Topic: ACA

[Oniya]

http://www.washingtonpost.com/blogs/fact-checker/wp/2013/10/30/obamas-pledge-that-no-one-will-take-away-your-health-plan/?tid=pm_politics_pop

I found this little gem and was amazed at some of things I did not KNOW about ACA...like I now have to pay to treat those i substance abuse programs....so if i understand this...i could break the law and get  caught with using drugs...get insurance [they cannot deny me] and let others help pay for my drug problem....wow what the heck am i waiting for...i think getting a kilo of crack nis great place to start

Oddly, if you replace 'substance abuse programs' with 'Planned Parenthood', you'll get some of the Tea Party's arguments.  Not to mention that substance abuse programs are intended to get people off drugs so that they stop breaking the law and become productive members of society.

[Valthazar]

Oddly, if you replace 'substance abuse programs' with 'Planned Parenthood', you'll get some of the Tea Party's arguments.  Not to mention that substance abuse programs are intended to get people off drugs so that they stop breaking the law and become productive members of society.

We all know what the intentions of these programs are - it is how they end up resulting, and its economic impact on our country, that are troubling.

[mia h]

I know many here are big on "pull your weight" and help the little guy but I just looked at my last pay stub....

Yes, health care has to paid for but the argument is mostly the wrong way round. The debate mainly focuses on costs etc. but doesn't it make sense to decide wat health care provision should look like and then work out how to organise and pay for it afterwards?

It's in my interest that everyone else has access to good affordable health care, anyone who isn't able to work because they are ill costs me money both in terms of benefit payouts and them not being active in the wider economy. It's also better if health care is focused on prevention instead of treatment but there's also less money to be made from prevention. Obesity is a huge (excuse the pun) problem it's far cheaper to educate people with things as simple as cooking classes instead of having to treat them for diabetes and heart problems and fitting gastric bands etc. The US has the highest health care costs per capita in the world, but the life span of the average American is in decline, if that doesn't tell you that health care in broken then I'm not sure what will. The ACA is maybe half step in the right direction but there are bigger problems that need solving.

[Retribution]

I have never said US health care is not broken. In fact in other threads I have in fact said it is broken, but call me a skeptic I always like to know what the dollar amount is on a check before I sign it.

[Valthazar]

call me a skeptic I always like to know what the dollar amount is on a check before I sign it.

If everyone considered this before supporting laws due to purely humanitarian reasons, we'd be in much better fiscal shape as a nation.  There's a lot of things that are the "right thing to do," but if we can't afford it, it's a no-go.

[mia h]

But call me a skeptic I always like to know what the dollar amount is on a check before I sign it.

And the amount you paid towards law enforcement and the military was what again?

[Valthazar]

And the amount you paid towards law enforcement and the military was what again?

I don't think he's talking about the budgetary allocation.  He's talking about bills proposed in Congress, and the costs associated with new legislation.

[mia h]

I don't think he's talking about the budgetary allocation.  He's talking about bills proposed in Congress, and the costs associated with new legislation.

And I think he's big enough to speak for himself

[Retribution]

And if you think I am all on board with the spending in those you are mistaken as well. Look, I am not one of those all about the bottom line types. In fact I think it is a pretty poor way to run things. Having said that I work inside of the system and the way Peter is robbed to pay Paul disturbs me. There are a lot of great ideas out there that I think it would be reasonable to pass. Once the funding is set up for them, but many are passed with fuzzy funding and funds are then stolen from other supposedly dedicated funds. And here are some examples:

Dedicated wildlife funds generated from sale of hunting and fishing licenses as well as Pittman Robertson Act funds http://www.fws.gov/southeast/federalaid/pittmanrobertson.html   are supposed to go to the resource.  They have a nasty tendency to not http://www.examiner.com/article/illinois-corruption-exposed-by-sportsmen-and-attorneys

This happens across the board with many, many, funds http://illinoisissues.uis.edu/archives/2012/04/fundsweeps.html  The money generated from user fees such as say a tax on a specific item purchased are supposed to be channeled to a specific use. A "sweep" is when well they are not and the funds are diverted to another use. Over time this makes an utter mess of the budgetary books http://www.michigan.gov/documents/detroitcantwait/DetroitFactSheet_412909_7.pdf
http://www.huffingtonpost.com/tag/illinois-budget-crisis
http://en.wikipedia.org/wiki/2008%E2%80%9312_California_budget_crisis

Then when money is supposedly saved it is done in ways that show those managing programs clearly do not know what those working in the programs are supposed to be doing. What their mission is http://voices.washingtonpost.com/federal-eye/2011/02/gao_report_details_mismanaged.html in short some hair brained scheme will be enacted to supposedly save money that ultimately -prevents- those trying to do their job from well being able to do their job. Where as if they had just spent the freaking money where they were supposed to the citizen's would be getting what they paid for.

