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Lots of questions to ask befoe we repeal Affordable Care Act

To The Daily Sun,

Since the presidential election it has become a foregone conclusion that the Affordable Care Act will be either repealed or replaced. The question is, will the resulting program be better than or cost less? Time will tell.

How did this most maligned of laws come into being? Who's idea was it, Anyhow? Well, in answer, its not a new idea. Many countries have their version of universal health care. Hilary Clinton lobbied for it while Bill was in office. Congress wasn't interested. As a matter of fact, they were downright rude to her, as I recall.

Later the state of Massachusetts came up with a workable version of universal health care and made it a reality. It wasn't universally liked by the insured, but it solved most of the health care problems that existed in the state. One of the hardest problems to solve involved the emergency rooms of their hospitals. The ER's were becoming clinics for the uninsured. The were treating everything from coughs to cuts. The hospitals were being forced to absorb the cost of unpaid bills run up by an uninsured indigent population. Costs were negatively affecting the bottom line of most of the hospitals. Trauma centers were failing to deliver high quality service to the real emergencies. Part of the Massachusetts plan provided for wellness clinics. The clinics were, in part, a solution the ER crisis. Not only were they cheaper, they were much less chaotic. Everyone profited; even the state. The state budget looked better after the initial start-up costs were absorbed.

When Obama came to Washington, he was primed to get some things done. Once he got the mess that Bush handed off to him back from the brink of disaster, he had a little time to attack some other problems. Teddy Kennedy was making a concerted effort to get some attention given to health care. Being from Massachusetts, he suggested the Obama administration put forth a similar program for the nation. And so, the Affordable Care Act was conceived but not yet born. They knew that it should probably be signed into law before the mid-term elections because evidence was building that Carl Rove had plans for his version of the House of Representatives.

Vast amounts of paper were generated to create a framework that was introduced as bill to Congress. Many of the opponents of the bill complained that they were being asked to vote on summaries of the bill because of its size. Wrangling over the future shape of the bill took place in 2009. The Republican minority were unified in its opposition to the bill. Finally a conference committee of the House and Senate reported the bill out for a vote. Prior to the vote, Senator Kennedy died and Scott Brown, a Republican won the election to replace him. Ten democrats had to make sure the independents were voting for the bill before it was brought to the Senate floor for a vote. Passage was achieved by the slimmest of margins and sent to the president for his signature in the spring of 2010.

It was immediately challenged in court. Eventually the Supreme Court confirmed the constitutionality of the act. Republicans in congress have endeavored to rescind the law or at least obstruct the orderly introduction by the Obama administration. Moving forward in the face of the negative Republican maneuvers was difficult but progress was made. Procedures required to enroll those in need of affordable health insurance were created. Because some states refused to set up exchanges, the federal administration had to implement and manage programs in those states. Many of the potential insurers were reluctant to commit to the program because of the on-going battle between the Democrats and the Republicans in congress.

Several features of the act were highly desired by the insured under the plan. Coverage of young adults to the age of twenty-six, the ending of the exclusion due to preexisting conditions and the adding guarantees of the appeal of any arbitrary withdrawal of coverage were the most popular.

In reference to costs, the ending of lifetime limits on coverage caused a few headaches because insurers were being asked to take on added risks. Because all increases of premium must be justified as reasonable, some insurers decided not to participate. Another feature that made the insures unhappy was the ruling that premium dollars be spent primarily on healthcare, not administrative fees demanded by insurers in an effort to guarantee an attractive bottom line for their corporation.

The act endeavored to provide preventive care options, allowing primary care doctor choices and the ability to seek emergency care outside the plans network. Many users of the plan especially appreciated that feature.

So, whatever replaces the current plan must include the list already enumerated. In addition there must be a well understood method of payment for services. All involved; the insurers, the doctors and the patients must have the same understanding of how the payment system works. Focus should on the improving health care delivery, the managing and sharing the personal data while observing HIPPA rules.

One of the concerns expressed by the Republicans has been the cost of plans available to small businesses. Even before the advent of the Affordable Care Act that was a offered as an excuse for some small businesses to not offer health care plans to their employees. Any improvement in that area will have to be focused toward insurers and providers of service. High deductibles are placed on covered services. This practice is one of the sore points that keeps on irritating the premium payer because of the out-of-pocket cost that pile up before the plan pays anything. It is like paying the premium twice. So, can plans be developed to lower the deductibles without causing premiums to soar? Are there lessons that can be learned from the Medicare system? What are the state and federal responsibilities to those below the poverty level. These are some of the questions to be answered before we revert to what existed before the ACA.

Bill Dawson

Northfield

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Accepting defeat with grace & dignity is beyond Democrat's range

To The Daily Sun,

SIX observations to the "bulldog" wing of Daily Sun Liberals. You all know the main actors: Cracraft, Loesch, Veverka, Vervaeke and Sappi.
1. Scott Cracraft is never going to support a Republican until all sinners repent. Not likely. Even if God had won last week on the Republican ticket and appointed the apostles to his cabinet, Scott would have said, "I can't support someone with such deeply held religious beliefs, I am voting for Barbra Streisand". When Romney was the Republican nominee, Scott couldn't support someone of such wealth, but Hillary, the multi-millionaire liar got his vote this year. Why? Right church, Democrat. Right pew, nincompoop liberal. Right prayer, more "free" from government.
2. It had been the teaching since our founding that Americans rallied around the winning president in a show of solidarity and a unified front to our enemies. It was called the "honeymoon" period. Out of their abundant, generosity Democrats will give Trump HALF of what a honeymoon is "the screwing."
3. I have a news flash for donkey jockeys. It wasn't the old, white men who voted Trump in, it was the disenchanted, disenfranchised, disillusioned, working class in the tens of millions who voted the larger than life Trump in office. Hillary's so called "DEPLORABLES." Even women in certain voting strata voted by majority for Trump. They compared Trumps sex habits to Bill Clinton's and declared a draw on the "dropped draws" issue. The megaphone of non stop "race baiting" and "gender baiting" didn't save the liberals bacon this election. Voters now see through the THIN VEIL of self serving, political clap trap on those issues.
4. If we want to look to what a sore, vindictive loser looks like Look no further than the Democratic Party. To accept defeat with grace, dignity and style is beyond their ability. They are indeed a dangerous breed to god fearing, working-class Americans. The "New Democrats" are the most divisive and dividing force in the nation. Did Republicans self destruct in DEFIANCE in the streets after Obama won or destroy private property or burn down Harlem ? Nope. This style of vengeful protesting outrage is now taught on campus by people like Scott. "Opposing logic" must be demonized, marginalized, humiliated, then destroyed by any means necessary.
5. We have had an Electoral College since the beginning for reasons everyone knows, and has long agreed with. If we didn't have it, 40 states and more than half of America would never see a presidential nominee. Don't even total the vote. It is as meaningless as the baseball team that gets 100 hits with no runs and loses to the team with one run and one hit. Democrats say we won on hits, but lost on runs. Sorry the game wins on runs, not hits. Don't like how it is scored? DON'T PLAY!
6. This election forever ends the Democrat's mirage that the Citizens United Supreme Court decision gave Republicans an election advantage with money from deep pockets that could influence or even buy an elections out come. Hillary Clinton put that issue to bed FOREVER. She took in 80 percent of all the the millionaire and billionaire-class contributions to PACS while she outspent Trump by 50 percent. She still lost. Just as true in many other races for both houses. That the Republicans have a special pipeline into big money that disadvantages Democrats is 100 percent contrived, politically-induced BS.
Tony Boutin
Gilford

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