10 November 2012

Prospects for health finance reform ("Obamacare")

With the election decided, it’s clear that health reform — the Affordable Care Act — is here to stay. One of its key provisions enables states to expand Medicaid to cover low-income adults with incomes up to 133 percent of the poverty line, with the federal government paying nearly all of the cost...

The Congressional Budget Office estimates that if all states adopt the expansion, they will spend only 2.8 percent more on Medicaid from 2014 to 2022 than they would have spent without health reform. And that estimate doesn’t account for the ways in which expanding Medicaid will save states money, such as by cutting the cost of treating uninsured residents in emergency rooms and health clinics.

While governors in Florida, Texas, Louisiana, and several other states have said they’ll reject the Medicaid expansion, most states are either moving forward or their governors remain undecided, as this map shows. In many of the latter states, governors had said that they wanted to wait until after the election to decide. 
Image and text from Off the Charts Blog, via The Dish.


  1. This is the last hope for many, many sick people. Sick people who aren't even ALLOWED to buy even super expensive, super big deductible, super low benefits insurance. Not. Allowed. Due to pre-existing conditions. An inhumane standard set by capitalism at its purest and most cruel. Too many states simply refuse to face it because these people aren't suffering in front of their eyeballs. --A.

  2. I'm Brazilian. So, if I make english mistakes, please, forgive.

    Another day I was talking about "Obamacare", comparing with our "SUS" (Unique Health System), with some friends.
    And the first thing I think is: "how USA have not a free health for your citizens already??"

    Then I start to criticize Brazilian's free health.
    First, our free health is a constitutional right. What reflect directly in ours taxes. We pay to much for health.
    After that, our people is corrupt. What makes our politics corrupts, too. Here, the money we pay to health is taking alway. So, our free health just do not work as it should.
    So, that Brazilian who work hard and can get real money, run as fast as him can to pay for private health.

    I start to think: Maybe USA is too more rich than others countries just because do not invest in free health. North-Americans are so much more smart: use that money to provide excelent schools, trying to form better citizens through education.
    I know: There is others exemples of free health, who works too much fine. But I like to take Brazil as exemple, because we are an social experiment. Here we can see what a government can use mechanisms to ensure the rights of a population that simply does not think, or reacts demands.
    The best Brazilian's idea for health is taking off "SUS", create a national cadastre of people with needs and use the taxe's money to pay for that people.

    But States have a better people then Brazil. And you have all conditions to be - again - a world reference.

    1. I start to think: Maybe USA is too more rich than others countries just because do not invest in free health. North-Americans are so much more smart: use that money to provide excelent schools, trying to form better citizens through education.

      Arthur, I think you may overestimate the excellence of American education. It has some great schools, but on the whole the standard is quite low compared to other first world nations.

      Stan I know you're an educator, please correct me if I am wrong in that, as it's a statement made from nothing more than vague memory of having read it before.

    2. Jim, I don't have the experience or data to make an overall assessment of that sort. I would guess that top-of-the-line graduate education opportunities here are as good as anywhere in the world, but overall undergrad education lags on lots of parameters. And I think that underperformance may reflect more than just the institutions themselves - the input of families on children's education for example (I was taught to read by my mom before I entered first grade).

    3. LOL.
      I take all of my medical care from the brazilian public system. My father's recent half a dozen cirurgies were all paid for it (he's an retired elderly citizen). He wouldn't be able to afford the costs. It's the reason he's alive.
      The public, costless parenthood service in my city was awarded the best health initiative over americas (including Canada) this year by the United Nations. It zeroed the vertical transmission of HIV in a 2,5 million-people city. That's the care my child is going to receive to be born.
      In fact, the real cost of health is bigger in societies where it is not a public service. The United States have the single least efficient expenditure in health in the entire planet, with health costs covering 17.6pc of the GDP (according to CMS - 2010). So the facts are the opposite of what you describe.
      But that "our people is corrupt" mentality is what really reveals the meaning of what you say. Who corrupted the people? It's race, its land, its ungodly, un-european ways? What gives you the seniority to judge the nation? Are YOU a corrupt person, for instance, and that's how you can judge everybody? Or are you trying to make an excuse to be corrupt, and to vote in corrupt people?

    4. The top countries in education are Finland, Denmark, New Zealand, Australia, Canada... All countries with universal health care btw..


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