So please pardon me, as I keep saying I would like to see our health care fixed. I think it is horribly broken. But I fail to see how enacting poorly conceived concepts fixes anything. Indeed I often think it makes things worse. As for ACA I have no real issue with what it wishes to do I think it is noble. But as we are seeing it is a very confusing issue and piece of legislation. *points up at all those links* [EDIT referring to links throughout this thread] So when I see the problems with things like coverage of those who already had insurance and their increase expense and the like I cringe. The reason I cringe is I see the track record and I feel like "oh god they fucked up again."

We have all heard the horror stories about the military paying for $500 hammers. But then they cannot manage to get proper armor on Hummers in Iraq because of price concerns. [EDIT added a place money should be spent] There are similar problems in other public programs. And I -do- think health care is something the government -should- be involved in. But the repeated failures make me cringe. And there are many, many, many, very competent government employees. Those who do their level best to do their job to the best of their ability. They unfortunately find themselves managed by political appointees who have no clue what their job is but simply had the right connections to get a peach appointment.

These are all signs of a system that is badly broken. And for the life of me I fail to see how a broken system can fix another broken system.

[Retribution]

And to get back on topic http://politicalticker.blogs.cnn.com/2013/11/05/obama-further-refines-you-can-keep-your-plan-pledge/?hpt=hp_c2 my issue is this seems to not be doing quite what it was sold as doing. In fact people like Phaia find themselves in a worse place than before. And I find the stance of "well that is a small percentage" or "some have to make sacrifices for the greater good" to be pretty arrogant. Who made someone god so that they could say the needs of family A are more important than the needs of family B? These are all examples of how government tends to not do things like this very well.

[Kythia]

When you artificially alter this equilibrium pricing point for a business (whether it is advantageous for mass consumers or not), it immediately sends shocks waves through the pricing for other product varieties the company sells.  If you want me to elaborate on this further, I can - but essentially, if a company is operating at the peak price point (which most corporations have the labor/time required to achieve), then suddenly reducing the price for one commodity type will make it extremely difficult to maintain prices for other products, without running at a loss.  This is because, whether or not they are reaping gigantic profits, their business plans are so delicately crafted in the short-term, that it would most certainly introduce risk into the business/industry.  For example, a company could be running a $5,000,000 profit/year.  But if expense reports, dividends, and income contracts are already clearly defined for how this profit will be distributed, the company is in great jeopardy if the "anticipated" revenue stream is suddenly altered.  The company's credit line may be affected, their leveraged debt may not be paid on time, etc.  So you can understand why artificial fluctuations in price can drastically affect a healthcare company - thus leading to many existing plans being dropped.

Yes.

But what precisely is your point?  Lets assume that "Kythia and Valthazar Medical Insurance Ltd" has indeed found an optimal price point for our various insurance policies - #1 through #30.

As a result of ACA, policies #1 through #10 now need to be adjusted, as they don't meet the baseline.  Precisely how we adjust - remove them or adapt them - isn't overly important.  Our accountants have been busy beavering away to get us our financial forecasts for the year.  However, our accountants have, you know, ears.  So ACA didn't come out of the blue - they, like the rest of the world, knew full well that ACA was coming in. 

What you seem to be arguing is that this will create a price shock in our well run company.  This is, can only be, true if the change was unexpected.  If our accountants have made profit/loss forecasts while paying no attention whatsoever to a major legislative change that affected our business and was announced long in advance then your "well run" condition doesn't apply.  If they haven't done that, if they've actually been competent, then there's no price shock.

[Valthazar]

What you seem to be arguing is that this will create a price shock in our well run company.  This is, can only be, true if the change was unexpected.  If our accountants have made profit/loss forecasts while paying no attention whatsoever to a major legislative change that affected our business and was announced long in advance then your "well run" condition doesn't apply.  If they haven't done that, if they've actually been competent, then there's no price shock.

