Universal Healthcare - Is It In Our Future? Let's discuss.

[dbussone]

I hope this does not develop into a political debate, despite the topic. Please try to maintain a rational discussion - even though it might be personal.

For those worried about TVH and its recent happenings, or those who wring their hands over what they perceive to be poor access to physicians here in TV, or those who don't care for the local selection of physicians - these are the least of concerns in my opinion.

I have had several very large Canadian hospitals ask me to help them develop ways to generate income producing services; a group of German legislators request help in developing non-governmental programs, and watched the British NHS collapse upon itself. I helped another group of US hospitals find a way to care for Canadians who have alternative private insurance to provide them more timely care.

Instead, I suggest you consider the rules and regulations that exist here and are being developed in our country.

The link below will take you to an article that I hope you read. Universal healthcare is typically very heavily dominated by governmental fiat - whether part of a law or not. I believe Obamacare is the forefront of this effort in the US, and will continue to make changes most individuals find disagreeable.

This article should be particularly touching for couples who live here in TV. My wife and I celebrated our 47th anniversary this week. I will do whatever I can to eliminate the "pure governmental" option.

(I recognize that we have many wonderful Canadian seasonal residents in TV. IMO the US system of healthcare is second to none, but is being destroyed on a rapid basis.)

Elderly Couple Forced to Live Apart Weep in Heartbreaking Photo - NBC News (http://www.nbcnews.com/news/world/elderly-couple-forced-live-apart-weep-heartbreaking-photo-n638336)

I look forward to hearing your comments.



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[Fredster]

I believe many people think we should have National Healthcare.

But I don't agree with those that do, and this is how I see it.
Our Federal government does not have a positive history or track record of administering
and running any large government program in an efficient or cost effective manner.
It just isn't in the nature of our governmement
bureaucracy to pull it off.

Yes, we need more accessibility, and lower costs, while
maintaining quality of care, but the Federal government
is not the answer.
JMHO

[dbussone]

I believe many people think we should have National Healthcare.



But I don't agree with those that do, and this is how I see it.

Our Federal government does not have a positive history or track record of administering

and running any large government program in an efficient or cost effective manner.

It just isn't in the nature of our governmement

bureaucracy to pull it off.



Yes, we need more accessibility, and lower costs, while

maintaining quality of care, but the Federal government

is not the answer.

JMHO



Thanks for your view on this topic.


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[villagetinker]

Dbusonne,

I agree and share your concerns. Recent news articles about 3 of the largest insurers pulling out of selected states (Obamacare) only points to more problems. They cannot turn a profit, apparently because there are not enough healthy young people signing up. Now add todays news that the insurance companies are going to raise rates (large significant increases) on long term care plans. None of this is good news.
We have decided to not accept VHS generous offer of using their Advantage plan because of the very real possibility of care being withheld due to excessive costs to the plan. This is not acceptable.

I have no idea where this is headed. I also have a very real concern with the current generation of youngsters that think they are "entitled" to whatever they want. I our era, no one was "entitled" to much of anything, we WORKED for what we wanted, and for our retirement.

It will be interesting to see how this discussion goes. Hope we can keep it civil.

[dbussone]

Dbusonne,

I agree and share your concerns. Recent news articles about 3 of the largest insurers pulling out of selected states (Obamacare) only points to more problems. They cannot turn a profit, apparently because there are not enough healthy young people signing up. Now add todays news that the insurance companies are going to raise rates (large significant increases) on long term care plans. None of this is good news.
We have decided to not accept VHS generous offer of using their Advantage plan because of the very real possibility of care being withheld due to excessive costs to the plan. This is not acceptable.

I have no idea where this is headed. I also have a very real concern with the current generation of youngsters that think they are "entitled" to whatever they want. I our era, no one was "entitled" to much of anything, we WORKED for what we wanted, and for our retirement.

It will be interesting to see how this discussion goes. Hope we can keep it civil.



Thank you for your thoughtful response, VT.


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[VApeople]

Yes, Universal Health Care is in our future. Death is also in our future. However, right now we are alive and we are very satisfied with our healthcare, so we are just trying to enjoy every day of our life together.

[Nucky]

This is the number one issue on my mind. After doing the correct thing and raising a family and working hard our whole life we end up in TV. What a stroke of luck we have been blessed with. Now for us its a matter of getting and staying healthy quickly. We truly have no say in what will become of our healthcare. We have to hope for the best. I had a great boss for about twenty years who was an old school man and didn't have his managerial staff pay a penny for the health care of themselves and the employee's family. What a guy. He covered everything. Then when he sold the company after 9/11 a humongous corporation took over and shortly after we were paying about $200 a week for terrible coverage. I'm still paying a few bill's from back then.

I just do my best, make decisions the best I can and have faith that things will work out. I spent the winter of 2014 barely sleeping because of worrying about health care. I almost drove myself to the point of needing health care because of health care....no more for me. The only reason I shared here is because of dbussone....a good man looking for EVERYONES thoughts. I just want to finish out my time as happy as I can and take care of my wife....but reality is she is taking care of me.

[goodtimesintv]

Keep in mind while reading the Canadian article below:

- Population of USA = 318 million. Population of Canada = 35 million.

- USA "Gross domestic product increased at a 1.0 percent annual rate instead of the previously reported 0.7 percent pace, the Commerce Department said on Friday in its second GDP estimate.

Economists polled by Reuters had expected that fourth-quarter GDP growth would be revised down to a 0.4 percent pace."
(CNBC "US Q4 revised GDP up 1.0% vs 0.4% growth expected" 2/26/16)

Now consider:

(Canada) Missing on the campaign trail: Talk of health care

Pharmacare, a seniors strategy, home care: All relegated to passing references. Evan Solomon on the missing heart of the election campaign

"....The federal government promised to continue the so-called escalator—a six per cent increase in funding each year—for five years, until 2016-17.

Then, reality hits. The government will tie its health care contribution to the provinces to economic growth, with a floor of three per cent. So, here we are, four years later, and, in case you haven’t noticed, economic growth is pretty hard to come by. In other words, get ready to hit the floor. Hard.

Health care spending by the provinces is almost certain to outstrip GDP growth, and the aging demographic will make it worse. “Premiers feel strapped, regarding fiscal sustainability,” Page says.

For the provinces, which spend about 40 per cent of their budgets on health care, it will soon seem like a patient learning to function without a limb. This explains why Quebec Premier Philippe Couillard, a surgeon who knows an amputation when he sees one, is raising the matter of the Canadian Health Transfer payments.

