re: What is the REAL reason we can not go back to the old healthcare system.

The number kept changing because it kept rising. (but was consistently in the 40-millions during Obama's presidency pre-ACA enactment). The ACA was designed to slow healthcare spending growth. It's debatable whether it's responsible, but it's not debatable that healthcare growth slowed (though it's picking back up recently).

Consumers do want a version of our system that works better. The ACA was actually created to be that (a Heritage foundation model created as an alternative to single payer). Republicans can't seem to get their heads around the nature of the healthcare economics, though. They try to give healthy folks the option to opt out and require sick people to pay what they can't, but they get care anyway. Everybody ends up getting care but it's more expensive and not just for the poor.

quote:

---

The government wants to control as much as they can. Less government in health care would have been better. Allowing Insurance companies to cross state lines would have been better

---

This is a canard. It won't fix anything. I say do it, just to shut up the right but it won't have the effect of lowering premiums.

Once hubment intervenes, they'll never be allowed to let go.

People forget that prior to Obamacare, the insurance companies were continuously raising premiums, denying coverage, holding us all hostage, and 20 million or so people who did not have health coverage got it. The old days were not so good which is a reason why the ACA passed in the first place. Our entire healthcare system ( including pharma)has been dysfunctional for 1/2 Century, and now is probably the right time to go for universal healthcare like the rest of the civilized world who has better services and lower cost. The key would be to manage it effectively.

Amen, brother. The ACA has helped my patients and extended family tremendously. I started out as a doubter, but through travel, reading and working with other physicians who have worked in other countries, I've come around to the belief that universal systems are the way to go.

quote:

---

universal healthcare like the rest of the civilized world who has better services

---

Link?

quote:

---

Technological advances which are expensive

---

Name another field in which technological advances increase cost.

In 1990, you could buy:
A Honda Civic LX for $10,450
An Apple Mac LCII for $2400 (just the CPU, no display)
A mobile phone for $1400 (with a $1 per minute rate)

A 2017 Civic LX lists for just under twice what it cost 27 years ago, but is orders of magnitude safer, more efficient, more comfortable and more loaded with features. $2400 buys you a MacBook Pro capable of editing 4K video. And cell phone carriers give phones away for free if you sign up for $50 a month plans (with per-minute call rates too small to calculate, so they throw them in for nothing).

And yet, a routine apendectomy, which cost around $5000 in 1990, would run you an average of $35000 today. And complication rates are roughly the same.

Stop scapegoating "technology" for the unsustainable rise in health care costs. It clouds your view of the real reasons.

quote:

---

Commonwealth fund rankings come out every three years and came out this past week

---

Hahaha I was hoping someone would post that.

You are a smart guy doc, have you looked into the study? It is totally biased toward socialized medicine.

Where should we start?

1. The bogus reporting of infant mortality rates?
2. The exclusion of cancer outcomes?
3. The reliance of patient surveys?
4. The equal weight of bogus categories like "equity"?

But don't take word for it. Just read the quote from page 27 of the study...

quote:

---

Any international comparison of health care is subject to inherent weaknesses, such as the absence of medical record clinical information or timely health outcomes data. The measures, methods, and data used in this analysis are far from perfect. Different measures, moreover, are given equal weight in the rankings and are not weighted based on independent evidence of what patients value most highly.

---

It goes against everything logical to think that we have inferior healthcare compared to European countries. Why aren't people flying to Europe or Canada for medical care?

Is our healthcare spending out of control? Yes
But we are the epicenter of technological advancements in medicine, and there is no place you would rather be with a life threatening illness and you know that deep down inside.

They should bring back obamacare and just have it cover insulin, birth control, and nicorette patches

quote:

---

24% of rural Americans get coverage from the expansion of Medicaid - that is a HEAVILY pro-Republican section of the country.

---

The Rio Grande Valley of Texas and the Mississippi Delta are HEAVILY pro-Republican?

Hardly.