Repeal or replace?

[Into the Night]

If by "safety net" you mean health insurance, that is correct. I have always maintained health insurance, either through an employer or myself. It is stupid not to as life can turn on a dime.

Anyone who does not have health insurance is one hospital visit away from financial devastation. Not to mention the poor care you have to settle for if you don't have it.

Watch out for them dimes...they can KILL you! I hear they're more dangerous than stepping on a Lego brick!

Even if you have health insurance, you can easily be financially devastated. Go read your policy again.

 

[Diogenes]

You and the Parrot.

Please don't presume to impute a position to me that I have not espoused. I believe you're a better person than that.

 

[EdwinA]

Medicare pays a pittance to doctors. You are clueless. Doctors should be paid well. It isn't a dead end govt job and never should be.

No they don't; you're mistaken. What happens is they just send in huge bills and hope nobody notices they're over-charging the hell out of people, then occasionally they get a cut in what they ask for, but it pays well enough. You're the one who is clueless. Being a primary care GP never was supposed to be a road to wealth. It was a decent middle class professional career, while the big bux went to skilled surgeons. Office visits before Medicare would run $2-$5; now they bang it for $175 and rarely do anything but prescribe expensive drugs of which they get commissions for, and could easily substitute over the counter generics for. It's a racket now, a lucrative one.

 

[Diogenes]

Medicare isn't free, as some keep trying to claim. It gets deducted directly from your Social Security. If your SS doesn't kick in at 65, then you have to pay a premium out of pocket.

You have to pay a premium for Part B regardless.

My Medicare insurer is making a bundle off me, and paying nothing out.

You have Part C.

Part A: Covers inpatient hospital stays, skilled nursing facility care (not long-term custody), hospice care, and some home health services.
Most people get it premium-free if they or their spouse paid Medicare taxes for at least 10 years (40 quarters) while working. Those who don't qualify pay a monthly premium: up to $278 in 2025 if they have 30–39 quarters, or up to $505 if fewer than 30 quarters. No premium for those with 40+ quarters.​

Part B: Covers doctor visits, outpatient care, preventive services, lab tests, durable medical equipment, and some home health not covered by Part A.​

Virtually all U.S. citizens and legal residents age 65+ are eligible, plus some younger people with disabilities or ESRD (end-stage renal disease).​

​

Everyone pays a monthly premium: standard is $185 in 2025, but higher for individuals with annual income over $103,000 (or $206,000 for couples), scaling up to $628 for the highest earners.​

Part C: Medicare Advantage. Private plans (like HMOs or PPOs) that bundle Parts A, B, and often D into one plan, sometimes with extras like dental or vision. Anyone enrolled in both A and B can choose a Part C plan instead of original Medicare, as long as one is available in their area. Premiums vary by plan. Many have $0 additional premium beyond Part B, but others charge $10–$200+ monthly on top of the Part B premium. Plans can change costs and coverage yearly.​

Part D: Covers outpatient prescription drugs through private standalone plans or as part of Medicare Advantage (MA-PD). Anyone with Part A or B can enroll. Premiums are set by private insurers and average around $40–$60 monthly in 2025, but vary widely ($0–$100+). Higher-income individuals pay an extra surcharge on top (IRMA), adding $13–$86 to the premium based on income brackets matching Part B.​

 

[Into the Night]

No, it isn’t. The out-of-pocket maximum is the total amount you’re responsible for in a calendar year, a finite limit.

Except for exclusions (sometimes they even list some of them!), and exceeding calendar year maximum payout.

I’m not sure I understand. Are you saying you don’t have health insurance and pay for everything yourself?

He never said any such thing. Go read his post again.

If you’re healthy, that’s fine, for now. But it can change in an instant if you get sick or injured and you can be responsible for a six or seven digit bill. I have homeowner's insurance, never filed a claim. But it's there in case of catastrophic damage. Same with health insurance.

You will find BOTH home policies carry many exclusions, and it is even MORE so with health insurance.

Physicians have bills to pay too.

So?

They didn't pay hundreds of thousands in school loans to run a charity.

Who says they have hundreds of thousands in school loans?

Hippocratic oath does not mean "works for free." People are not entitled to the services of another person.

They are entitled to exactly that, at the agreed upon price.

 

[EdwinA]

Even if you have health insurance, you can easily be financially devastated. Go read your policy again.

Yep. Some people think their insurance will pay for everything; not even close to being true.

 

[Diogenes]

Medicare pays a pittance to doctors.

No, Medicare does not pay providers “a pittance.”

Its reimbursement rates are generally lower than private insurance but higher than Medicaid and structured to cover costs for most efficient providers.

• Physicians: Medicare pays about 80% of what private insurers pay on average for the same services (per MedPAC analysis). For primary care, the gap is wider (~60–70% of private rates); for procedures, it’s closer.
• Hospitals: Medicare inpatient rates are roughly 85–90% of private payer rates, though margins vary. Many hospitals run negative margins on Medicare patients (–8% in 2023 per AHA), but this is offset by higher private payer profits.
• Cost basis: Rates are tied to provider costs (via DRGs for hospitals, RVUs for doctors), not market rates. Providers who operate efficiently can profit; high-cost or low-volume ones lose money.

Bottom line: Medicare pays less than private plans, sometimes below full cost for certain providers, but it’s a major revenue source (covering ~20% of hospital patients and 25% of physician revenue). Calling it “a pittance” is inaccurate.

