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EDIT: Originally published under the title: Why I Hate Obamacare. People were getting distracted by the title.

Maybe hate is too strong a word. But I really don't like Obamacare. When the GOP talks about costs - they are right. The costs could be enormous. Industy's love for the bill makes me very suspicious. Let's think about why and locate the culprits (hint: It's the GOP). It's time for a history lesson.

*

Lo these many years ago, left-wing democrats were arguing for a true national healthcare system, in which the government would fund all costs for everyone. We will call this "Medicare-for-all,

The Republicans resisted, refusing to even consider such a thing, though they did help pass universal emergency-room access and Reagan signed this in 1986. This helped many people. It did so in the least efficient way possible, but let's not overlook the genuine help.

Then Clinton was elected and Hillary started the famous health-care debacle. Many plans were floated, but the issue quickly became toxic, 1994 elections followed, and no serious attempt at health-care returned.

In the meantime, both right-wing and left-wing think tanks (I never thought I would miss the Heritage foundation, but it really did have a lot of smart people thinking about market-based solutions to real problems. They even allowed conservatives to disagree with each other and engage in healthy debate), continued to work with the issue of healthcare.

There was basically a universal agreement among all serious people that something had to change in our system.

Moderate democrats, starting at Yale, came up with the "public option." Moderate Republicans at Heritage came up with the "individual mandate." In the meantime, states started to experiment. Romneycare. MNcare. Healthcare for poorer kids. Lots of ideas out there, some working better than others.

Medicare Part D is instructive. Everyone agreed that seniors needed help paying for drugs. One could approach the problem of seniors trying to get drugs in all sorts of ways: One could simply pay for them via medicare. One could regulate the pricing on the market. One could highly limit the patent system so that competition would ensue. One could enable generics to undermine expensive drug pricing. Instead, the Republicans created a program that doesn't actually cover the cost of medicines for many lower income seniors (like my father-in-law), but DOES give hundreds of millions of dollars to the Pharma industry. Of course, lots of Democrats voted for it, because who wants to vote against drugs for seniors?

In 2008, people like me wanted a debate between Medicare-for-all and the public option. Instead, Baucus declared the former DOA because it wouldn't get Republican support - and presumably because he actually thought it was too liberal.  Months passed. Meetings, debates, collaborations, as the Democrats rejected their own ideas, one after another, in pursuit of support from any Republicans.

Medicare-for-all: not even on the table.
Public-option: But, said Republicans, that won't be fair to our corporate masters, because people will choose the public option and put them out of business because it will be so much better (so much for competition).
Lowering medicare to 55 - can't do that thanks to Lieberman (but let's not focus on Joe, as also the GOP had by that point made its radical turn).

Finally, the Democrats chose a Republican plan generated by a Republican think tank and implemented by a Republican governor - and future presidential candidate - as a solution sure to get bipartisan support.

People like me worried: Instead of providing healthcare, the government would make sure that people received massive subsidies - money paid directly to the industry that had been so unethical, expensive, and inefficient for so many decades.  

The government would allow people to buy affordable healthcare and pay the industry to provide it. In theory, the regulations would keep it honest and affordable, but I had my doubts. Any sensible person had their doubts as soon as they saw the industry lobbying for it.

The truth is - we don't know yet. Cost estimates are coming in nice and low for taxpayers. Taxpayers will be able to buy insurance on the exchanges for reasonable rates. But that doesn't mean that the true costs of healthcare are going down, because we haven't seen what the subsidies look like.

-------------------------------------------

Tomorrow, the GOP is going to shut down the government. When you can get GOP officials to talk about the problems with Obamacare, they talk about a bill passed under dodgy circumstances, without true debate, without any bipartisan support. If the Democrats passed this bill alone, they argue, the GOP can repeal it alone (except for the inconvenience of not being able to win elections). When you ask them why, you'll hear a lot of talk about costs.

Some of that talk is true. The costs are real.

They are real because Obamacare relies upon the Republican "idea" that you can solve problems by paying industry to do something, rather than the government just doing it themselves.

It will not be efficient.

It wasn't efficient for student loans (empowering banks to make govt guaranteed loans at higher rates of interest).

It wasn't efficient for Part D.