Elections are as much about controlling what is not being debated as they are about what is being debated. That’s why Stephen Harper has not sent out a Franklin-style search party looking for the lost health care debate. He wants this election to be about the economy and security, not health care, which he knows plays well for the opposition......."

Why we're not talking about health care this election (http://www.macleans.ca/politics/ottawa/why-were-not-talking-about-health-care-this-election/)

[njbchbum]

The cost of healthcare in America is not an independent factor. It is significantly impacted by a litigious society, the cost of lawsuits aganist medical facilities and personnel as well as the costs associated with pharmaceutical and therapeutic care and of malpractice insurance. Asking America's government to step in and step up to address the matrix of all of those factors in a way that would design a comprehensive plan to address each and all of those factors equitably and generate a fiscally sound and affordable healthcare-for-all program/policy is unrealistic. An economy based on the permissiveness of deficit spending is as solid as a house built on sand.

[dbussone]

Great discussion so far. Thanks for posting. What do YOU think?


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[rubicon]

goodtimesintv and njbchbum. I appreciate and agree with your resourceful remarks and statistics.

Fraud and abuse in our healthcare system, welfare system etc abounds and government is ineffective in managing these abuses. simply stated the government doesn't care because its only taxpayers money

We suffer greatly now because our government is too large and too complex and too political to be effective. Its a monster out of control. The VA comes to mind

I am by nature against central power. The founders made it clear that the states created the federal government and not the reverse.

In the corporate world while I understood the benefit of a home office I found too often that a home office never understood what field operations people really did

All of this makes me very much a free enterprise aficionado and I believe the better way to achieve nirvana in our health care system vis a vis health insurance system is to open competition countrywide. As to regulations a balance has to be struck between open enrollment and pricing based on realistic underwriting criteria. Perhaps for the truly less fortunate subsidizing is a reality and a must?

But never in my lifetime would I vote for universal healthcare because it will only leads to sub-standards for all of us but the very rich and powerful. Government makes for bad business practices as medicare, Fannie and Freddie etc have shown because its all based on politics which has another name votes

And as Ronald Reagan humorously reminds us "the closest thing to eternal life is a government program. Bad programs never die they are implemented, funded and simply continue under the coverage of darkness

[Cedwards38]

Frankly, I see no other solution to the problem of unbridled greed in the pharmaceutical industry and the skyrocketing cost of all forms of healthcare, than a universal single payer system.

If the Declaration of Independence, adopted as the basis for our structure of American government, states that we are entitled to certain unalienable rights endowed by our Creator, and those include LIFE, liberty, and the pursuit of happiness, then healthcare should be thought of as a right rather than a privilege. Thus if we have a right to healthcare, then it follows that our federal government, as the only earthly entity with authority over us all, should provide for that right. Besides that, I just think that no man, woman, or especially child should suffer, or lose their life, or face personal or family bankruptcy in America because they can not afford health insurance or health care, and I'm willing to pay for that.

Yes, the federal government attempts to manage incredibly massive programs like Social Security, Medicare, FEMA, and our military defense, and we often hear of the abuses within these programs. But there are abuses in private sector systems also, and I don't think we can or should allow the fact that mistakes will be made keep us from trying to fix this or any other problem. America has always done it's best things for moral reasons, and this is another one of those.

Thanks for bringing up the topic!

[ColdNoMore]

...that I'm surprised it is upstairs and not down in the basement in the Political Forum.

Kudos to the mods for allowing it to be here, where more folks can see it. :thumbup:

As to the subject, it still amazes me that the greatest nation this planet has ever seen seems to put more emphasis on sending our young men and women to war...than in taking care of the health of its citizens.

Particularly sad and infuriating is the fact that we don't even properly take care of those who come back from those wars. And this isn't a problem that can be pointed at a particular party...as it has been happening at least since the Vietnam War. :(

It isn't coincidental that those most opposed to UHC are also those that already have decent health coverage either from companies that once provided it (which so many no longer do) or are covered under what is in essence UHC...through Medicare.

It's my opinion that if the real reasons for opposing UHC were honestly expressed, a lot of it would come down to a "I got mine, forget you" or "your kind doesn't deserve it."

I also recognize the huge obstacles of having a government run this type of program, as we can see how so many other government programs are so riddled with waste and inefficiencies. While I believe ACA was a great idea, it should have never been allowed to have been written by the health industry special interest groups and should have been handed off to an academic group...without influence from lobbyists and those whose interests were self-serving.

It's just my deep and firm belief that if we can find the money and expertise to so efficiently operate and fund a military that exceeds the next five (7?) nations combined...we can figure out a way to try and take care of our citizens health.

And while no country has a 'perfect' system, the ones in the link below have at least made the decision that their own citizens are what is most important...and they've made the effort.

7 Countries That Show Us How Health Care Should Be Done | Mic (https://mic.com/articles/46063/7-countries-that-show-us-how-health-care-should-be-done#.lBqugf7Xk)


In addition, it's not like our current system is actually that effective for the average person...based on the same link above. :shrug:


The World Health Organization ranked American health care 37th in the world, and in a recent comprehensive, comparative study, the

Commonwealth Fund ranked America’s health care system last on the basis of 21 indicative factors. Analyzing the countries that have surpassed the U.S. in these rankings highlights a puzzling reality: What places these other countries ahead of the U.S. is not just their universal health care systems, but also their significantly lower health care costs and undeniably greater efficiency and equity. How’s that possible? Read about seven of those countries and find out.

And since I have obviously taken a different view than the majority on TOTV have, I am hopeful that the mods will delete the personal attacks and allow for an honest discourse of the merits of the thread subject...not attacks on individual posters. :ho:

[graciegirl]

I am concerned because I have a friend who lives in Austria who had to wait four months for a mastectomy and the income tax there is at fifty percent. NO...honest, check on it.
Taxation in Austria - Wikipedia, the free encyclopedia (https://en.wikipedia.org/wiki/Taxation_in_Austria)

It isn't that in theory it is something good, but just like most things in theory, when a huge government adopts the practice, and greedy people and their lawyers get involved, not to mention those with NO moral compass, then it becomes a terrible mess and the quality of healthcare becomes not nearly as good. NOT anywhere close to what we are used to.

It is a glittering generality to say that people are just selfish who don't want it. That offends me. I don't want it because it doesn't work well at all. Your choices are gone. If we didn't have the choice to take our daughter to a skilled surgeon who had done dozens of corrections on supra valvar aortic stenosis, she wouldn't be here today.

