Supreme Court due to Supreme Court Justice John Roberts, appointed under Bush and praised by Cruz, who dd not strike it down. That is one of the points that Trump hits Cruz on. In the Republican Party there are lots of RINOs (Republicans in name only) who are all in it together with the Democrats.

Here is an article from the National Review which represents the conservative think tank establishment wonks who are opposed to Trump explaining why Obamacare has been a failure

www.nationalreview.com/article/426121/obamacare-bad-news

Actually pre Obamacare we had a standard insurance plan. It covered behavioral health with a $30 copay. Our monthly premiums came to just less than $16k a year for the family plan. Today the exact same family plan premiums come to just over $29k per year. Our copay spend is through the roof with $50 to see a specialist who is in network. ER and urgent care visits are 30% copay with hospital stays $500 a night plus 20% copay. This year we have budgeted $20k going out in copays. We are extremely lucky that all of our costs are reimbursed via the expat package that DH is on. Local hires in his office don't have that benefit. The ration doctor appointments and medication instead.

Quite frankly this is not sustainable nor is it affordable. Middle class families are asking their employers to make them contractors so they can avoid company plans. The cost of social security is lower than what they save with a subsidized program. I also have yet to meet someone employed by my employer under the age of 26 who pays for their own insurance like they should do. This isn't exaggerated. Those kids who voted for 'change you can believe in' have not been quite so honest. There should be a community service fine if you are under 26, employed and not on your offered plan. I fully understand why they do it. They save about $8k a year which is a lot when you are making $50-60k a year as a recent grad.

Many of the things listed as problems are largely due to an exclusively private health insurance system. Obamacare has always been limited by staying within this system instead of going for health for all. Not that GOP would ever let that pass.
The young and the healthy are of course less likely to purchase insurance, particularly if they are on lower incomes and consider it's best to invest in a house, a car or starting a family.
If, as a baseline, everyone had to contribute towards health insurance (similar to what happens to car insurance), then it would be fairer as it would level the field between the healthy and the not so healthy. The main problem remains in relation to the poorest, and I don't think it will ever be solved by private insurance schemes of any sort. The same in relation to affordable insurance schemes, run by different companies to more expensive schemes.
The reality is that for those in lower incomes to have health protection, then those in higher incomes will have to pay for them, one way or another.
Another problem is the overall cost of health in the US, which is much higher than in Europe, which is due to many things including insurance and how private insurers can't control costs, and fear of litigation.
See a balanced analysis here: www.pbs.org/newshour/rundown/health-costs-how-the-us-compares-with-other-countries/

"He [Jonathan Gruber] has been described as a key architect[2] of both the 2006 Massachusetts health care reform, sometimes referred to as "Romneycare", and the 2010 Patient Protection and Affordable Care Act, sometimes referred to as the "ACA" and "Obamacare".

en.wikipedia.org/wiki/Jonathan_Gruber_(economist)

"ObamaCare architect: 'Stupidity' of voters helped bill pass"
...
In a clip unearthed Sunday, Massachusetts Institute of Technology Professor Jonathan Gruber appears on a panel and discusses how the reform earned enough votes to pass.

He suggested that many lawmakers and voters didn't know what was in the law or how its financing worked, and that this helped it win approval.

"Lack of transparency is a huge political advantage,” Gruber said. "And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass."

thehill.com/policy/healthcare/223578-obamacare-architect-lack-of-transparency-helped-law-pass

Is there a point to your post, apart from copying and pasting?

Not sure how that man calls it stupidity of the American voter if the law was passed by Congress. It was not in a direct election.

"many lawmakers and voters didn't know what was in the law or how its financing worked,"
I bet many congresspeople actually don't care about the laws, but how they'll be perceived by their voters and what they can get from lobbyists.

I find this sentence really funny:
"If you had a law that made it explicit that healthy people are going to pay in and sick people are going to get subsidies, it would not have passed,"
Erm... even in private health insurance, healthy people pay in and sick people get subsidies. It's how insurance works.

If this is what passes by intelligence, then Sarah Palin is a genius.

In the end he states "but I'd rather have this law than not."

So, what was your point, claig?

'So, what was your point, claig?'

To inform that Obamacare is the continuation of Romneycare and that it was passed due to lack of transparency and would not have been passed otherwise according to one of the architects of it.

'In the end he states "but I'd rather have this law than not."

