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BlueCheese

(2,522 posts)
Tue Jun 26, 2012, 02:35 AM Jun 2012

What's the philosophical difference between Medicare Part D and the individual mandate?

As I understand it, both extended health insurance coverage--either for prescription drugs or general medical care-- through private insurance. Medicare Part D basically takes federal tax dollars and uses it to subsidize private prescription drug plans. The ACA's individual mandate cuts out the government part, and requires individuals to pay the insurance companies directly. (If anything, Medicare Part D is less coercive-- Medicare recipients are not actually required to join, though they do pay a late enrollment penalty if they join later than they can.)

Medicare Part D passed mainly with Republican votes; only a few Democrats supported it. The ACA, of course, passed entirely with Democratic votes, if I remember correctly.

In retrospect, it seems a lot of the arguments both in favor of and against Medicare Part D also apply to the ACA--on the one hand, it's better than nothing, a lot of people are genuinely better off; on the other, it's a giveaway to private health insurance companies and doesn't go as far as it should.

If you support the ACA now, did you also support Medicare Part D? If you opposed Medicare Part D, do you also oppose the ACA? Are there important distinguishing features between the two that I've missed?

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What's the philosophical difference between Medicare Part D and the individual mandate? (Original Post) BlueCheese Jun 2012 OP
It is a tax. /nt still_one Jun 2012 #1
They both suck. Thus, no philosophical difference. Luminous Animal Jun 2012 #2
Part D was planned to enrich Bush's buddies and bankrupt Medicare. I could never afford it. freshwest Jun 2012 #3
No one gets penalized for not taking Medicare part D. dkf Jun 2012 #4
Yes, I chose to stay with the prescription plan I had, and have not applied for Part D on my .... dmosh42 Jun 2012 #5

freshwest

(53,661 posts)
3. Part D was planned to enrich Bush's buddies and bankrupt Medicare. I could never afford it.
Tue Jun 26, 2012, 03:20 AM
Jun 2012

I don't know that ACA changes anything for me but it is supposed to help those on Medicaid. I don't qualify for that and am essentially uninsured and do not see doctors anymore. Anything I need is paid for cash from my income.

But I know many people for whom the Medicaid program means they have a chance to have survive and have decent lives. I support single payer, but we will not get it as there is no magic wand. The elimination of this program will not trigger pressure from the public to get it because they don't have insurance.

Because it never did before. Anyone that wants to opt out of ACA supposedly can. Americans not want single payer because they do not believe in equality. If they did in large numbers, we would have solved this debate years ago.

Many folks, including some on DU, are alive because of the ACA provisions that stopped their insurance company that they have from dropping them due to their current life threatening illnesses. They need this to continue so they will not be cut off of the treatments they are now getting in order to get better.

I want non-profit single payer but it can only happen with a full Democratic majority to put the bills in. Obama will not veto such a bill if it was presented to him and does not have the support of the insurance lobby because the ACA has already stopped them from passing a lot of their costs onto the consumers. They are getting a profit, but it it much smaller.

The SCOTUS and the American people can decide if they want to push for a substitute for the ACA but that push was years in coming. With Romney, it will not have the waivers or exemptions for lack of money that the current plan has.

Philosophically would have to include the intent. Part D was specifically put into force to bankrupt the system. The ACA was not, it was meant to regulate the business that is running health care insurance now. It is stop gap and my hope was that the planned reduction, and there are billions that will sent to insurance holders soon to reimburse them for the regular overcharges the insurance company put on the insured, that the reduced profit margin would make the insurance companies ready to stop their opposition to the single payer.

If they see that the government is not going to allow them to rip people off like it did with Part D, it won't want to play for those dolllars anymore. Then single payer can be put through. If the ACA is gone and the Executive Orders being planned don't make it single payer or keep it as the ACA intended, we will be at the same place we were in order to give the GOP the White House. And the cost of insurance will continue to divide the American people further into haves and havenots.

dmosh42

(2,217 posts)
5. Yes, I chose to stay with the prescription plan I had, and have not applied for Part D on my ....
Tue Jun 26, 2012, 05:37 AM
Jun 2012

Medicare. I do use Part A and B of the Medicare.

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