[NotGolfer]

Great discussion! Thanks Dbusonne for beginning it. I for one am againest UHC for all the reasons the others here have stated. I have many serious health issues and need to see specialists from time to time. So far, I've had fairly good luck with my health-care providers here in T.V. (we have TVHC). That said, when I read what the government is putting into place....remember when Obamacare wasn't quite there yet and ALL the promises being given?? Folks will have to wait (it's already happening in some instances) and if I remember correctly, once one reaches 75 there will be concerns. The healthcare system will have the power to deny care. Folks scoffed at the notion of "death panels"...well I think that will also become a reality. It's never a good thing when governmental agencies get their fingers in the "pie". Already Big Pharma and Insurance companies have way too much power. One more thing came to my mind as well....a few years ago 2017 was given as a year for changes in H.C.

[2BNTV]

Universal healthcare was first proposed in the late 40's or early 50's and it didn't pass.

The ACA was passed and it leaves a lot to be desired.

I don't think we will ever see universal healthcare work in this country. The countries that do have universal healthcare usually have a very high tax rate. People resent when more money is taken from them. The healthcare industry in the USA is too big, to lose control of their market.

I remember the days where one worked for a company and didn't have to pay much to get decent health coverage. I don't know what changed, as this has become an uncontrollable monster.

Is it a matter of healthcare companies being competitive with their rates? Do we need some form of regulation without letting the government run healthcare coverage?I know everything gets more expensive as time goes on, but this is absurd.

I don't think I will ever see a real good universal system of healthcare coverage but I am sure this will be an ever evolving system of healthcare, whether it may be good or bad. Unfortunately, I think healthcare is going in the wrong direction.

[dbussone]

Frankly, I see no other solution to the problem of unbridled greed in the pharmaceutical industry and the skyrocketing cost of all forms of healthcare, than a universal single payer system.



If the Declaration of Independence, adopted as the basis for our structure of American government, states that we are entitled to certain unalienable rights endowed by our Creator, and those include LIFE, liberty, and the pursuit of happiness, then healthcare should be thought of as a right rather than a privilege. Thus if we have a right to healthcare, then it follows that our federal government, as the only earthly entity with authority over us all, should provide for that right. Besides that, I just think that no man, woman, or especially child should suffer, or lose their life, or face personal or family bankruptcy in America because they can not afford health insurance or health care, and I'm willing to pay for that.



Yes, the federal government attempts to manage incredibly massive programs like Social Security, Medicare, FEMA, and our military defense, and we often hear of the abuses within these programs. But there are abuses in private sector systems also, and I don't think we can or should allow the fact that mistakes will be made keep us from trying to fix this or any other problem. America has always done it's best things for moral reasons, and this is another one of those.



Thanks for bringing up the topic!



You are welcome. Thanks for sharing your thoughts.


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[dbussone]

We have a diversity of comments for the most part. I'm hoping we hear from many more of our fellow posters. Good stuff, and interesting as well. Thanks for participating.


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[blueash]

Those presently on Medicare did not pay enough into it for the care they are getting now. Those getting lifetime corporate insurance did not have their salary lowered enough to cover what it is now costing the company to cover you. The cost of health care continues to escalate beyond any reasonable previous estimate.
Someone has got to pay the bill. You want an MRI for your aching hip? You didn't pay for that. You paid into a system that had Xrays at 25 dollars each. So please stop saying you earned your health care coverage.
The ACA has struggled to get healthy younger people to sign up. It has done well getting sick people to sign up and therein lies the rate increases demanded by carriers. The unenforced penalties for remaining uninsured are too low to encourage those non-compliers.
Think of it this way. If your automobile insurance cost 800/ month and there was no penalty for driving uninsured other than a 10 ticket and no concern with your assets being at risk in an accident, would most people by that coverage?
So the solution is universal coverage, like we have universal fire protection, universal police protection, universal road construction, universal military, and universal clean water. It that a threat to Aetna or BCBS, maybe. But they can continue to offer coverage in parallel with the government option.
If you are so convinced that the government can't run anything efficiently, then it will very easy for Aetna to simply charge the same as the cost of the universal coverage and turn a handsome profit.
Example, if the cost of care of the average American is 800/mo then you the consumer have the option of receiving your coverage via the government option, or selecting an alternative insurer which would then receive that 800/mo from the government for the exact same coverage package with all the same doctors and hospitals and medications.
No networks.
If you want non-standard care, not covered. If you want only brand name drugs, extra cost, but identical for all carriers. If Aetna is so efficient they will love this plan. No adverse selection, just sign up all those who prefer to deal with Aetna and not a government agency.
How does this get financed? Same way we pay for healthcare now. All employers will pay something into the cost of care as a tax as will employees. Some money will come from income taxes, some corporate, some from perhaps a tax on financial transactions.
And it is a myth that the cost of malpractice insurance or defensive medical care is what drives up healthcare.

[ColdNoMore]

Those presently on Medicare did not pay enough into it for the care they are getting now. Those getting lifetime corporate insurance did not have their salary lowered enough to cover what it is now costing the company to cover you. The cost of health care continues to escalate beyond any reasonable previous estimate.
Someone has got to pay the bill. You want an MRI for your aching hip? You didn't pay for that. You paid into a system that had Xrays at 25 dollars each. So please stop saying you earned your health care coverage.
The ACA has struggled to get healthy younger people to sign up. It has done well getting sick people to sign up and therein lies the rate increases demanded by carriers. The unenforced penalties for remaining uninsured are too low to encourage those non-compliers.
Think of it this way. If your automobile insurance cost 800/ month and there was no penalty for driving uninsured other than a 10 ticket and no concern with your assets being at risk in an accident, would most people by that coverage?
So the solution is universal coverage, like we have universal fire protection, universal police protection, universal road construction, universal military, and universal clean water. It that a threat to Aetna or BCBS, maybe. But they can continue to offer coverage in parallel with the government option.
If you are so convinced that the government can't run anything efficiently, then it will very easy for Aetna to simply charge the same as the cost of the universal coverage and turn a handsome profit.
Example, if the cost of care of the average American is 800/mo then you the consumer have the option of receiving your coverage via the government option, or selecting an alternative insurer which would then receive that 800/mo from the government for the exact same coverage package with all the same doctors and hospitals and medications.
No networks.
If you want non-standard care, not covered. If you want only brand name drugs, extra cost, but identical for all carriers. If Aetna is so efficient they will love this plan. No adverse selection, just sign up all those who prefer to deal with Aetna and not a government agency.
How does this get financed? Same way we pay for healthcare now. All employers will pay something into the cost of care as a tax as will employees. Some money will come from income taxes, some corporate, some from perhaps a tax on financial transactions.
And it is a myth that the cost of malpractice insurance or defensive medical care is what drives up healthcare.