Kythia, not sure if you have been following my other posts in this thread, but if you know what the guaranteed cost for ACA will be on insurance companies, you definitely know something that no one else knows.

You see, the cost of ACA is largely contingent on how many new enrollees there are through these new government exchanges.  Especially in an industry like healthcare, where it is critical to maintain a steady stream of premiums from individuals who likely won't get sick, to maintain a reserve from which to pay out claims.  Many of the projections for new enrollees provided by the government are turning out to be largely inaccurate.

For example, in today's news:
http://online.wsj.com/news/articles/SB10001424052702303661404579178231174626314

(edit: sorry if that link doesn't work.  Try this link, then click the news article from there.  Seems to be open access then.
https://www.google.com/search?q=young+people+health+pans&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a#q=young+people+avoiding+health&rls=org.mozilla:en-US%3Aofficial

As quoted:  "Insurers say the early buyers of health coverage on the nation's troubled new websites are older than expected so far, raising early concerns about the economics of the insurance marketplaces.  If the trend continues, an older, more expensive set of customers could drive up prices for everyone, the insurers say, by forcing them to spread their costs around."

"The average enrollee age at Priority Health, a Michigan insurer, has ticked up to age 51 for newcomers, from about 41 years old for plans offered for the current year, said Joan Budden, chief marketing officer. Arise Health Plan, Wisconsin's largest nonprofit insurer, said more than half its 150 signees are over 50, a higher proportion than expected, while declining to be specific on its target age."

I hope this explains the uncertainty I am referring to with regard to ACA.

[gaggedLouise]

Kythia, not sure if you have been following my other posts in this thread, but if you know what the guaranteed cost for ACA will be on insurance companies, you definitely know something that no one else knows.

You see, the cost of ACA is largely contingent on how many new enrollees there are through these new government exchanges.  Especially in an industry like healthcare, where it is critical to maintain a steady stream of premiums from individuals who likely won't get sick, to maintain a reserve from which to pay out claims.  Many of the projections for new enrollees provided by the government are turning out to be largely inaccurate.

For example, in today's news:
http://online.wsj.com/news/articles/SB10001424052702303661404579178231174626314

(edit: sorry if that link doesn't work.  Try this link, then click the news article from there.  Seems to be open access then.
https://www.google.com/search?q=young+people+health+pans&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a#q=young+people+avoiding+health&rls=org.mozilla:en-US%3Aofficial

As quoted:  "Insurers say the early buyers of health coverage on the nation's troubled new websites are older than expected so far, raising early concerns about the economics of the insurance marketplaces.  If the trend continues, an older, more expensive set of customers could drive up prices for everyone, the insurers say, by forcing them to spread their costs around."

"The average enrollee age at Priority Health, a Michigan insurer, has ticked up to age 51 for newcomers, from about 41 years old for plans offered for the current year, said Joan Budden, chief marketing officer. Arise Health Plan, Wisconsin's largest nonprofit insurer, said more than half its 150 signees are over 50, a higher proportion than expected, while declining to be specific on its target age."

I hope this explains the uncertainty I am referring to with regard to ACA.

I thought major insurance companies were also in the business of acquiring cash through loans to meet some of their running expenses. We all know America is very much a credit-driven economy, it's not as if these companies are sitting on their hands or slowly amassing safe money through grinding work on their safe operations until they can afford to expand their customer base a bit or make a few new offers.

If a company has a good trademark, or even an established one (and a good credit rating) it would normally have no major problem getting loans to help take it through some readjustments to its business.

Major companies have means of getting credit that you and I don't have, that no ordinary private citizen has (plus they're able to raise money through issuing new shares). It's seriously misleading sometimes to size it up as if a big company with millions, even hundreds of millions of bucks getting turned annually is running on the same "revenue and costs gotta add up in cash, every month" terms as a household budget.

[Valthazar]

Major companies have means of getting credit that you and I don't have, that no ordinary private citizen has (plus they're able to raise money through issuing new shares). It's seriously misleading sometimes to size it up as if a big company with millions, even hundreds of millions of bucks getting turned annually is running on the same "revenue and costs gotta add up in cash, every month" terms as a household budget.

Yes, in theory, they could take out loans for the purpose of covering future claims.  I find this to be an unlikely solution we will be seeing, however, since there isn't a clear avenue of where they will be able to recoup this leveraged funding in the future.