It won't be efficient for the ACA.

It will, however, enable a lot of people get healthcare.

-----------------------------------
A few final thoughts: When someone says that the ACA "passed without honest debate" - They are either forgetting or lying.  We remember the months and months of debate before the GOP decided that the pathway back to power was nihilism. we remember these months because that's when the Democratic House, Senate, and President decided to implement Republican ideas.

When someone says the bill "passed it without any GOP support" - They are forgetting or lying about the great efforts, including the betraying of core left-wing values, to bring any Republicans on board. You can't force the GOP to support it when they have made the political calculation - a correct one  as it turns out - that it's more important to destroy Obama's presidency and regain power than it is to work on the healthcare system. That decision has brought the GOP power.

And still, many republicans refuse to admit there is a healthcare problem. They invoke  Reagan's emergency room law from '86, though they don't like to tie it to St. Ronnie. . Millionaire GOP officials and media personalities say, "We have the best healthcare in the world." They say, "Folks just go to emergency rooms and everything is fine." I hear it constantly. Ted Cruz just said that if someone wants healthcare, they should just go and get a job that provides healthcare. Problem solved!

---------------------------------

I can accept that some people have a political and moral code in which providing universal healthcare is not necessary. I disagree, both ethically and pragmatically, but I can accept it.

It's the people who claim they care and yet rail against the ACA for whom I have no respect. Because the ACA is not the end of the world. It will help people get care. Its benefits will likely outweigh its costs. It will certainly be good for the millions who now get healthcare who couldn't afford it. But it will be expensive and it will be inefficient, and it will be these things because it is based on the core conservative philosophy - government money can only be spent if it enriches industry along the way.

This has to be just a step along the way to a better system. I don't think we'll get Medicare-for-all, but we can get to a more tightly regulated insurance market.

-----

I am history professor and essayist for the likes of CNN, The Atlantic, and The Nation.

I have a blog: How Did We Get Into This Mess? It updates daily.

To read more, you could 'like' my public Facebook page.

Or you could follow me on Twitter:

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Comment Preferences

  •  Do you have insurance? (2+ / 0-)
    Recommended by:
    gchaucer2, ban nock

    Can you purchase insurance if you don't?

    What is so unnerving about the candidacy of Sarah Palin is the degree to which she represents—and her supporters celebrate—the joyful marriage of confidence and ignorance. SAM HARRIS

    by Cpqemp on Mon Sep 30, 2013 at 06:10:21 AM PDT

    •  Yes (1+ / 0-)
      Recommended by:
      Kevskos

      I'm very lucky. And that's why I wrote at the end of the diary, if you got there:

      It will help people get care. Its benefits will likely outweigh its costs. It will certainly be good for the millions who now get healthcare who couldn't afford it.
    •  Why would this matter? (0+ / 0-)

      So you can use a "Oh well, it must be nice to be rich enough to afford insurance" attack to try and disqualify the author and thereby debase his argument without the need to actually articulate one yourself?  So weak....

      I agree with the diarist in that this is not the end-result we all want in the Health Care Reform fight but I am MILES away from using the word "hate".

      1.  This was a realistic achievement.  We do not have super-majorities in both houses.  We can not railroad ideal policy through the legislative process.  We can all dream the impossible dream, but we need to actually be able to get things done in DC.  ...and we did.

      2.  Single-payer vs Insurance Co.'s aside there are other key issues of policy and principles that have now been forced into the mainstream norms.  Pre-existing condition exclusions are immoral.  Period.  Life-time caps are cruel.  Period.  High-deductible no-insurance insurance policies are scams.  Period.  These things are all addressed.  Add on the parental policy allowance up to 26 years of age and some other minor tweaks to young children coverage and we have successfully redefined the concept of "Minimum Coverage".

      3.  The inefficiencies will help us make our next argument.  Once we show that the coverage policies work.  That the hospitals and doctors can handle it.  That people can and will pay reasonable amounts, etc... then we can start looking at the money being wasted and talk about further adjustments.  That waste will be the leverage we need.

