patrick.net

joeyjojojunior says

How did ACA affect mortality in 2009? or 2010?

I cited data 2010-2015. Some provisions came into effect immediately. 3.7bn vs 500 million is more than 7:1. The advertising and marketing budget of PhRMA dwarfs both of those numbers, so they're moot: the point is the ratio ends up being more than 7:1. If you can find anyone who outspent PhRMA's advertising and marketing budgets, please link. From the moment the WH made its secret deal with PhRMA in August 2009, which the WH denied initially but admitted later, the pro-Obamneycare propaganda outweighed anti-Obamneycare. I saw it, and I continue to see it in CA where the State and the Kaisers' Empire advertise everywhere. One truth in your link is that real people would "get the last word." The legislation continued to poll around -10 through 2016, when voters completed the 2010-2016 process of separating Democrats from power.

Recently though, House Republicans proposed even worse legislation, so polls have turned favorable. That's your best hope: Republicans doing something even worse, making Obamneycare look almost decent in comparison. Thus the two-step dance continues: always blame "the other" side, pay no attention to the crooks on "your" side selling you down the river. Otherwise, it's a crap sandwich and most people could smell it even if you couldn't.

"3.7bn vs 500 million is more than 7:1"

So you are lying and pretending that the $3.7MM number was all spend on advertising when the article explicitly says otherwise. Par for the course.

"Recently though, House Republicans proposed even worse legislation, so polls have turned favorable. That's your best hope: Republicans doing something even worse, making Obamneycare look almost decent in comparison. Thus the two-step dance continues: always blame "the other" side, pay no attention to the crooks on "your" side selling you down the river. Otherwise, it's a crap sandwich and most people could smell it even if you couldn't."

And more curious lying. I'm not a big backer of ACA. I've always been on record here saying we need to look at what works at other 1st world countries and adopt the best parts. My hope for ACA was that it started us down the path to single payer. Denying coverage to people shouldn't be the solution--rather it should be reducing the cost of care.

joeyjojojunior says

rather it should be reducing the cost of care.

How do you do that while maintaining quality and preventing rationing?

"How do you do that while maintaining quality and preventing rationing?"

Not sure if you're being facetious or genuinely asking, but here's a good start:

http://issues.org/26-2/milstein/

"Senate Republican leaders on Thursday unveiled a fresh proposal.... Republicans said the revised bill would provide roughly $70 billion in additional funds that states could use... The bill already included more than $100 billion for such purposes.

The new bill, like earlier versions, would convert Medicaid from an open-ended entitlement to a system of fixed payments to states. But in the event of a public health emergency, state Medicaid spending in a particular part of a state would not be counted toward the spending limits, known as per capita caps.
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If an insurer offered “sufficient minimum coverage” on the exchange that remains subject to federal mandates...it could also offer coverage outside the exchange that would be exempt from many of those mandates...the Republican bill would create a fund to make payments to insurers for the costs of covering high-risk people enrolled in health plans on the exchanges.
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People who enroll in catastrophic health insurance plans would be eligible for federal tax credits to help pay premiums. Such plans typically have lower premiums and high deductibles.
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The bill would, for the first time, allow people to use tax-favored health savings accounts to pay insurance premiums.
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Like the previous bill, it would end the requirement that most Americans have health coverage, and it would make deep cuts to Medicaid, capping payments to states and rolling back its expansion under the Affordable Care Act.
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In a notable change, the bill would keep the two taxes imposed by the Affordable Care Act on people with high incomes: the 3.8 percent tax on investment income and the 0.9 percent payroll tax.
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Republicans expect that an analysis of the new bill will be released by the nonpartisan Congressional Budget Office early next week.
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Mr. McConnell has said he intends to take up the revised bill next week...."

The new bill looks a bit more like NIxon's plan for a voluntary private system with federal backing. Compared to the OP bill, this edition would continue some of the current taxes and subsidies, buying patronage network support by continuing to monetize chronic conditions rather than cure them. Neither bill includes any money for research, as usual from Republicans, many of whom oppose science and favor faith healing. Where the previous bill might have encouraged and rewarded biotech entrepreneurs developing disruptive cures, this edition seems to maintain more of the chronic revenue models in existing legislation.

https://www.budget.senate.gov/imo/media/doc/BetterCareJuly13.2017.pdf

Interesting article on US health care costs and outcomes. It appears the inflection point where our system went off the rails was ~1980. That's when the costs started skyrocketing out of control without any additional benefits in life expectancy.

https://www.nytimes.com/2018/05/14/upshot/medical-mystery-health-spending-1980.html

"The United States devotes a lot more of its economic resources to health care than any other nation, and yet its health care outcomes aren’t better for it.
That hasn’t always been the case. America was in the realm of other countries in per-capita health spending through about 1980. Then it diverged.
It’s the same story with health spending as a fraction of gross domestic product. Likewise, life expectancy. In 1980, the U.S. was right in the middle of the pack of peer nations in life expectancy at birth. But by the mid-2000s, we were at the bottom of the pack.
What happened?"