Of course he says that because he was one of the architects, but Trump and Cruz have said they will scrap it and Trump blames Cruz for having praised John Roberts, a Bush Supreme Court appointee, who didn't oppose it when he was claimed to be a strong conservative choice on the Supreme Court, appointed by Bush and supported by Cruz.

The fact is the law is that you are now required to buy your employers plan if you are not covered by your spouses plan. If you are under 26 and your employer offers insurance you are required to take it. Zero efforts have been made to enforce this. What is happening is that under 26s are uninsured and paying the fine which is something stupid like $300 on their tax return.

That seems to be one of the big problems. Was that low fine set up originally? Or negotiated to get the law passed?

Most of the problems with obamacare are a result of the difficulty in getting acceptance for a more sensible single-payer or NHS type scheme.

I can understand that an NHS scheme might be a step too far for Americans, but I don't understand why a social insurance system isn't acceptable. Here in France everyone pays a straight 8% of salary for healthcare, covering 70% of most healthcare costs (100% for things like maternity care or cancer). Your employer has to offer, but you do not have to accept, top-up insurance.

It's similar here in Portugal.
For private services, and shorter waiting times, people pay extra for health insurance. But everyone with an income contributes and all (including those without income) can benefit from a public service, which is free for no or lower incomes and attracts nominal fees for medium and higher incomes.

The fact is the law is that you are now required to buy your employers plan if you are not covered by your spouses plan.

This would indicate otherwise.

www.healthcare.gov/have-job-based-coverage/change-to-marketplace-plan/

If insurance companies can't refuse people whom they judge will cost them money, then obviously they have to put up premiums for existing customers and / or reduce benefits.
So, those on higher than average incomes, like Supermum and her friends, pay more to enable others to have insurance at all. That's one of many disadvantage of healthcare via private insurance instead of via income tax.

I understand you don't like being worse off, but what is your alternative suggestion to provide healthcare for those who couldn't access it before ?

Republican-leaning Independents look key to them winning any election.
Gallup shows Trump slightly ahead of Cruz, with Kasich in net favourable ratings. So, it is not clear if Trump would make Republican chances any worse than they would be already, with their long-running demographics problem

Whites are 71 % of the 2016 electorate and if the votes of people of color split the same way they did in 2012, then Republicans would need 63 % of white voters to win, whereas Democrats would require only 36 % of the white vote.

If Trump is the nominee, he may lose a significant chunk of Republican voters - and they are overwhelmingly white.
He could only won if he gains a similar number of blue-collar white voters who normally vote Democrat.

He has openly stated that he loves the "uneducated"
So, his tactics are probably geared to hoover up all the low information white voters of both parties.
Also, once nominee, to really hammer Hillary on sleaze, to bring out all those can't stand Her - her negative rating is nearly as bad as his.

seneca You can always do that but you don't get a subsidy that you get if your employer doesn't offer a plan.

Call it 10% of your income (I know it's 9.66% but this is for ease of calculation), on an income of $55k if you are buying coverage for just yourself through my employer you are putting out $8k per year. So you buy via the exchange and you won't qualify for the subsidized rates so in the NY metro area the rate for a single person is about $8-10k per year. For a family the non-subsidized rates start at about $15k.

DH and I might be top income earners but neither of us are blind to how absolutely unaffordable these healthcare costs are. We are darn lucky that DH has burst through the ranks income wise. For a family with a household income of $150k, healthcare is a huge burden. These people might seem high income compared to what people are making in poorer states like Alabama but the reality is that here in Northern NJ a 3 bed house in a lower middle class area has property taxes of over $10k per year. Property taxes tend to be in the range of $15-25k per year.

Basically to deny that Obamacare hasn't been good is short sighted at best. I think there should have been much more fundamental reform with each state being forced to offer basic insurance for all persons not insured at cost. They do this for children already so not too hard to expand it.

Clearly people have noticed the changes in healthcare and it is helping Trump a lot. The problem is that he isn't the person I want in charge of fixing the system! I'd like to see Sanders present a plan of how he would change things.

want2be I don't really understand your gripe here. I get a subsidised healthcare plan with my work. If I don't want to take it, I can buy another, but no one will subsidise me if I do! Why should they?

American costs are high because your private insurance system has driven up costs over the years. Americans spend something like 17% of GDP on healthcare, versus (IIRC) around 9% and in the 11-12% range in continental Europe, but are less well covered. This is not the fault of obamacare but because your system incentivises providers to game the system.