      Красота спасет мир --F. Dostoevsky

      by Wisper on Mon Sep 30, 2013 at 06:27:55 AM PDT

      [ Parent ]

      •  I understand what both of you are saying. (0+ / 0-)

        I agree in theory. But today, as I see it, we have two choices in front of us. We can buy affordable insurance, or not. I need it desperately.

        What is so unnerving about the candidacy of Sarah Palin is the degree to which she represents—and her supporters celebrate—the joyful marriage of confidence and ignorance. SAM HARRIS

        by Cpqemp on Mon Sep 30, 2013 at 06:44:22 AM PDT

        [ Parent ]

  •  Fix your title, please. (3+ / 0-)
    Recommended by:
    chicago minx, Lollardfish, Kevskos
    "Why I hate Obamacare"
    It's the process that you hate.

    Don't blame the baby.

    Notice: This Comment © 2013 ROGNM UID 2547

    by ROGNM on Mon Sep 30, 2013 at 06:11:56 AM PDT

  •  Whoa boy! I hope this isn't a hit and run and the (2+ / 0-)
    Recommended by:
    gchaucer2, ban nock

    diarist sticks around to entertain his readers.

    There is no existence without doubt.

    by Mark Lippman on Mon Sep 30, 2013 at 06:17:26 AM PDT

    •  I'll be around (1+ / 0-)
      Recommended by:
      Kevskos

      As my teaching schedule permits.

      •  The word "costs" appears with more frequency than (0+ / 0-)

        almost any other word in your piece.  The word "expensive" is also represented.  

        It doesn't seem like you have a thorough understanding of economics or finance.  Providing health insurance isn't free because health care isn't provided for free.  Paying claims for medical care to providers and facilities does indeed cost money.  

        The EGTRRA & JGTRRA tax cuts of 2001 & 2003 had a cost of over a trillion dollars.  The wars in Afghanistan & Iraq had a cost well over a trillion dollars and the US is still paying $80 - $100 billion a year in Overseas Contingency Operations.  The Dept. of Defense budget is around $600 billion a year.  The top five government contractors in 2012, Lockheed Martin Corporation, The Boeing Company, Raytheon Company, General Dynamics Corporation, and Northrop Grumman Corporation had contracts worth $106 billion for the year.

        These are just numbers.

        It might be worth your while to study modern monetary theory and gain an understanding about where money comes from.   Your phobia about costs and spending could be cured (ha! pun) if you thought for a moment about how money is created.  Where does it come from?  

        Only the government has the authority to create money which it spends into the economy where it circulates and changes hands.   Think of this as the lifeblood of our economic system.

        There is no existence without doubt.

        by Mark Lippman on Mon Sep 30, 2013 at 07:24:53 AM PDT

        [ Parent ]

        •  Non-sequitors and condescension != rebuttal (0+ / 0-)
          •  You betray your intention by your refusal to even (0+ / 0-)

            consider the ideas of another.  If you don't understand modern monetary theory and our economic system, that's ok.  No one is born with that information.  Trivializing it won't make it evaporate or go away.  You remind me of a child who covers his eyes and thinks it makes him invisible.

            There is no existence without doubt.

            by Mark Lippman on Mon Sep 30, 2013 at 07:44:54 AM PDT

            [ Parent ]

        •  Your comment (0+ / 0-)

          Alright, I have now read this several times through. Let me see if I have your critique right:

          I argue: Obamacare is inefficient because it's pays subsidies to private industry to provide services rather than directly providing said services. This is a GOP idea and it's not a good one, though it's better than nothing.

          You reply: It's ok! We just invent money anyway, so it doesn't matter if it has huge costs.

          In your framework, then, cost is never a criterion to be applied when assessing a program, because money is fundamentally infinite? That's an interesting position, but not one I share.

    •  It won't matter though (1+ / 0-)
      Recommended by:
      Kevskos

      People won't rec it so in an hour it'll be gone. Runs against the grain. If I had titled it - why I hate republican ideas, it might have had a chance.

      That said, I don't want our NECESSARY defense of Obamacare against the GOP to undermine our awareness of its flaws.

