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Social programs in the Trump II era. Medical and other safety net plans.

Tero

Illuminator
Tero
Joined
Oct 16, 2010
Messages
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Location
North American prairie
Trump and Musk will try to repeal Obamacare. If that happens, there are in fact state level regulations that somewhat control medical care. I assume they will partly survive. The states like Washington have a state run system in place. It would not take much to cut it off from Obamacare and run it as stand alone. But the costs will go up. People will not be cut off for existing conditions.

My situation is the blog in my sig link. Just cutting and pasting from there.

Medical care will be a primary factor. Our state is small. The penny pinching philosophy does not add any state level health coverage. For the poor, our governor tried to block Medicaid expansion. We forced him with a referendum (our state is not totally hopeless!). They are all national plans and the Obamacare choice is one company, if you are 60-65. I am on Medicare, which will weaken for two years at least. I would be looking at the state healthcare rules and in general the safety net they have put up. Nearby there are states with bigger populations that have better safety nets to survive the Trump II term. It will not be Missouri for sure, already tried that.
 
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I don't think most people that get their insurance through the ACA would be able to afford it without the federal subsidy. Without the subsidy, my plan would be over $900 a month.
 
surrogate said:
I don't think most people that get their insurance through the ACA would be able to afford it without the federal subsidy. Without the subsidy, my plan would be over $900 a month.
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True. But you can get it for less if you make your deductible 20 000. It's better yo owe that than owe the hospital 200 000.
 
Tero said:
True. But you can get it for less if you make your deductible 20 000. It's better yo owe that than owe the hospital 200 000.
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And then you find out that whatever procedure you need isn't covered, or it is covered but the team of "doctors" at the insurance company have decided it's not medically necessary for you at this time. Bad insurance plans are never bad in just one way, they're bad in all the ways.

Remember: the point of insurance is to make money for the insurance company by NOT paying for your medical care. It's against their interests for you to go to the doctor at all.
 
Repealing the ACA will mean that the poor will get sicker and poorer - which is exactly what Trump and his cronies want.

They'll have more money for themselves and an increasingly large underclass they can exploit to make even more money.

A $20,000 deductible effectively means no insurance because you won't even be able to afford the investigative action and procedures and even the deductable will bankrupt you.
 
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The Don said:
They'll have more money for themselves and an increasingly large underclass they can exploit to make even more money.
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The underclass is also their primary voting base. Of course they want it to be as big as possible. More of the poorly educated, we love the poorly educated! Let's make them sick, starving, and desperate so they flock to us on election day!
 
Safe-Keeper said:
The underclass is also their primary voting base. Of course they want it to be as big as possible. More of the poorly educated, we love the poorly educated! Let's make them sick, starving, and desperate so they flock to us on election day!
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Sounds about right.

Is there a message the Democrats could develop to reach these folks or would they have to flat out lie ? Policies are unimportant IMO, it's all about slogans for the majority people who are too busy with their lives to be particularly interested in politics and policies.
 
"Vote Harris and get $100 000 and a free Ferrari!" Facts don't matter to them anyway.
 
In the general sense, the way this rhetoric works in America is that entitlement programs such as assistance for food and rent and subsidies for healthcare insurance are postured as wealth-shifting by liberals to support the lazy and undeserving efforts of the "takers" at the expense of the "makers." Repealing these measures is postured as getting rid of "wasteful mandates" that force people into regimented situations and replacing them with plans that offer "choice," where the choice is to accept, say, a useless healthcare insurance policy that pays out next to nothing and simply reaps premiums. Morally it's postured as compelling people to be responsible for their own outcomes, because of course in America anyone can become a billionaire if they just work hard enough and resist government interference.

Prior the ACA, healthcare insurance was a wildly lucrative business in the United States. It still is, although not quite as much. The value of the ACA lies not so much in providing affordable plans and subsidies, but in the coverage requirements and other regulation. The ACA forces insurance companies to actually act like insurance. It goes a long way toward forbidding junk policies that are little more than grifts. Thus the rhetoric is likely to sound something like, "We're not taking away your healthcare insurance; we're just making it easier for you to choose a plan that better fits your budget and circumstances instead of having to deal with what the government pushes on you."

Deregulation is almost always recast as improving efficiency, unleashing innovation, and enhancing consumer choice: things any blue collar Joe can appreciate. But any fruits of efficiency rise to the top. "Innovation" means coming up with new, unregulated ways to turn money into more money (e.g., "mortgage backed securities" and "collateralized debt obligations"—remember those) and thereby grow too big to fail. And customer "choice" means "choosing" to spend your money on a lot of disclamatory fine print.
 
The Don said:
Sounds about right.

Is there a message the Democrats could develop to reach these folks or would they have to flat out lie ? Policies are unimportant IMO, it's all about slogans for the majority people who are too busy with their lives to be particularly interested in politics and policies.
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We sent them a message. "Your are the mark, Trump is a conman." They were already hypnotized.
 