I don't understand your figures either (9.66% of $55k is not $8k) - but those costs are actually not that far different from what middle and higher earners pay here. My DH and I pay over €8k in government health insurance contributions a year, and between me and my employer a further €3k in top up insurance fees. That's about $15k at typical exchange rates. Comprehensive healthcare insurance is expensive, even in France where it costs €23 for a GP consultation and under €50 to see most specialists.

Sorry, it's early here, there was a typo in the sentence about healthcare costs - it should say "9% in the UK".

According to the analysis I linked to earlier, even before Obamacare the US was paying more than twice the highest payers in Europe (8000 vs 3000 dollars), a much higher percentage of GDP, as Mistigri pointed out, and with worse health indicators except for cancer and waiting times. Life expectancy is worse. They get more tests done and more procedures undertaken, that may not be really necessary, such as C-sections.
I get additional private health care and my experience is that they're indeed test and procedure happy, even when alternatives could be had or could wait and see how things progress. Vs the annoying, but probably more realistic, state based doctor who tells us to wait and see what happens.

My point is that Trump is gaining traction with the points he makes about Obamacare. The changes made were terrible for the vast majority. It's fsiled to address the issues which make healthcare expensive in the first place. One such area that needs to be addressed is the cost of medical school. Another area is the cost of liability insurance. Both areas are through the roof in terms of cost which pushes the prices up.

The doctors here don't over prescribe or over test in my experience because insurance companies won't pay for it. I can give multiple examples where my family have had the wait and see approach adopted. Yes all of my kids will be via CS but if I was forced to deliver vaginally it would be a disaster long term because my pelvis isn't shaped for delivering babies. I'm pretty sure in the UK my son would have been an EMCS.

In fairness, Want2B, once act was never going to cover those serous systemic issues. My understanding was it was simply designed to get more people access to the insurance necessary for healthcare.

I always puzzle why Americans seem so attached to their system of private delivery of health care. To me, it's such a human fundamental need, I don't think it should be privatized at all. How can you be sure your doctors are not just racking up costs and fees as opposed to doing what is best practice for you? Who wants insurers deciding what care you get? It seems like such a battle and compromise of essential care.

The increases do sound horrific though. Is there any talk of tweaking the income levels for NY?

In the interests of research, I checked my own and between the public tax I pay for healthcare and the private company plan I also have (just me, DH has own plan and kids are off plan), it is c7000e which is about $8000. So pretty similar BUT from what you have said ( $20k in copay ) I suspect the charges I get from the hospitals etc must be far lower and the copay elements also seem far lower.

There's just no way we'd ever hit that level of payment on top of the public and private payments already made. And I've had 2 babies and my gall bladder out in the last 6y!

One thing I do agree with Supermum about is that liability issues are a big part of the problem. There obviously should be compensation for medical mistakes, but many of the awards are out of proportion. Nearly every medical provider I have notes in their files prominently that I am a lawyer. I think I probably do get over-tested as a result.

I think they should take fault finding out of it Seneca. People who suffer harm in hospital should get compensation regardless of whether there was specific negligence or not. Again a public system of compensation would probably work best.

The current system of fault finding being necessary leads to years of delays and huge costs in defending these by who? Ah yes, the insurers.

That's the thing. You have never needed insurance to access healthcare. If I walk into my local hospital here I give them my Amex and get what I need care wise because the hospital doesn't accept our insurance. The issue has always been affording healthcare.

The changes made have not made healthcare affordable. When people voted for Obama they thought he was going to make healthcare affordable and available to all. Well it sure isn't affordable and there are plenty of people who choose to pay the fine and remain uninsured because paying 10% of their income on healthcare insurance means they can't cover basic living costs such as rent.

That is exactly the thing. Why aren't Americans screaming for something similar?

Though I guess while it has gone up for you, some now have access who didn't before. Is the issue really that you are just beyond the level where you get subsidized rates?

Maybe Obama's objective was to make the current system so bad for those have always had insurance, that people would be screaming for a national health service where healthcare would really be affordable to those who can't be insured, and even for those who are currently insured.

I think it's more of a cultural and political issue than one of affordability by the state. The problem would be to convince people to pay mandatory (effectively) taxes to cover health costs for everyone, rather than have a choice of product.
I don't think Congress would ever let that pass unless the vast majority of the population would be for it, but they won't because they don't care about what goes on outside the US.

It's somewhat like the issue of an ID card for the UK. Lots of other countries have them with no problems, but the UK has resisted it so far, even though IMO it increases identity theft and creates problems for those without passports or other forms of photo ID. (but I digress - this is not the issue here)