:BigApplause:....:BigApplause:

[goodtimesintv]

Those presently on Medicare did not pay enough into it for the care they are getting now. Those getting lifetime corporate insurance did not have their salary lowered enough to cover what it is now costing the company to cover you. The cost of health care continues to escalate beyond any reasonable previous estimate.
Someone has got to pay the bill. You want an MRI for your aching hip? You didn't pay for that. You paid into a system that had Xrays at 25 dollars each. So please stop saying you earned your health care coverage.
The ACA has struggled to get healthy younger people to sign up. It has done well getting sick people to sign up and therein lies the rate increases demanded by carriers. The unenforced penalties for remaining uninsured are too low to encourage those non-compliers.
Think of it this way. If your automobile insurance cost 800/ month and there was no penalty for driving uninsured other than a 10 ticket and no concern with your assets being at risk in an accident, would most people by that coverage?
So the solution is universal coverage, like we have universal fire protection, universal police protection, universal road construction, universal military, and universal clean water. It that a threat to Aetna or BCBS, maybe. But they can continue to offer coverage in parallel with the government option.
If you are so convinced that the government can't run anything efficiently, then it will very easy for Aetna to simply charge the same as the cost of the universal coverage and turn a handsome profit.
Example, if the cost of care of the average American is 800/mo then you the consumer have the option of receiving your coverage via the government option, or selecting an alternative insurer which would then receive that 800/mo from the government for the exact same coverage package with all the same doctors and hospitals and medications.
No networks.
If you want non-standard care, not covered. If you want only brand name drugs, extra cost, but identical for all carriers. If Aetna is so efficient they will love this plan. No adverse selection, just sign up all those who prefer to deal with Aetna and not a government agency.
How does this get financed? Same way we pay for healthcare now. All employers will pay something into the cost of care as a tax as will employees. Some money will come from income taxes, some corporate, some from perhaps a tax on financial transactions.
And it is a myth that the cost of malpractice insurance or defensive medical care is what drives up healthcare.

I like what you wrote. But the real problem is that under your proposed system, Aetna and all the others like it are going to keep on charging as they wish, because their most lucrative business will still come from the federal government and Congress employees who fought tooth and nail (during ACA mandate making)......to keep their 20+ PRIVATE plans with us paying about 70% of their premiums for them.

See plan comparison list here, and then see "Premiums" in the menu:

Health & Insurance : Plan Information - OPM.gov (https://www.opm.gov/healthcare-insurance/healthcare/plan-information/plans/2016/state/fl)

.

[NYGUY]

We can quit saying we will never vote for Universal Healthcare. We will be dead. Those coming after us will vote for it. This is an interesting conversation, but 20 year old's should be having it.

[graciegirl]

We can quit saying we will never vote for Universal Healthcare. We will be dead. Those coming after us will vote for it. This is an interesting conversation, but 20 year old's should be having it.

Most of the times your posts are great, but this one is brilliant.

[petsetc]

I remember (as all our age do) when there were regulated monopolies, airlines, utilities, phones ... That was ended to allow the "free market" to bring down prices and promote competition ... not sure how that's working out.

Social Security (and the VA) are legislatively prohibited from negotiating drug pricing. Although the $ amount of fraud in the Medicare system is staggering, as a % of total dollars it is not too bad.

The EpiPen was developed with federal funds, yet of the new $600 price, I believe the taxpayers royalty is zero.

Perhaps health care should not be a for-profit industry.

Just a few thoughts.

[goodtimesintv]

We can quit saying we will never vote for Universal Healthcare. We will be dead. Those coming after us will vote for it. This is an interesting conversation, but 20 year old's should be having it.

This is true and I agree with it. However, it is still our responsibility to teach our children and grandchildren what we have learned from experience, and can learn now, having the TIME to read and study while they are working to make ends meet.

And after reading, studying, and working in it for 40-50 years, WE still don't know all that goes into the sausage making that is DC--District of Collusion--and their "accountability" to us.

[Avista]

I remember (as all our age do) when there were regulated monopolies, airlines, utilities, phones ... That was ended to allow the "free market" to bring down prices and promote competition ... not sure how that's working out.

Social Security (and the VA) are legislatively prohibited from negotiating drug pricing. Although the $ amount of fraud in the Medicare system is staggering, as a % of total dollars it is not too bad.

The EpiPen was developed with federal funds, yet of the new $600 price, I believe the taxpayers royalty is zero.

Perhaps health care should not be a for-profit industry.

Just a few thoughts.

My thought also. healthcare should be nonprofit. People should not make money from other people's illnesses

[Chi-Town]

Those presently on Medicare did not pay enough into it for the care they are getting now. Those getting lifetime corporate insurance did not have their salary lowered enough to cover what it is now costing the company to cover you. The cost of health care continues to escalate beyond any reasonable previous estimate.
Someone has got to pay the bill. You want an MRI for your aching hip? You didn't pay for that. You paid into a system that had Xrays at 25 dollars each. So please stop saying you earned your health care coverage.
The ACA has struggled to get healthy younger people to sign up. It has done well getting sick people to sign up and therein lies the rate increases demanded by carriers. The unenforced penalties for remaining uninsured are too low to encourage those non-compliers.
Think of it this way. If your automobile insurance cost 800/ month and there was no penalty for driving uninsured other than a 10 ticket and no concern with your assets being at risk in an accident, would most people by that coverage?
So the solution is universal coverage, like we have universal fire protection, universal police protection, universal road construction, universal military, and universal clean water. It that a threat to Aetna or BCBS, maybe. But they can continue to offer coverage in parallel with the government option.
If you are so convinced that the government can't run anything efficiently, then it will very easy for Aetna to simply charge the same as the cost of the universal coverage and turn a handsome profit.
Example, if the cost of care of the average American is 800/mo then you the consumer have the option of receiving your coverage via the government option, or selecting an alternative insurer which would then receive that 800/mo from the government for the exact same coverage package with all the same doctors and hospitals and medications.
No networks.
If you want non-standard care, not covered. If you want only brand name drugs, extra cost, but identical for all carriers. If Aetna is so efficient they will love this plan. No adverse selection, just sign up all those who prefer to deal with Aetna and not a government agency.
How does this get financed? Same way we pay for healthcare now. All employers will pay something into the cost of care as a tax as will employees. Some money will come from income taxes, some corporate, some from perhaps a tax on financial transactions.
And it is a myth that the cost of malpractice insurance or defensive medical care is what drives up healthcare.