I find this highly unlikely because it is a fact that as a result of ACA, there will actually be a net increase in customers for major insurance companies.  As a result, at least in the immediate short-term, insurance companies will likely see an increase in their net total of premium revenue.

The concern, however, is a disproportionate amount of claims payouts, due to many older, uninsured, and sicker patients enrolling.  So basically, although net total premium revenue increases, it is not increasing at a rate proportional to the potential payouts that will be incurred as expenses in years coming - statistically, of course. 

It is because the net total of premium revenue will increase though, that I am skeptical of insurance companies resorting to additional funding through loans.  Rather than incur interest payments without any promise of greater enrollment in the future, the far more sensible and straightforward thing to do as an executive would be to alter premium rates for existing customers, or of course, drop coverage of certain plans.

If you have a source that discusses insurance companies considering loans in responding to ACA, I would be interested to read it.

[mia h]

The concern, however, is a disproportionate amount of claims payouts, due to many older, uninsured, and sicker patients enrolling.

So a piece of legislation is enacted that among other things prevents insurance companies denying health coverage for pre-existing conditions, and as a result lots of people who were denied coverage because of pre-existing conditions buy health insurance. What were the odds of that happening? 

[gaggedLouise]

So a piece of legislation is enacted that among other things prevents insurance companies denying health coverage for pre-existing conditions, and as a result lots of people who were denied coverage because of pre-existing conditions buy health insurance. What were the odds of that happening? 

It's sort of tempting to quote sample Grandmaster Flash: "They said it couldn't be done!"  - they being the lobbyists and on-the-floor puppeteers.

[ShadowFox89]

So a piece of legislation is enacted that among other things prevents insurance companies denying health coverage for pre-existing conditions, and as a result lots of people who were denied coverage because of pre-existing conditions buy health insurance. What were the odds of that happening? 

 How dare those cancer patients and *gasp* women make people pay more for insurance?

[kylie]

          It's been a common Republican rejoinder on sooo many issues, pretty much anything they don't like, to try to find any one little thing that has gone wrong so far (omg, a website glitched, what inconceivable systemic ineptitude that shows!) or even more often...  Common for them to say, but we don't know what some costs or results will be.  Well, there are lots of things where one doesn't know exactly but you have to take your best guess.  Lots of things people pay for because it's not just the right thing, but the thing that might be necessary to keep the rest of the economy together or to keep a growing contingent of your people from giving up, incurring more costs to weather and drag out the issue, doing something individually foolish or destructive, or leaving the country.  Of course, if you happen to have an opposition that is doing everything it can to defund the government in general and to enable corporations to make more loopholes in the legislation along the way -- I mean, I find it rather hard to believe Democrats did this all by themselves -- then it's sort of a self-fulfilling prophecy, aka plain out sabotage. 

           And I have to agree with Louise.  You don't reasonably throw away half or more of the population's regular needs merely because they happen to be somewhat more expensive in absolute terms.  It's particularly nasty to do that when those are people that the society has currently (in practice, despite lip service to the contrary) taken it for granted are being generally exploited -- for example, women bearing the brunt of service industry work, being expected to be the compromising and nurturing ones, generally put up with anything from wallflower jobs to nastiness to harassment, and often being paid much less than their counterparts even in the same exact job descriptions.  If we can afford to have half a dozen carrier battle groups or more officially active?  Then we can afford to dig up some cash and pay for mammograms and I daresay even at least a couple abortions apiece.

          I'm becoming more inclined to agree (with Val) on the point that it would all be more practical if it were closer to a single-payer system, so the particulars of the solution on offer is one problem.  But when you start claiming some things are just "too" expensive to require most people to chip in a little so that they can get indirect benefits of other groups in society being supported, I want to see some very careful calculations and explanations about exactly how much it has to cost (that is, in a system where the overall costs are not running away anyway) and how you are going to prove that the people who you think are just "too" expensive, are perfectly dispensable culturally and economically for the rest of the society.  To the point that everyone else can really better afford not to care.  Otherwise, my default position is more that more people should be willing to trade more effort and benefits across the society in kind, and recognize that caring for other people in the system benefits everyone, regardless of whether one is the immediate and personal beneficiary of a specific coverage or not.

     

[Retribution]

So a piece of legislation is enacted that among other things prevents insurance companies denying health coverage for pre-existing conditions, and as a result lots of people who were denied coverage because of pre-existing conditions buy health insurance. What were the odds of that happening? 