  •  Bullshit. N/T (3+ / 0-)
    Recommended by:
    Cedwyn, gchaucer2, JayRaye

    Speak softly and carry a big can of tuna.

    by Cat Whisperer on Mon Sep 30, 2013 at 06:18:44 AM PDT

  •  Hmm. (5+ / 0-)
    ...The truth is - we don't know yet. ...
    Why not see how it works first?  I would refer you to Ted Cruz's favorite book, Green Eggs and Ham.

    I'm not always political, but when I am I vote Democratic. Stay Democratic, my friends. -The Most Interesting Man in the World

    by boran2 on Mon Sep 30, 2013 at 06:19:03 AM PDT

  •  I had to take my hand (6+ / 0-)

    out of a warm epson salt soak just to reply -- I dried my hand and wrist while guffawing at the certainty of your title and then reading

    The truth is - we don't know yet. Cost estimates are coming in nice and low for taxpayers. Taxpayers will be able to buy insurance on the exchanges for reasonable rates. But that doesn't mean that the true costs of healthcare are going down, because we haven't seen what the subsidies look like.
    The sign up is tomorrow and coverage starts in 3 months and yet you hate Obamacare.  You must have lovely insurance.

    I have no insurance -- I had to go to urgent care because of a cat bite last week.  I had to use the expired antibiotics which are in my freezer because 14 pills cost $215.  That's after I spent $52 on augmentin which made me violently ill.  I then proceeded to crush the same hand in a heavy glass door while transporting a heavy box of legal briefs.  I'm looking at a black hand on a white arm with a golf ball sized lump.  Methinks it isn't broken -- but not sure since I have no fucking insurance.

    Now back to soaking my hand thinking others should soak their heads.

    " My faith in the Constitution is whole; it is complete; it is total." Barbara Jordan, 1974

    by gchaucer2 on Mon Sep 30, 2013 at 06:22:08 AM PDT

    •  I'm glad you read to the end (0+ / 0-)

      But perhaps I was unclear. I didn't say repeal it. I'm glad it's there. But all the worst things about it come from an attempt to appease the GOP. An attempt that failed.

    •  get well (1+ / 0-)
      Recommended by:
      gchaucer2

      if it were me that cat would have used up #9

      “Conservation… is a positive exercise of skill and insight, not merely a negative exercise of abstinence and caution…” Aldo Leopold

      by ban nock on Mon Sep 30, 2013 at 06:42:23 AM PDT

      [ Parent ]

      •  Thanks, ban nock (1+ / 0-)
        Recommended by:
        ban nock

        She bit me 5 years ago and that one was far worse.  She's adopted -- at age 7 in 2001 and we all think she was abused.  She's pretty close to the end as it is.  

        " My faith in the Constitution is whole; it is complete; it is total." Barbara Jordan, 1974

        by gchaucer2 on Mon Sep 30, 2013 at 06:51:03 AM PDT

        [ Parent ]

        •  still has teeth obviously (1+ / 0-)
          Recommended by:
          gchaucer2

          I read part of your post re slamming door etc. Avoid walking under ladders maybe.

          I've self treated for some very real things, it's ok but not best. Can't wait for Jan 1 also.

          “Conservation… is a positive exercise of skill and insight, not merely a negative exercise of abstinence and caution…” Aldo Leopold

          by ban nock on Mon Sep 30, 2013 at 07:08:01 AM PDT

          [ Parent ]

    •  gc, so sorry to hear about your injuries. will (1+ / 0-)
      Recommended by:
      gchaucer2

      you be checking out the exchange tomorrow to see what you will be able to purchase?  I hope it is good news for you.

      wishing you a speedy recovery.

      "Don't Bet Against Us" - President Barack Obama

      by MRA NY on Mon Sep 30, 2013 at 07:33:13 AM PDT

      [ Parent ]

      •  Thanks, MRA NY (1+ / 0-)
        Recommended by:
        MRA NY

        I'm going to have my finger on the trigger at 12:01 a.m.  I'll be digging out my 2012 tax return later today and be ready to go.  

        " My faith in the Constitution is whole; it is complete; it is total." Barbara Jordan, 1974

        by gchaucer2 on Mon Sep 30, 2013 at 07:49:40 AM PDT

        [ Parent ]

        •  being in Pa, there isn't currently anything for me (1+ / 0-)
          Recommended by:
          gchaucer2

          though i know they are working on a waiver where I might be able to buy something (as a smoker, i think it still won't be anything i can afford).

          what i really need is a job!