Excellent post. Employers will like it as they will not have the administration costs they once had either in house or an outside firm. Employees will like it, because they will have the freedom to choose an employment path without losing their coverage. The ACA is a step in that direction. But the compromises needed weakened it.

[dbussone]

My thought also. healthcare should be nonprofit. People should not make money from other people's illnesses



Having worked in healthcare for as long as I did, I can assure you that there is little difference between for-profit and not-for-profit hospitals. Both need to make money to stay open. One pays dividends to its investors, the other retains its profits. One pays taxes, the other doesn't. And on it goes.

I've worked in both environments. Given two capable and similar facilities I could go to either. However, my physician's preference would play a significant role in my decision. And I think this relationship is going to continue to change if we move closer to universal healthcare.



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[Madelaine Amee]

Frankly, I see no other solution to the problem of unbridled greed in the pharmaceutical industry and the skyrocketing cost of all forms of healthcare, than a universal single payer system.

If the Declaration of Independence, adopted as the basis for our structure of American government, states that we are entitled to certain unalienable rights endowed by our Creator, and those include LIFE, liberty, and the pursuit of happiness, then healthcare should be thought of as a right rather than a privilege. Thus if we have a right to healthcare, then it follows that our federal government, as the only earthly entity with authority over us all, should provide for that right. Besides that, I just think that no man, woman, or especially child should suffer, or lose their life, or face personal or family bankruptcy in America because they can not afford health insurance or health care, and I'm willing to pay for that.

Yes, the federal government attempts to manage incredibly massive programs like Social Security, Medicare, FEMA, and our military defense, and we often hear of the abuses within these programs. But there are abuses in private sector systems also, and I don't think we can or should allow the fact that mistakes will be made keep us from trying to fix this or any other problem. America has always done it's best things for moral reasons, and this is another one of those.

Thanks for bringing up the topic!

You are not alone in your thinking .......... I suspect there are many of us who agree with you. Were it not for the greed and corruption throughout both parties more would be done to help those that really need it.

[rubicon]

Indeed a complex topic and one too large for these pages.

One poster views healthcare as a right. I find it convenient when people invent rights for themselves. there is no legal or constitutional basis for such a right, no more than saying people have a right to own a home. We saw what that sort of thinking did to the housing industry with lax underwriting and we see how we are in multi-trillion dollar debt for student loans that many students believe they have a right not to pay back...........................and another dimension to this issue of "my right" is the fact that I am entitled to a lot of right ...its the American way

As to funding the short of it is that the federal government is too big too complex too under educated to handle managing 1/6th of our economy.

The central issue in the OP's topic is funding. The ACA laws were passed with the option to let people in or out at their leisure. Insurance is a pooling of resources by many for the benefit of some especially when it comes to catastrophic losses that the average family cannot absorb. so we have people who get sick buy insurance treat get better drop out. We have young people who being healthy will never opt in until they have a need. etc etc.

Again with sensible regulations and underwriting private insurers can do a better job both managing benefits vis a vis premiums and the fraud and abuse associated with this funding because it all means profit. and keep in mind insurance laws are written that contain the expense component of premium remain fixed. Premium are calculated on an ongoing basis to reflect what is occurring in the economy (marketplace) ACA insurance companies bleeding money are going to individual policies not in ACA to subsidized their losses . Tell me where or when the government worried about expenses or spending. I mean its someone else's money and it is low lying fruit to be picked at any time

This is an issue for us now because we are affected by it now. ACA instigated the mess we are in now. It has reverberated across the healthcare spectrum. My company because of ACA stopped negotiating insurance for its retirees because ACA removed the insurability option. so now the company offers an annual stipend and we do our own search . Ironically we chose the same health care plan as was offered by our company. the kicker is they tell me if we opt out then we are subjected to insurability. The reasoning is obvious and stated above.

ACA has been a disaster and it was meant to be because its authors really wanted a single payer system and so they intentionally have placed a lot of people in harms way to get their political agenda. IMHO people will rue the day they concede to government control vis a vis free enterprise for this large portion of our economy.

[blueash]

I like what you wrote. But the real problem is that under your proposed system, Aetna and all the others like it are going to keep on charging as they wish, because their most lucrative business will still come from the federal government and Congress employees who fought tooth and nail (during ACA mandate making)......to keep their 20+ PRIVATE plans with us paying about 70% of their premiums for them.

See plan comparison list here, and then see "Premiums" in the menu:

Health & Insurance : Plan Information - OPM.gov (https://www.opm.gov/healthcare-insurance/healthcare/plan-information/plans/2016/state/fl)

.

No, Aetna could only charge the rate the government established as its cost to provide coverage, and that payment would come from the government just as Medicare Advantage plans are paid now. Except no networks, no excluding Mayo, none of that. They could of course have a higher cost plan where instead of 800/mo, they offer a 1000/mo plan where they get 800 from the gov't and 200 from you. No tax benefit to you or an employer for that additional cost.
And yes, we need to vigorously prosecute Medicare frauds and yes we need to allow the Gov't to negotiate drug prices. None of that alters the basic arguments in favor of universal coverage, which was not allowed into the ACA at the insistence of the big insurance companies.
For more information on it perhaps read:
United States National Health Care Act - Wikipedia, the free encyclopedia (https://en.wikipedia.org/wiki/United_States_National_Health_Care_Act)

[Paper1]

We have a diversity of comments for the most part. I'm hoping we hear from many more of our fellow posters. Good stuff, and interesting as well. Thanks for participating.


Sent from my iPad using Tapatalk

With so many recieving health care at little or no cost with others picking up tab through income tax UHC is inevitable. IMO

[Cedwards38]

Indeed a complex topic and one too large for these pages.

One poster views healthcare as a right. I find it convenient when people invent rights for themselves. there is no legal or constitutional basis for such a right, no more than saying people have a right to own a home. We saw what that sort of thinking did to the housing industry with lax underwriting and we see how we are in multi-trillion dollar debt for student loans that many students believe they have a right not to pay back...........................and another dimension to this issue of "my right" is the fact that I am entitled to a lot of right ...its the American way

As to funding the short of it is that the federal government is too big too complex too under educated to handle managing 1/6th of our economy.