Honestly the inability of insurance companies to deny coverage due to pre-existing is one of the things I like about ACA. I also like for example that it covers birth control because as I have said before unplanned pregnancy I feel is one of the main causes of many of our social problems not to mention just plain poverty. I am not utterly against ACA and I think the obsession with repealing it is just plain insane, it passed deal with it Tea Party.

On the other hand I do not like the way it puts the squeeze to some self employed and middle class who are then held up as being rich and snobby when they are just trying to make ends meet and do not have an extra couple hundred bucks a month laying around.

[Retribution]

          It's been a common Republican rejoinder on sooo many issues, pretty much anything they don't like, to try to find any one little thing that has gone wrong so far (omg, a website glitched, what inconceivable systemic ineptitude that shows!) or even more often...  Common for them to say, but we don't know what some costs or results will be.  Well, there are lots of things where one doesn't know exactly but you have to take your best guess.  Lots of things people pay for because it's not just the right thing, but the thing that might be necessary to keep the rest of the economy together or to keep a growing contingent of your people from giving up, incurring more costs to weather and drag out the issue, doing something individually foolish or destructive, or leaving the country.  Of course, if you happen to have an opposition that is doing everything it can to defund the government in general and to enable corporations to make more loopholes in the legislation along the way -- I mean, I find it rather hard to believe Democrats did this all by themselves -- then it's sort of a self-fulfilling prophecy, aka plain out sabotage. 

           And I have to agree with Louise.  You don't reasonably throw away half or more of the population's regular needs merely because they happen to be somewhat more expensive in absolute terms.  It's particularly nasty to do that when those are people that the society has currently (in practice, despite lip service to the contrary) taken it for granted are being generally exploited -- for example, women bearing the brunt of service industry work, being expected to be the compromising and nurturing ones, generally put up with anything from wallflower jobs to nastiness to harassment, and often being paid much less than their counterparts even in the same exact job descriptions.  If we can afford to have half a dozen carrier battle groups or whatever the current number is, I don't believe it's down to four yet anyway?  Then we can afford to dig up some cash and pay for mammograms and I daresay even at least a couple abortions apiece.

          I'm becoming more inclined to agree with on the point that it would all be more practical if it were closer to a single-payer system, so the particulars of the solution on offer is one problem.  But when you start claiming some things are just "too" expensive to require most people to chip in a little so that they can get indirect benefits of other groups in society being supported, I want to see some very careful calculations and explanations about exactly how much it has to cost (that is, in a system where the overall costs are not running away anyway) and how you are going to prove that the people who you think are just "too" expensive, are perfectly dispensable culturally and economically for the rest of the society.  To the point that everyone else can really better afford not to care.  Otherwise, my default position is more that more people should be willing to trade more effort and benefits across the society in kind, and recognize that caring for other people in the system benefits everyone, regardless of whether one is the immediate and personal beneficiaries of a specific coverage or not.

   

Did you not read this link? http://politicalticker.blogs.cnn.com/2013/11/05/obama-further-refines-you-can-keep-your-plan-pledge/?hpt=hp_c2 This is not glitches, but yes single payer really does not sound bad to me.

[kylie]

Did you not read this link? http://politicalticker.blogs.cnn.com/2013/11/05/obama-further-refines-you-can-keep-your-plan-pledge/?hpt=hp_c2 This is not glitches, but yes single payer really does not sound bad to me.

           Generally speaking, I really don't appreciate the "did you not read" opening, aka it would appear to be hinting:  "You must not have been paying attention [to the line I want everyone to remember first]."  Maybe if I were playing the ping-pong game of quoting one person, one blurb at a time and it's all yours, then it would make more sense (however purposefully annoying).  But I was not. 

             Apart from the more basic (and quite sufficient) reason that I don't believe I am required to be quizzed on your line of choice or anything else in particular simply because I stick my head into the conversation, nor to provide a narrow quote and riposte style for every single post...  You are talking about something different.  And that is perfectly fine, but your insisting that I talk about only the part of the broader conversation you want (or else be branded a bad reader, etc.) is not fine with me.     

