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    • Context: I live in Ireland. We have a public health service which costs 300m a year, a very substantial part of the yearly budget.

      My father was taken to hospital last Monday night (pneumonia). He went to the A&E of the public hospital and was put on a trolley for the night.
      I visited tuesday morning and the accident and emergency was chockablock with people on trollies. Nurses had to weave amongst them, the Nurses station had two people on trollies in front so, when you went to speak to them, you were speaking over two sick people.

      Every nook and cranny had people on trollies. All the beds in teh wards were taken.
      This wasn't flu season, just an ordinary monday night tuesday morning.

      He has health insurance so I got him transferred to a private hospital, to a room on his own, nurses checking every hour, full facilities.

      The NHS, in England has a 6 hour rule, Patients are either discharged or moved to a ward within 6 hours of arrival at a&e.

      The NHS is, again, a substantial part of the english budget spend on publc services, but it works.

      If you don't have private health care, through no fault of the nurses and doctors on the front line, you are not going to get adequate medical care.

      If one person had msra or any other contagious illness.. it would spread rapidly in these crowded conditions.

      It is a two tier system, health insurance gets you access to private hospitals, consultants, no waiting list for operations.

      Public health means waiting for appointments to see consultants, long lists for operations, ....

      I remember the debate over obama care.. has it made health care affordable in the US? or are you screwed there also if you can't afford health insurance?

      article from the Irish times for reference:

    • There are still many who do not have insurance. And while the allegation is everyone has access, as I say, many do not. Whatever the reason.

      The more loaded question is whether insurance is more affordable. For me, the short answer is no. For many others who are covered by the exchanges, having insurance is better than not.

      I doubt very seriously that the actual costs to provide care have gone down.

    • Obamacare made some progress in providing insurance to people who had none before, but it did nothing to reduce the cost of healthcare, and despite a bit of window dressing, wasn't really meant to. Americans continue to pay far more for poorer public health outcomes than the rest of the industrialized world, but if you ask them, most would probably say they have the best healthcare system in the world. It's astonishing.

    • I have extended family in Southern Utah, a predominantly older white retirement community that voted 87% Trump. We go out there a couple of times a year and my father-in-law's house is basically open to his many friends, who talk and drink coffee while Fox plays in the background. They are wonderful, loving people who would do anything for a friend in need.

      One of their favorite topics is Obamacare and how evil it is. A few of the younger ones are on the ACA, the Affordable Care Act, and they like it, but none will touch Obamacare.

      However, my wife's brother began to have trouble breathing. He's a sheetrock installer with no healthcare. He could go to the emergency room, but there wasn't much they could do because it's a chronic condition, not an emergency.

      So we offered to pay for Obamacare for him. Unfortunately, it was like dancing with the devil and betraying his country for my father-in-law to agree. But to his credit, at least from my perspective, he gave in and signed up for Obamacare.

      My wife's brother has since gotten great treatment including biopsies on the spots on his lungs to find out they are benign. But they still think Trump is the best thing to happen to the country in decades.

    • I always thought it was interesting that most of the people I see in pictures holding "Don't socialize our medicine" signs appear to be Medicare age.

    • They are the same but opponents of The Affordable Care Act nicknamed it Obamacare to get people to hate it. I tried to point that out but was met with anger and emphatic fake news statements, so I gave up most of the time.

      One thing I have to give Trump credit for is making Obamacare popular. Obama was unable to achieve that.

    • it’s only recently come into full effect. Idk. The idea of affordable care available to everyone is great. That the bill was not well thought out in the affordable aspect, not so great. I now pay about twice what I did before for half the coverage.

      That could have been avoided with careful planning and changes the could have unified many of the administrative aspects of health care (medical malpractice, coding for insurance, etc). The withdrawal of companies from CA has also reduced choices here as well.

      If both sides of the isle had talked, the solution could have been great and it’s not.

    • I believe that it's inefficient because although it was able to be passed, every effort was made to sabotage it along the way. It's badly compromised. My hope is that it's the foot in the door and that eventually the focus will switch from trying to kill it to trying to fix it.

    • I think people would like you to view it as “sabotage” but I don’t know that you can. 2000 pages with little discussion before the vote?

      That was pushed through in the truest meaning of the phrase.

    • I think you may be in error there, ian.

      "H.R. 3962 was presented to the House of Representatives in July of 2009,
      and wasn't signed into law until March 23, 2010, after months of
      revisions, amendments, and debates about the bill."

    • She didn's say she hadn't read it :)

      Seriously, she wasn't talking to congress critters. She was talking to members of the National Association of Counties. She was talking about the benifits of the ACA, not the language of the bill. Also, everybody leaves out the rest of her statement -- "away from the fog of the controversy". Death panels? Really?

      It was a stupid thing for a politician to say, given how other politicians will do exactly what they did -- turn a sound bite from a speach to one group into an exhortation to another group to pass a bill they hadn't read. It's sad that the public doesn't bother asking "who was she talking to?", "What were they talking about?", and "Is that all she said?".

    • I may have missed something important in the conversation so feel free to correct any misperceptions I have. My understanding is the original ACA (Obamacare) was heavily debated and many compromises were made over a long period of time. Both Pelosi and Obama knew all the details and fielded extensive questions. They held a bipartisan 3-hour open debate on C-SPAN.

      It's probably more accurate to call it Romneycare because it was modeled after the health care Romney instituted in Massachusetts as Republican governor. Obama gave an extensive interview to Ezra Klein of VOX just before leaving office that I listened to where he said that (a) Romneycare was widely respected and (b) since it was Republican, they thought they could do something bipartisan.

      At the heart of the debate that divided left and right is the mandate that everyone must pay for health insurance if their employers don't cover them. It's what makes the math work. It's like public education or roads. If only the taxpayers with children in school had to pay taxes for school, a lot of families wouldn't be able to send their kids.

      When the new administration came in, they wanted to repeal and replace Obamacare. It was that bill that was hard for anyone to read because it was rushed through without time for review. When McCain famously objected to the rushed no-time-to-read-it process and voted it down, they set the wheels in motion to make Obamacare not work by eliminating the mandate, among other things. That's why your premiums are climbing so fast and the insurers want out.

    • Ian, that's at the level of cheap shots. Your contention was that the bill was jammed through. It wasn't. That's a fact. Another fact is that that compromises made during the process significantly reduced the efficiency of the law. A third fact is that if Sen. Joe Lieberman had voted for the public option, instead of bowing to pressure from insurance companies, we'd have far more affordable healthcare today.

    • Snopes did a nice summary of the difference between the ACA (Obamacare) process and the Republican attempt to repeal it. There's simply no comparison: the attempt to repeal was far more secretive.

    • I think that the whole thing is a political cluster fuck that didn't do what it could or should have done. That fact that Nancy Pelosi said she didn't read it? That's no cheap shot. Just a really poor choice of words on her part. Or indicative of the process.

    • That's my opinion Sid. Sorry, but you're not going to change it.

      And I don't think you realize that I don't blame one party; I blame both. We were sold a bill of goods that should have been a lot better than it is.