The central issue in the OP's topic is funding. The ACA laws were passed with the option to let people in or out at their leisure. Insurance is a pooling of resources by many for the benefit of some especially when it comes to catastrophic losses that the average family cannot absorb. so we have people who get sick buy insurance treat get better drop out. We have young people who being healthy will never opt in until they have a need. etc etc.

Again with sensible regulations and underwriting private insurers can do a better job both managing benefits vis a vis premiums and the fraud and abuse associated with this funding because it all means profit. and keep in mind insurance laws are written that contain the expense component of premium remain fixed. Premium are calculated on an ongoing basis to reflect what is occurring in the economy (marketplace) ACA insurance companies bleeding money are going to individual policies not in ACA to subsidized their losses . Tell me where or when the government worried about expenses or spending. I mean its someone else's money and it is low lying fruit to be picked at any time

This is an issue for us now because we are affected by it now. ACA instigated the mess we are in now. It has reverberated across the healthcare spectrum. My company because of ACA stopped negotiating insurance for its retirees because ACA removed the insurability option. so now the company offers an annual stipend and we do our own search . Ironically we chose the same health care plan as was offered by our company. the kicker is they tell me if we opt out then we are subjected to insurability. The reasoning is obvious and stated above.

ACA has been a disaster and it was meant to be because its authors really wanted a single payer system and so they intentionally have placed a lot of people in harms way to get their political agenda. IMHO people will rue the day they concede to government control vis a vis free enterprise for this large portion of our economy.

It's true that, oftentimes people conveniently invent "rights" for themselves that are not prescribed for them by the government, but are you suggesting that American citizens do not have a unalienable right to life that is endowed by our Creator? And if we do have this right to life, does that not imply that adequate healthcare for all citizens is required?

I know that it is the Declaration of Independence, duly adopted by the Second Continental Congress in July 1776, that states that, "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness." Aren't rights established by the Declaration, because if not then we are all still British citizens. If this thinking is wrong, then is the right to liberty and the pursuit of happiness in question as well? The right to life, from the Creator, is self-evident rather than conveniently invented.

[bob47]

I wish I understood this subject better. Here are a few observations and thoughts.

When I retired, my company provided health insurance until we received medicare, at which point all support stopped. The company claims to have contributed the first $10,800 per year for premiums, and my wife and I paid an additional $7,000 per year. $18,000 per year for premiums for 2 people, with a large deductible. How many Americans can afford that?

Any universal coverage will have to have limits and make compromises that will disappoint some folks. To pick one example, is fertility treatment coverage a necessity? These decisions will will cause some heated discussions.

It seems like Medicare is government run universal health care for old folks, and it seems to work pretty well for those that have it. I don't know if it's sustainable. I do know that my health care costs have gone down a lot since we are on Medicare, and we have no complaints about what is covered.

We are fortunate here in The Villages to meet a lot of folks from Canada and I often ask them what they think of their medical system up there. Not one has had personal complaints about how their system works.

No answers here. Just some personal observations.

[Paper1]

Most of the times your posts are great, but this one is brilliant.

I have to disagree that this post is brilliant, it just says we would rather leave mess to our grand children. We should address it. IMO

[rivaridger1]

Like it or not the senior citizens of this country are already enrolled in a " Universal Health Care " program called Medicare. Rich or poor, it does not matter, all are participants. The rich can opt out and pay for private health care, but they can not opt out of paying basic Medicare insurance premiums or at least that is my understanding. Curiously, for something administered and managed by the Federal Government it seems to work, the cost issues and sustainability of the program aside for the moment. If you really want to start an interesting thread on this forum submit an argument the Medicare program should be disbanded and that we need to revert to the private health care system which existed in this country in the 1940-50s when if you were not rich, did not have access to employer sponsored health care, or simply did not have he money to pay for the generally limited private health insurance then available, if you got sick good luck. In those decades your illness went untreated until you were admitted to the hospital to die. Prior to then, it was even better, since you simply died at home after lots of painful suffering.

How any senior enjoying the benefits of this " Universal Health " care program can argue in good conscience the younger "citizens " of this country no matter their economic circumstances or state of health should not have similar access to health care escapes me.

I know some will feel differently but at least start your argument, if it indeed has substance, with the proposition the current Medicare program should be legislated out of existence and that all those dependent on it should in the future rely on their own financial resources and/or the charity of their friends and neighbors for their health care needs.

As to costs, which really control the sustainability of any " Universal Health " care program, they must be regulated in some fashion. Do you regulate the cost of medical services and drugs and risk losing the advances in health care the profitability those services and drugs profits create ? Do you regulate the profitability of the services and drugs to allow for the advances in medical science to continue ? Do you tell the citizens they live in a capitalistic society and they need to willingly absorb whatever costs result from that decision ? Who else can do any of these things other then the Federal Government ?

Who other then the Federal Government has the power and ability to both mandate participation in a " Universal Health " care program and to regulate the cost of the program itself ? I personally do not wish that was the case, but private enterprise would not appear to be up to the task of doing so and would be need to be empowered by the government to do so as well bringing us back to square one.

[fraurauch]

Like it or not the senior citizens of this country are already enrolled in a " Universal Health Care " program called Medicare. Rich or poor, it does not matter, all are participants. The rich can opt out and pay for private health care, but they can not opt out of paying basic Medicare insurance premiums or at least that is my understanding. Curiously, for something administered and managed by the Federal Government it seems to work, the cost issues and sustainability of the program aside for the moment. If you really want to start an interesting thread on this forum submit an argument the Medicare program should be disbanded and that we need to revert to the private health care system which existed in this country in the 1940-50s when if you were not rich, did not have access to employer sponsored health care, or simply did not have he money to pay for the generally limited private health insurance then available, if you got sick good luck. In those decades your illness went untreated until you were admitted to the hospital to die. Prior to then, it was even better, since you simply died at home after lots of painful suffering.

How any senior enjoying the benefits of this " Universal Health " care program can argue in good conscience the younger "citizens " of this country no matter their economic circumstances or state of health should not have similar access to health care escapes me.

I know some will feel differently but at least start your argument, if it indeed has substance, with the proposition the current Medicare program should be legislated out of existence and that all those dependent on it should in the future rely on their own financial resources and/or the charity of their friends and neighbors for their health care needs.