          "Don't Bet Against Us" - President Barack Obama

          by MRA NY on Mon Sep 30, 2013 at 07:51:43 AM PDT

          [ Parent ]

  •  Would you care to explain (1+ / 0-)
    Recommended by:
    MRA NY

    precisely how Medicare for All or a public option could have passed e. g. the Senate?

    I'm talking logistics here: where you find the 60 senators necessary to overcome a filibuster.  Joe Lieberman, besides being Joe Lieberman, wasn't even technically a Democrat; Nebraska (Ben Nelson) has a very heavy concentration of insurance interests.  They had both indicated very clearly that there were no circumstances whatsoever under which they would vote for a public plan.  Or do you think there was ever any possibility at all of getting even one Republican vote?  I certainly don't.

    Other major social programs have started with a lot of holes that got filled in later, over time.  Look at the history of Social Security, for example.

    •  Two points (0+ / 0-)

      1. We'll never know. They didn't try. I often wonder if in a world between medicare-for-all and individual-mandate, we might have ended up at public option.

      2. I recognize the realities of the situation. I repeatedly say in the diary that I am glad the ACA is there and that it will help people. This is a good thing. That doesn't mean we have to be blind to its flaws.

      •  Count the votes (0+ / 0-)

        The bill needed 60 votes to get through the Senate.

        There were 60 votes.  Just.

        Two of those votes made it very clear that there were no possible conditions under which they would vote for any kind of public plan.  Even a public option.  Those two votes represented states with heavy insurance interests.

        So again, what possible path was there?  Do you think Lieberman and Nelson could somehow have been convinced?  Do you think two Republicans would have crossed over?  I don't.

        But you know what?  Had they actually tried to put up that amendment, I think it would have gotten into the bill.  Some Republicans would have crossed over to put it there.

        ...but once there, it would have been very difficult to remove.  Why?  Again, those 60 votes.  Maybe the Democrats would have hung tough and maybe not.  But the bill, in that form, would not have passed.  Again, Lieberman and Nelson.

  •  You left out the cheapest Medicare D alternative (3+ / 0-)
    Recommended by:
    Lollardfish, Kevskos, ban nock

    The government could run their own pharmaceuticals plants, creating the needed drugs with no profit motive, thus becoming the cheapest pharmaceutical manufacture around, and providing the cheapest possible drugs.  Ie, socialized pharmaceticals.  Just hedge it in so that no one at the 'exec' level got paid more than, say, 2-3 times what any other employee gets, to prevent the sort of imitation of the private sector that still happens in some government enterprises.

  •  First, nobody "loves" the ACA, but there are... (0+ / 0-)

    reasons to like it; the first being it does provide care for people who are shut out of the market.

    Second, as more people join the exchanges, the door to single payer is pryed that much more open.  When the Apocalypse does not occur, when people see that the government can provide a useful service, it will that harder to gin up opposition to improving the ACA.

    Finally, it may not be perfect, but it is a good first step.  I don't care if it was a Republican idea implemented by a Republican governor.  It was an idea that dates back to when the GOP wasn't entirely evil, corrupt or insane.  It will work as well as expected and probably better than expected.  

    Until the next big push, it is a good first step.

    Tax and Spend I can understand. I can even understand Borrow and Spend. But Borrow and give Billionaires tax cuts? That I have a problem with.

    by LiberalCanuck on Mon Sep 30, 2013 at 06:28:59 AM PDT

  •  I'm sorry buy you are just plain wrong. (0+ / 0-)

    Across the country, the insurance rates that the companies have submitted are below, and sometime well below, the rates of last year.  These are real numbers, not speculation.

    I will agree that single payer would be better, but think about what's going on.  Obamacare is very much like Medicare, only without the government option.  The insurance companies know that if they increase the rates too fast, there will be demand for a public option, which would make Obamacare almost Identical to Medicare.  The next step would be the private companies pulling out because they can't compete against the public option.  It'll take a long time, but this is better than what we have now.