Americans can't seem to warm up to the notion of healthcare as a human right and not as a discretionary commodity. The prevailing notion in America is that healthcare is no different than any other luxury. If you can't afford dry-aged ribeyes or heated seats in your car, then that's just simple economics and you aren't otherwise entitled to them. There is a subtext in American society that being poor is both avoidable and morally questionable. Another article of faith in America is that healthcare is necessarily expensive. And finally, the whole notion of healthcare insurance rankles the Makers-versus-Takers crowd who believe themselves to be fundamentally healthy and don't want to subsidize the healthcare costs of "sick people." Being sick and/or poor is naively equated to being morally undeserving.
 
JayUtah said:
Americans can't seem to warm up to the notion of healthcare as a human right and not as a discretionary commodity. The prevailing notion in America is that healthcare is no different than any other luxury. If you can't afford dry-aged ribeyes or heated seats in your car, then that's just simple economics and you aren't otherwise entitled to them. There is a subtext in American society that being poor is both avoidable and morally questionable. Another article of faith in America is that healthcare is necessarily expensive. And finally, the whole notion of healthcare insurance rankles the Makers-versus-Takers crowd who believe themselves to be fundamentally healthy and don't want to subsidize the healthcare costs of "sick people." Being sick and/or poor is naively equated to being morally undeserving.
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I think it's this way because that's how business like it: they like that their employees are dependent upon them for health insurance. It makes changing jobs or leaving jobs more difficult, and the reduction in mobility means the employers can exploit the workers more. Lose your job means losing your insurance, and if you get too sick to work...well, hope you happen to be rich!
 
Safe-Keeper said:
The underclass is also their primary voting base. Of course they want it to be as big as possible. More of the poorly educated, we love the poorly educated! Let's make them sick, starving, and desperate so they flock to us on election day!
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As long as you tell them it's because of immigrants, brown people, LGBT people, and of course, females, they'll lap it up.
 
When thinking about repealing the ACA, Speaker Johnson started hyperventilating so hard that his son had to double-check his Dad's browser history.

Its toast. The only hope is some of the GOP from purple districts might throw the brake lever. But even then they'll allow for some serious weakening of the Act.
 
TragicMonkey said:
I think it's this way because that's how business like it: they like that their employees are dependent upon them for health insurance.
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And this is ironic considering the genesis of amployer-provided healthcare insurance. During World War II, salaries for some critical employees were frozen to discourage war profiteering. This forced employers to be more creative in how they could offer increasingly attractive compensation packages. Thence the genesis of "benefits." The employer could offer non-salary compensation in the form of subsidies for common expenses.

The other aspect of reduced mobility is the pre-existing condition bar. Prior to the ACA, insurers could reject paying for treatment for conditions that existed prior to the policy. Anyone with any sort of chronic condition could effectively be uninsurable. If you work for Ford and have insurance through Blue Cross and you quit and go to Chevrolet that offers United Healthcare, UHC could say, "Sorry, your diabetes is a pre-existing condition and we won't cover your insulin." When someone has a profit motive in not supplying the contracted-for service, you can be they will expend as much effort as is profitable in order to evade the obligation. When you see the size and sophistication of the "Fraud Prevention" divisions in the major insurers and try to absorb the byzantine details of the policies, you can see what the real agenda is.

The notion of a for-profit company positioned between the patient and the healthcare provider is understandably foreign to some. As others have noticed, it's been long enough that people don't remember the wild, lawless frontier that was healthcare insurance before ACA. And the propaganda machine seems to have succeeded at drawing a false distinction between the ACA (i.e., the accepted status quo) and "Obamacare," which is somehow communism that should be repealed.
 
Don't worry. the Silicon Valley Tech Bros will move fast and break things, thereby fixing healthcare and social security.
 
JayUtah said:
Americans can't seem to warm up to the notion of healthcare as a human right and not as a discretionary commodity. The prevailing notion in America is that healthcare is no different than any other luxury. If you can't afford dry-aged ribeyes or heated seats in your car, then that's just simple economics and you aren't otherwise entitled to them. There is a subtext in American society that being poor is both avoidable and morally questionable. Another article of faith in America is that healthcare is necessarily expensive. And finally, the whole notion of healthcare insurance rankles the Makers-versus-Takers crowd who believe themselves to be fundamentally healthy and don't want to subsidize the healthcare costs of "sick people." Being sick and/or poor is naively equated to being morally undeserving.
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It's the myth of rugged individuslism. There's something in the Americsn psyche about not being a real person unless you do it all yourself.
 
Gulliver Foyle said:
It's the myth of rugged individualism. There's something in the American psyche about not being a real person unless you do it all yourself.
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Perhaps they should offer a level of ultra-cheap medical insurance where they have to buy their own chainsaw to trim their fingernails. REALLY cheap premiums, but there's likely to be an uptick in amputated legs.
 