As to costs, which really control the sustainability of any " Universal Health " care program, they must be regulated in some fashion. Do you regulate the cost of medical services and drugs and risk losing the advances in health care the profitability those services and drugs profits create ? Do you regulate the profitability of the services and drugs to allow for the advances in medical science to continue ? Do you tell the citizens they live in a capitalistic society and they need to willingly absorb whatever costs result from that decision ? Who else can do any of these things other then the Federal Government ?

Who other then the Federal Government has the power and ability to both mandate participation in a " Universal Health " care program and to regulate the cost of the program itself ? I personally do not wish that was the case, but private enterprise would not appear to be up to the task of doing so and would be need to be empowered by the government to do so as well bringing us back to square one.

I couldn't agree more!

[spuds51]

It's true that, oftentimes people conveniently invent "rights" for themselves that are not prescribed for them by the government, but are you suggesting that American citizens do not have a unalienable right to life that is endowed by our Creator? And if we do have this right to life, does that not imply that adequate healthcare for all citizens is required?

I know that it is the Declaration of Independence, duly adopted by the Second Continental Congress in July 1776, that states that, "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness." Aren't rights established by the Declaration, because if not then we are all still British citizens. If this thinking is wrong, then is the right to liberty and the pursuit of happiness in question as well? The right to life, from the Creator, is self-evident rather than conveniently invented.

If I'm following you you're saying that in the Declaration of independence the word LIFE means all entitled to health care be cause it is a necessity of LIFE. Maybe we should add food to that as well after all we all need food for life.
What do you think would happen if the government had a universal food plan? I had a friend that owned a grocery store..he said you could always tell the ones that had no money. They were the ones with the most food. Guess what the store is going to do when the government is paying for all food. Yep, jack up the prices.
One poster says a universal health care plan is doable by charging a fee to the employer and employee. As of the end of 2015 almost 40% of the country was not working, most were on some government assistance already. Besides, haven't we already done that? It's called Medicare. As for people getting more than they payed in..that's how all insurance works. If you pay $150. a month for your car insurance and wrap it around a tree you are getting more out of than you payed in.
Right now the federal government is paying between 6 and 7 % of the federal budget for just the interest on the national debt. Interest rates are at historic low rates. If it would rise to more normal levels that amount would rise substantially. Our national debt has now surpassed our gross domestic product. And here is another little sobering thought if you add the national debt, liabilities, ( such as government pensions and retirements), other unfunded obligations that figure at the close of the 2015 fiscal year was 76.4 trillion dollars. That represents 90% of the combined net worth of all holdings. That is every single thing in this country. All buildings, cars, banks accounts, TV's everything. Yet people want to start more social programs. I don't get it. Oh well, I'm going to go play golf...I'm sure it will all take care of itself.

[PTennismom0202]

We have am employment-based model. We're the only one in the world. If you're lucky to work for a company big enough and generous enough to offer health insurance, you've seen your portion of the cost shifted in your direction lately. That's because it's going up due to technology, and little bit because of defensive medicine. And people expect to have the best! There is no law that requires employers to offer health insurance, so why should they? Young people have a hard time getting jobs and many don't get health insurance even if they work full time. When they get sick they often go to the ER (which is way more expensive than the PCP) and then either the hospitals writes it off as bad debt, some states have insurance companies subsidize the uninsured, or the patient goes deeply into debt. What are we going to to do make sure every American has adequate health insurance so that the costs aren't subsidized by someone else, or drive them into debt?

There are 700,000 physicians, millions of other providers, and 5,000 hospitals in the country. They want to be paid fairly (or maybe fairly +) for the care they give. We've had 2 serious attempts to build a way to get everyone covered. One was back in Clinton's first term. The second one is the ACA. How can we use these professional providers and hospitals, keep them private, and cover everyone? Every other first world country in the world has national health insurance -- not an employer-based program. I think we've got to go this way. I am sure that will be a very unpopular idea in TV, but how else are you going to rearrange the deck chairs (patients, employers, professional providers, institutional providers and insurance companies) to get to universal coverage? BTW, Medicare is a national health service. Any national health program will need tight medical policy/Utilization Review program (what's covered?, under what conditions?, who can perform the services? how often?...+more controls), and probably an annual aggregate budget shared by all providers. Right now there is no stomach for this -- only taking the ACA away.

[justjim]

An old thread that I found not only interesting but also informative. We seniors with our Medicare are sort of like a "snug bug in a rug". It's pretty easy for us to say let's abolish the ACA while we are "snug as a bug in a rug" with a hybrid form of Universal health care known to us as Medicare. Arguably we seniors are more healthy and are living longer because we have health care.

Now Medicare is not perfect and certainly ACA is far from perfect. Neither are substainable without some changes. Perhaps painful changes.

It's true our employers provided most of us some form of health care insurance during our working years. Because of great changes and global competition many of our former employers either went out of business or moved elsewhere some even out of the United States. In order to remain competitive in a global economy, many companies have cut back on benefits that includes retirement and paid health care. Even government employees are being required to contribute more to their benefits (especially health insurance) and Billions are owed to pension systems and are no longer sustainable. Pensions are definitely another topic for discussion in another Thread.

The next several years many challenges in health care are going to take place
and how we embrace the changes will determine what type of hybrid system we end up with here in TV and across the country. How we are going to pay for our health care is yet to be determined.

[BK001]

We can quit saying we will never vote for Universal Healthcare. We will be dead. Those coming after us will vote for it. This is an interesting conversation, but 20 year old's should be having it.

Yes they should ... but will they?

I was fortunate, throughout my HR career, to have worked at several fine (and generous) NY professional practice firms in both the legal and accounting industries.

And while the firms' contribution for employees was a generous percentage of the medical premium, they all had some sort of an employee contribution. Young people starting out have many competing desires for their entry level salaries ... first car, apartment, clothes, vacations, tuition loan repayments, etc.

I can not count how many times I counseled a new employee who chose not to participate in the medical -- even using scare tactics such as "... I know you are healthy and invincible ... but what if, god forbid, your appendix bursts without warning. Who is going to help you? Do you really want to put your parents at risk and possibly have to ask them to spend their retirement savings, or worse, sell their home because you didn't signup for medical coverage?"

Occasionally my tactic was successful. (Same was true with 401K signups where the company had a match program!) Try convincing this population that it is the best financial move available to them.

They can be a difficult demographic for discussions about healthcare and retirement issues.

[Paper1]

Indeed a complex topic and one too large for these pages.