  •  My brother-in-law is purchasing insurance... (0+ / 0-)

    through ObamaCare for about $107/month.  The plan has a high deductible and he'll likely be paying most of his medical expenses out of pocket since he's healthy and 30 years old. It's more of a catastrophic plan.

    And I'm guessing that the insurance policy costs more than $107/month. He is working as a house painter and is being payed under-the-table. As far as the government is concerned, he is out of work. So he is (1) cheating on his taxes, (2) cheating on his health insurance and (3) everyone else is giving money to an insurance company so he can do so. And the truth of the matter is that the $107/month he is paying will not reduce his medical costs unless he gets seriously ill. It's an additional cost for him.

    I'm not a fatalist about Obamacare; There are some good things in it that will help countless people. But I still can't see why my brother-in-law couldn't just buy into Medicare and cut out the for-profit middleman.

    If you're not part of the solution, you're part of the precipitate.

    by HairyTrueMan on Mon Sep 30, 2013 at 06:47:13 AM PDT

    •  How is he purchasing (2+ / 0-)
      Recommended by:
      sewaneepat, Dave in Northridge

      something that doesn't exist?  Your BIL is not a very good exemplar for the workings/not workings of Obamacare.

      " My faith in the Constitution is whole; it is complete; it is total." Barbara Jordan, 1974

      by gchaucer2 on Mon Sep 30, 2013 at 06:54:46 AM PDT

      [ Parent ]

      •  Is my father-in-law lying? (0+ / 0-)

        That would be weird since he works for the federal government on ObamaCare and is helping my BIL get enrolled. Are you saying that they're both lying? Or are you saying that it doesn't exists YET, which I know?

        If you're not part of the solution, you're part of the precipitate.

        by HairyTrueMan on Mon Sep 30, 2013 at 07:03:18 AM PDT

        [ Parent ]

        •  I'm saying no one (0+ / 0-)

          in the entire country can enroll for Obamacare until tomorrow.  Coverage begins 1/1/14.  I didn't call anyone a liar -- I asked how your BiL can be paying 107 dollars for a policy that doesn't exist.  Now you are saying that your father in law is helping your BIL enroll -- which means he isn't paying $107 and based on fraudulent information.  

          Your words, not mine.

          " My faith in the Constitution is whole; it is complete; it is total." Barbara Jordan, 1974

          by gchaucer2 on Mon Sep 30, 2013 at 07:12:55 AM PDT

          [ Parent ]

          •  I said he "is purchasing"... (0+ / 0-)

            not "is paying." I suppose I wasn't clear enough. My brother in law will be signing up on day one, at a cost of about $107/month for a high deductible plan. Unless he gets seriously ill or injured, he will be paying almost all of his medical expenses out of pocket, just as he does today. Meanwhile, the insurance companies will be collecting his money and taxpayer money to pay for the catastrophic plan. And the best part for the insurance company is that they are nearly guaranteed at least a 15% profit on the premiums alone. That doesn't include what they will make on investing the unearned premiums.

            If you're not part of the solution, you're part of the precipitate.

            by HairyTrueMan on Mon Sep 30, 2013 at 07:41:19 AM PDT

            [ Parent ]

            •  From healthcare.gov (0+ / 0-)

              in response to the question;  When will prices be available?

              Prices of Marketplace plans have not been set yet. Prices will be available October 1, 2013, when open enrollment starts and you can begin shopping.
              Your brother in law is pocketing 100% of his income -- he'll be subsidized at honest tax payers' expense.  

              " My faith in the Constitution is whole; it is complete; it is total." Barbara Jordan, 1974

              by gchaucer2 on Mon Sep 30, 2013 at 07:45:41 AM PDT

              [ Parent ]

  •  I just wrote a long post about why Medicare for (0+ / 0-)

    all would not be

    a true national healthcare system, in which the government would fund all costs for everyone.
    but somehow got logged off just as I posted it so it did not post.

    I don't have time or energy to write it all again, but the gist is that since Medicare does not fund all costs for everyone, Medicare for all would not do so either.

    Part B and Part D have premiums. Part B premiums are approximately $100 per month. Part D varies depending on the plan and company but I think the average is around $40 a month (probably a little higher now, that was what it was a couple of years ago.)