              So yes, quite apart from the line you demand I repeat and focus upon...  Other things were happening in the last few posts that concerned me.  I was first mentioning the level of mocking and invective I saw where on some sites people said, oh look the healthcare website (not plans -- but rather website function, login, crashes, etc.) had problems and therefore it's obvious the government cannot possibly manage something this size.  Typical "big government is bad in principle" sort of logic.  To me, that's an obvious example of the right (or at least its online following) attacking national healthcare in principle with sweeping claims.  From which I move on to say regarding people saying it's impractical to cover all sorts of people, merely because they may have certain absolute costs and needs that others don't?  That would be just another sort of sweeping claim that may well not be very sustainable, in practice for the whole population.
   

[gaggedLouise]

I'd agree with Kylie that the "those particular folks are too expensive with the health care needs they're claiming - and they don't pay back by doing high-profile and well-paid work either" argument - that one often seems to slap women in the face. Especially working mothers, women who are doing most of the caring work, and home front, for their family and keeping up a job at the same time - or trying hard to find a job (or teenage girls who have landed in troubled times). Some of those are among the most exposed, the most likely to work long irregular hours and sometimes without knowing even three days in advance what their walk-on and walk-off hours are going to be, and the ones who can least afford to miss a curve in the road, or to be sick even for a few days.

But you know, no one can deny that caring for other people is to the benefit of everyone. No society survives if children are not taken care of, if women don't take the time to have kids, or if old people are not cared for either. And well, today - and over the past few hundred years - that kind of care and managing is 90% the work of women, and often miserably low-paid or totally unpaid work.

[Valthazar]

But you know, no one can deny that caring for other people is to the benefit of everyone. No society survives if children are not taken care of, if women don't take the time to have kids, or if old people are not cared for either. And well, today - and over the past few hundred years - that kind of care and managing is 90% the work of women, and often miserably low-paid or totally unpaid work.

There isn't any way to legislate that men must be actively involved in the lives of their children - other than taxing them to contribute monetarily, alimony, etc.  If you can describe how legislation could enforce male involvement in their kids lives, I'd like to hear it.

The reality though, is that most of the young, single mothers you are describing, had their children fathered by men who are already low-wage, or unemployed.  As a result, you have many men sitting in jail right now because they can't make their payments for taking care of the kid - I am not joking.  This is only furthering this problem.

You're describing some very relevant problems, but not providing any solutions.  Many men are simply opting out of stable relationships, because they're realizing that the government is moving towards fulfilling their role in a way.  If you father a kid when you're 18, what's the point in taking care of your kid and girlfriend, if the government already has very clear cut protocol in place in providing them healthcare, food, etc.

In other words, while I certainly support help for single mothers, I fear that too much devotion to this cause may actually have the undesired effect of de-incentivizing men to take care of their families, and only exacerbate the problem we have now.

edit: removed questionable statistic

[Retribution]

Okay, let me try this one more time since my frustration is starting to show in my tone. Yes, the web site glitches are pretty irrelevant as I am assuming they will be fixed in good time. -But- as several have pointed out here in print as well as in links there are some deeper problems. I am sorry that I become blatantly vexed at those things being ignored, but one can only repeat themselves so many times and then they become irritated. Now that I am not seeing red or at least as deep a shade  I can see we are falling into the trap of digging in our heels when we are not that far apart really. And I am sorry for my tone Kylie but I feel like you are simply ignoring what has been said several times because it is inconvenient to your arguments. So lets review:

There is nothing inherently wrong or evil with turning a profit. We all do that when we draw our pay checks it puts butter on the biscuit and beer on the table for levity's sake

Health care is broken and things like birth control and good basic coverage really should be mandated. But ignoring those who are in fact loosing coverage or having to pay more so that they find themselves in a position to choose between making the house payment and paying for insurance is no better a solution. Ignoring that on the left is no better a solution than choosing to simply ignore basic health care for women on the right.

When I become emperor of the world in a benevolent dictatorship what I would like to see is a Medicare like system. Maybe we should call it Retricare? Medicare works reasonably well and most carry supplemental insurance to help off set the costs. It is not perfect, but it is about as good as I have seen in this country. My real issue with ACA is that I am skeptical that it will fix what it was supposed to fix. For each problem it repairs such as coverage for birth control I see it making another Phila's situation for example. I am not anti ACA, but I am getting a feeling of zero sum gain. Yes, my position is changing and evolving, but right now I feel like there is a lot of noise for not much ground gained.

[mia h]

When I become emperor of the world in a benevolent dictatorship...

Oi!! Take a number. You can have your benevolent dictatorship after I've had mine.