One poster views healthcare as a right. I find it convenient when people invent rights for themselves. there is no legal or constitutional basis for such a right, no more than saying people have a right to own a home. We saw what that sort of thinking did to the housing industry with lax underwriting and we see how we are in multi-trillion dollar debt for student loans that many students believe they have a right not to pay back...........................and another dimension to this issue of "my right" is the fact that I am entitled to a lot of right ...its the American way

As to funding the short of it is that the federal government is too big too complex too under educated to handle managing 1/6th of our economy.

The central issue in the OP's topic is funding. The ACA laws were passed with the option to let people in or out at their leisure. Insurance is a pooling of resources by many for the benefit of some especially when it comes to catastrophic losses that the average family cannot absorb. so we have people who get sick buy insurance treat get better drop out. We have young people who being healthy will never opt in until they have a need. etc etc.

Again with sensible regulations and underwriting private insurers can do a better job both managing benefits vis a vis premiums and the fraud and abuse associated with this funding because it all means profit. and keep in mind insurance laws are written that contain the expense component of premium remain fixed. Premium are calculated on an ongoing basis to reflect what is occurring in the economy (marketplace) ACA insurance companies bleeding money are going to individual policies not in ACA to subsidized their losses . Tell me where or when the government worried about expenses or spending. I mean its someone else's money and it is low lying fruit to be picked at any time

This is an issue for us now because we are affected by it now. ACA instigated the mess we are in now. It has reverberated across the healthcare spectrum. My company because of ACA stopped negotiating insurance for its retirees because ACA removed the insurability option. so now the company offers an annual stipend and we do our own search . Ironically we chose the same health care plan as was offered by our company. the kicker is they tell me if we opt out then we are subjected to insurability. The reasoning is obvious and stated above.

ACA has been a disaster and it was meant to be because its authors really wanted a single payer system and so they intentionally have placed a lot of people in harms way to get their political agenda. IMHO people will rue the day they concede to government control vis a vis free enterprise for this large portion of our economy.
My wife and I are both 64 and are paying for our own health insurance so are in the small group that is getting keelhauled by medical juggernaut. When one says medical care is not a right that means someone has to make a call on what to do with people who cannot afford it. Do you do nothing, do you give them pain meds until they die, do you treat them up to a certain dollar limit, etc. Healthcare costs are one of the major reasons our manufacturing sector is dying. I am a believer in the free enterprise system but medical care is in an unsustainable profit making frenzy. Count me as a single payer supporter.

[justjim]

My wife and I are both 64 and are paying for our own health insurance so are in the small group that is getting keelhauled by medical juggernaut. When one says medical care is not a right that means someone has to make a call on what to do with people who cannot afford it. Do you do nothing, do you give them pain meds until they die, do you treat them up to a certain dollar limit, etc. Healthcare costs are one of the major reasons our manufacturing sector is dying. I am a believer in the free enterprise system but medical care is in an unsustainable profit making frenzy. Count me as a single payer supporter.

Agree or not this is a honest post on the subject.

[ColdNoMore]

My wife and I are both 64 and are paying for our own health insurance so are in the small group that is getting keelhauled by medical juggernaut. When one says medical care is not a right that means someone has to make a call on what to do with people who cannot afford it. Do you do nothing, do you give them pain meds until they die, do you treat them up to a certain dollar limit, etc. Healthcare costs are one of the major reasons our manufacturing sector is dying. I am a believer in the free enterprise system but medical care is in an unsustainable profit making frenzy. Count me as a single payer supporter.

It's sad to think that the greatest nation this planet has ever seen, puts so many things ahead of looking after the health of its citizens.

Especially since most other developed nations...have already came to that conclusion.

Hopefully, one of these days soon...that will be a stress that you no longer have. :thumbup:

[l2ridehd]

Unfortunately we are fast becoming a nation of people who believe they are entitled to everything without having to pay for it. If it comes from the government it must be free. This includes health care. Until we move away from the entitlement way of thinking we will never solve this problem. Making a decision to not work or work less or let someone else take care of me has to have consequences. Those that can't help themselves should get help from all of us who can. Those that can but don't should not. Then and only then can we as a nation succeed with things like health care for all and retirement plans that work and other government social programs.

So what do we do about the current health care issues? There are several things that can be done but will be painful and expensive for all.

1. Get the government out of health care EXCEPT for a high deductible, catastrophic, supplemental plan with no pre existing limits. Maybe something like a 20K annual deductible with a multi million cap and an annual premium that is affordable and require everyone have it. This way private insurance can become competitive when they know they have some maximum expense. Lots of other details needed but something along this concept.
2. A limit on tort for medical malpractice along with a license removal when any doctor is sued X times. Get the bad ones out and a cap on total expense will again make the insurance more affordable and allow doctors to cut cost.
3. Allow drug companies a better way to expense drug development and testing to cut the total cost of new medicines. This is an area that adds significant cost to medical care, but is also required if we want to maintain a best of the best health care system.
4. Make medical school more affordable by providing interest free subsidized loans for those wanting to become doctors.

These four steps would be costly, but less then the current "affordable care act" is currently costing. It would cost all of us more then we now pay but would also provide access to excellent care and eliminate the fear of going broke when you have a serious illness. Again lots of details needed but this type of plan would work and cut total cost for all of us in the long term while still providing the best health care available. And there would always be the naysayers who will want the government completely out and the lawyers who will still want the large tort fees and will lobby against it, but if everyone supported something like this it would work.

[Cedwards38]

I think it has to be and should be. What objective could be more important to our nation than the health of our families and individuals? Even though the ACA has provided a health coverage for approximatelly 20,000,000 people who did not have insurance prior to the law, there are still people who do not have insurance or can not afford the products the ACA has available.

I've argued before that the American Declaration of Independence, duly adopted by the Second Continental Congress states "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed.........."

If our government is on record that we have that unalienable right to life, then does the government not have on undeniable responsibility to ensure that all citizens, regardless of socioeconomic status, has healthcare. This includes children, elderly, and those with sundry preexisting conditions.

The ACA is troubled because not enough healthy people are signing up for the insurance. It is doing wonders for children and the sick, but to make it profitable it must also have many payers who use it very little. It's the same financing philosophy as that behind Social Security. It's funded by the working, who don't use it until later in life.

Thus I am an advocate of a single payer system, with negotiated health care fees and drug prices, so that every American can have access to quality healthcare without the threat of bankruptcy. Medicare for all.

How do we afford it? I'm also an advocate for massive reform of the federal tax code which will cause a fair system where the wealthy and corporations pay a much higher share of their income than they do currently. This means ending offshore sheltering of income from federal tax and a tax rate that is much higher on those with incomes over $250,000.