    Part B has a deductible (around $350 iirc) and then is an 80-20% co-insurance plan for things Medicare covers (which does not include routine dental, eye or hearing). You can get a supplemental to cover some or all of these costs. These are private insurance plans and the costs vary depending on the plan, location, age, and company chosen) but you can expect to pay at least 150 a month for a Plan F which covers all deductibles and copays and likely more.

    Part A also has a deductible and then has costs after so many hospital days.

    Part D has a deductible and co-pays though you can pay a higher premium and have no deductible. The co-pays vary depending on which policy you have.

    Right now I pay about $260 a month for my premiums (including supplemental Plan F). The only other costs I have are drug costs which while better than if I had to pay all drug costs myself is still quite expensive (I take 2 meds regularly and 1 occasionally).

    These are costs per recipient. No family plan for Medicare though I think you can get a discount if both people have the same supplement.

    Fro lower income people, there are some other subsidies plus Medicaid if one is eligible.

    Medicare is wonderful and I am so grateful to have it, but it is not a plan in which the government pays all medical costs by any means.

    You can't scare me, I'm sticking to the Union - Woody Guthrie

    by sewaneepat on Mon Sep 30, 2013 at 06:56:11 AM PDT

    •  Totally fair (1+ / 0-)
      Recommended by:
      sewaneepat

      Good criticism. It's true for my in-laws too.

      •  I think that Medicare is free healthcare is a (0+ / 0-)

        common misconception. I know that 3 years ago when I became eligible to apply for Medicare (3 months before I became 65), I was very surprised that there was a Part B premium. I knew I would have to pay for a supplemental and Part D, but I was surprised about the Part B premium and also about the deductibles and co-insurance (I'm not sure what I thought the supplementals were for, I just knew people bought them.)

        You can't scare me, I'm sticking to the Union - Woody Guthrie

        by sewaneepat on Mon Sep 30, 2013 at 07:40:32 AM PDT

        [ Parent ]

  •  Here's my issue (0+ / 0-)

    For a number of structural reasons I haven't been able to join the health plans at most of the places I teach (part-time explains the great bulk of why). I'm going to celebrate my 64th birthday in ten days. This means that in September 2014 I will start to sign up for Medicare. You CANNOT be in one of these exchanges if you are receiving Medicare. That means I have to buy a health plan that lasts about 280 days (give or take).

    I'm NOT at all happy that my first foray into the California exchange is going to cost me around $3000 for the ten months I have to buy insurance (and that's with a subsidy). But it's how the law works. Medicare for all would have been better, yes, but that's not what we have yet.

    Seneca Falls, Selma, Stonewall

    by Dave in Northridge on Mon Sep 30, 2013 at 07:12:40 AM PDT

    •  What do you think your premium would have (0+ / 0-)

      been under Medicare for all and what do you think the benefits would have been, especially compared with the plan you are getting under the ACA?

      You can't scare me, I'm sticking to the Union - Woody Guthrie

      by sewaneepat on Mon Sep 30, 2013 at 07:34:36 AM PDT

      [ Parent ]

      •  Why do you think I'd KNOW that? (0+ / 0-)

        Jim's Medicare was free. He didn't have Part B because we couldn't afford it.

        Seneca Falls, Selma, Stonewall

        by Dave in Northridge on Mon Sep 30, 2013 at 07:41:32 AM PDT

        [ Parent ]

        •  I wondered what you thought, not what you know. (0+ / 0-)

          As you apparently do know, Medicare is not free since you know you have to pay for Parts B and D. Part A is hospitalization only and is also not free (although the premium is).

          I just think it is important that if we are advocating for Medicare for all that people know that it also costs money. It is highly subsidized (the government pays 75% of the premiums for Parts B and D and the recipient pays the other 25%.) And then Medicare pays 80% of the cost of Part B and the insurance company pays approximately 75% of the cost of Part D drugs until the donut hole - though Part D is a mess  so it takes a lot of navigation to figure out which policy you need and even then you are likely to get screwed if anything changes about the medication you are on.)

          You can't scare me, I'm sticking to the Union - Woody Guthrie

          by sewaneepat on Mon Sep 30, 2013 at 08:02:09 AM PDT

          [ Parent ]

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