 

[Into the Night]

Please clarify, are you suggesting the alternative to Obamacare is for everyone to pay out of pocket with no insurance?

False dichotomy fallacy.

That was actually Obama’s original idea: to put private insurers out of business

Communism doesn't work.

and move toward a single-payer system.

Communism doesn't work.

Keeping the current program intact is what prevents that outcome. You think what we have now is bad? Wait until that happens. Lots of people will die.

Everyone dies, and I do mean everyone. You will too.

 

[Into the Night]

Fix ACA up is the answer.

Get rid of it. Communism doesn't work.

 

[EdwinA]

No, Medicare does not pay providers “a pittance.”

Its reimbursement rates are generally lower than private insurance but higher than Medicaid and structured to cover costs for most efficient providers.

• Physicians: Medicare pays about 80% of what private insurers pay on average for the same services (per MedPAC analysis). For primary care, the gap is wider (~60–70% of private rates); for procedures, it’s closer.
• Hospitals: Medicare inpatient rates are roughly 85–90% of private payer rates, though margins vary. Many hospitals run negative margins on Medicare patients (–8% in 2023 per AHA), but this is offset by higher private payer profits.
• Cost basis: Rates are tied to provider costs (via DRGs for hospitals, RVUs for doctors), not market rates. Providers who operate efficiently can profit; high-cost or low-volume ones lose money.

Bottom line: Medicare pays less than private plans, sometimes below full cost for certain providers, but it’s a major revenue source (covering ~20% of hospital patients and 25% of physician revenue). Calling it “a pittance” is inaccurate.

It's what pays for all those big hospitals and big HMO offices and drug company dividends. Most Americans couldn't pay current rates out of pocket, and Medicare is the giant piggy bank for many big corporations. Most of them go broke if Medicare was to fail.

 

[evince]

Doctors didn't all become rich until Medicare came along and now they use it as their private piggy banks and pig trough. Same with Big Pharma. Now getting a medical degree is considered an entitlement program. Used to be only highly specialized surgeons got wealthy from medical practices, and even small towns could support a GP doctor or two in middle class comfort. No more.

Yes Drs always became rich if they chose to

Many didn’t because they willingly treat meted all comers to their offices


Because they swore to an oath as a dr to do so

 

[Into the Night]

People with health insurance cannot go bankrupt from medical bills.

Yes they can!

You have a deductible and an out-of-pocket maximum; once that max is reached, insurance covers 100% of covered costs. Of course, coverage rules apply, like staying in-network with an HMO.

There are many exclusions. There is also a maximum payout.

From your AI-generated response,

You just failed the Turing test.

it’s clear you don’t understand the basics of how health insurance works.

*yawn* this same old song again. Inversion fallacy.

You can’t have a real discussion if you’re just copying and pasting from ChatGPT.

You just failed the Turing test again.

You started this thread but haven’t answered the actual question. Try giving your own answer. There’s no simplistic fix. “Save money and pay out of pocket” is absurd. Repealing Obamacare wouldn’t lower prices, it would trigger a government takeover, which is far worse. Suggesting otherwise shows a lack of grasp on the realities of today’s health care system.

Buzzword fallacy. Inversion fallacy.

 

[evince]

Get rid of it. Communism doesn't work.

Then why does it work so well in other major nations?

Facts are not your friend

 

[EdwinA]

es Drs always became rich if they chose to

No they didn't; people couldn't afford to make them all rich. plain and simple fact. Just because demand is unlimited doesn't mean the means to pay for it all is endless as well.

 

[Into the Night]

I have no idea. I am not in the field. More than 22 million people have insurance now than before ACA.

Argument from randU fallacy. Random numbers aren't data, Sybil.

No one in Europe bankrupts because of medical bills.

TANSTAAFL. Medical care is not free.

There must be a way.,

Communism isn't it.

 

[EdwinA]

Then why does it work so well in other major nations?

Facts are not your friend

Pretty simple; whenever the Reds get overwhelmed and their system fails, as they do regularly, they simply slaughter enough 'problem' people to get it back in line again. The slums in Red China are far bigger than the nice areas where the Cadre plays and shops. You're being fed bullshit.

 

[Into the Night]

Then why does it work so well in other major nations?

It doesn't. Communism gives you poor healthcare (if at all!), and is far more expensive for it.

Facts are not your friend

Buzzword fallacy. Go learn what 'fact' means, Vincy.

 

[evince]

No they didn't; people couldn't afford to make them all rich. plain and simple fact. Just because demand is unlimited doesn't mean the means to pay for it all is endless as well.

Why did nearly all parents want their kid to become a dr for hundreds of years in this nation?

Because it was a guarantee of success

 

[evince]

Pretty simple; whenever the Reds get overwhelmed and their system fails, as they do regularly, they simply slaughter enough 'problem' people to get it back in line again. The slums in Red China are far bigger than the nice areas where the Cadre plays and shops. You're being fed bullshit.

Oh

You are insane

Bye Felicia

 

[EdwinA]

Why did nearly all parents want their kid to become a dr for hundreds of years in this nation?

Because it was a guarantee of success

Because it was a nice middle class profession. You obviously know zero history; the middle class before the 1950's was pretty small, and colleges weren't cheap outside of NYC. For instance, the average railroad worker in 1910 made maybe $500-$600 a year. Those were 'good jobs' then, Meanwhile the average doctor made around $2,000-$5,000 a year, not rich by the standard then but substantially better than the average prole, who made up 80% of the population. 'city wages were higher, but then so were prices, so in many case they were worse off than rural workers.