Tero said:
Able bodied Democrats on the couch will need to get moving. You can only get Medicaid working so many hours a week.
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But if you make "too much money" you lose eligibility for Medicaid. Makes sense, right? Don't want people who could afford their own insurance to be using the safety net, right? Guess what the income thresholds are! Now lower that. Now lower that. Now lower that.

Missouri, for example, cuts off your Medicaid for a single adult if they make more than $20,030. For a household of two that generously increases to $27,185. The minimum wage in Missouri is now $13.75. So these employed Medicaid recipients can't work full-time without losing their Medicaid. So this is not going to work as an "incentive" to encourage them to get good jobs and work their way out of poverty...it's going to push them into working bad jobs with no benefits and low pay and limited hours, and keep them there.

It's not about saving taxpayor dollars or lifting people out of need, it's about maintaining an underclass of exploitable workers to make businesses more money. It will not trickle down.
 
With Medicare and medical I am OK, however, I can not find a doctor! The waiting times can be long. A year or so.
 
wasapi said:
With Medicare and medical I am OK, however, I can not find a doctor! The waiting times can be long. A year or so.
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My daughter faced the same problem when she changed companies and thus insurance companies. It took her several months to finally find a doctor who would prescribe her ADHD med because she couldn't get it just from her regular doctor (which took her a few months to find), it had to be prescribed by a mental health professional approved by the insurance company to prescribe them. Even though she'd been diagnosed 20 years before and had been taking the med since then, no mental health professional would prescribe them unless they interviewed her in person. Everyone she contacted with a 30 mile radius either wouldn't see her at all or had a six month wait! Thank goodness her old internist agreed to keep prescribing them but she had to pay out of pocket for six months.
 
wasapi said:
With Medicare and medical I am OK, however, I can not find a doctor! The waiting times can be long. A year or so.
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There seems to be a shortage of primary care providers all over the place. In my region we're constantly hiring new ones...and seeing recently-hired ones leave.
 
Safe-Keeper said:
"Vote Harris and get $100 000 and a free Ferrari!" Facts don't matter to them anyway.
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A bit too simplistic methinks. Not all Trump vters were cult members. Thye voted for Donnie as the lesser ot two evils. Thye will find out the horrid mistake they made.
One of the things I hate trump for, is frankly, he has empwoered al lthepeople outside the US who hate the US anyway.
TragicMonkey said:
But if you make "too much money" you lose eligibility for Medicaid. Makes sense, right? Don't want people who could afford their own insurance to be using the safety net, right? Guess what the income thresholds are! Now lower that. Now lower that. Now lower that.

Missouri, for example, cuts off your Medicaid for a single adult if they make more than $20,030. For a household of two that generously increases to $27,185. The minimum wage in Missouri is now $13.75. So these employed Medicaid recipients can't work full-time without losing their Medicaid. So this is not going to work as an "incentive" to encourage them to get good jobs and work their way out of poverty...it's going to push them into working bad jobs with no benefits and low pay and limited hours, and keep them there.

It's not about saving taxpayor dollars or lifting people out of need, it's about maintaining an underclass of exploitable workers to make businesses more money. It will not trickle down.
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I gree it will not trickle down, but you intrepertatin is just a little too classic "Capitalism is evil" Marxist for my taste.
 
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So what do we do. Go to the ER for every thing we want dealt with?
 
wasapi said:
So what do we do. Go to the ER for every thing we want dealt with?
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That's what a lot of people do.
And then we sit there for hours.
I took my mom to the ER one time and we waited for 7 hours despite my bringing it to the attention of triage! Her legs were the size of tree trunks. She ended up having several blood clots in both legs. They put her on heparin and kept her for two days as one could dislodge and kill her at any time. What really got me is the triage should have asked if she was a chemo patient, which she was. Blood clots are a well-known result of chemo.
 
dudalb said:
A bit too simplistic methinks. Not all Trump vters were cult members. Thye voted for Donnie as the lesser ot two evils. Thye will find out the horrid mistake they made.
One of the things I hate trump for, is frankly, he has empwoered al lthepeople outside the US who hate the US anyway.

I gree it will not trickle down, but you intrepertatin is just a little too classic "Capitalism is evil" Marxist for my taste.
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I didn't say capitalism is evil. It's just being implemented in an evil way. Capitalism is not inherently evil, it can be good provided people aren't consumed by greed and fear.
 
TragicMonkey said:
I didn't say capitalism is evil. It's just being implemented in an evil way. Capitalism is not inherently evil, it can be good provided people aren't consumed by greed and fear.
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Irony is too much greed always results in a business self destructing.
 
I am of the American people have not suffered enough yet. Now they probably will
Rude awakening time for many.
 
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