Impeding changes to our Health Care system

[classicman]

No thanks. You win. I'm out.

[Ibby]

Originally Posted by TheMercenary

My auto insurance has not risen 30% a year all the while increasing my deductible and covering less.

Right. So let's examine that. Why are healthcare costs (and health insurance costs) in America rising faster than in almost any other field, whether it's inflation costs or taxes or wages or iPhones? And why does healthcare, insured or uninsured, still cost more in America for the same level of care than in any other wealthy, industrial nation? I think most people would agree it's not just a matter of getting what you're paying for.

Originally Posted by TheMercenary

Obamacare will do nothing to control what insurance companies are going to charge you.

So the question becomes, HOW do we lower healthcare and insurance costs? Well, I guess the first question is SHOULD there be 'control', or at least an attempt to mitigate or lower healthcare costs? I unhesitatingly say, yes, there should be - i reject the notion that healthcare should be HARDER for the destitute to access, the notion that being poor means your only option is to just, well, be unproductive, suffer, and die if you get sick. So given that we're all paying too much for it, compared to other countries and to what we can afford (or what percentage of our incomes goes to paying for health insurance, compared to the past), how do we reduce costs without reducing quality of care?

I have been convinced both by living in a single-payer country and by the reams of economic and statistical evidence that a free-market system of health care, where your means and your means alone determine your health care, aside from any emotional or moral argument for universal coverage, introduces huge costs to the system when the uninsured require care, huge costs to the public when people get sick, languish, malinger, spread contagion, and otherwise suffer for lack of health care, and huge costs to healthy people as health care providers need more money from patients (thus from insurance companies (who then accordingly raise their rates)), to pay for the ones who aren't insured.

On top of the drawbacks to public health and to those WITH insurance or wealth, it is in the best interest of insurance companies to deny coverage in as many cases as possible - since profit is king, finding (legal if not legitimate) reasons not to pay policyholders is an advantage. With a single-payer system, where the government underwrites your insurance policy (which can be supplemented by private policies, but not replaced by, like a public option), we again get a collective risk/responsibility equation - but one where the scale and power of the government, coupled with the fact that the program would need to at best only break even, means that the delivery, to you, of quality, fast, efficient, cheap health care would be the #1 priority of both your insurer AND your doctor. Costs for the uninsured would also fall dramatically - I was not covered under Taiwan's single-payer system, as a foreigner, but for even relatively major things like root canals or ER visits, we would often pay out of pocket and find that it would literally not be worth submitting the claim to our insurance, once deductibles and processing and international mail were dealt with.

of course, obamacare isn't single-payer, or even public-option - it's only an individual mandate, the conservative (well, conservative until obama went for it and the right jumped ship) alternative to single-payer. I personally think that an individual mandate is a good thing for public health, but a better thing - too much so - for insurance companies, and leaves itself open to abuse. It might be better than things were, but it's just a teeny baby step, and one that leaves us more at the mercy of corporate health-care.

...and there is nothing else in obamacare to hate. Is there? Because the death panels are a lie. the end of "preexisting condition" denial is almost universally liked - if you have an argument against it please, by all means, out with it, but I can't possibly think of one. I agree with you that it's flawed and doesn't do enough to reign in costs, but is the solution just to dissolve it entirely? If you think it doesn't do enough, wouldn't you support MORE regulation, a STRONGER obamacare?

[Lamplighter]

A very good discussion, Ibram.

[TheMercenary]

Originally Posted by Ibram

...and there is nothing else in obamacare to hate. Is there?

Sure there is, plenty.

http://www.cato.org/pubs/wtpapers/BadMedicineWP.pdf

Because the death panels are a lie.

In name only, insurance companies already do that for you.

the end of "preexisting condition" denial is almost universally liked -

Oh I agree with that as well. But you don't need obamacare to do that.

I agree with you that it's flawed and doesn't do enough to reign in costs, but is the solution just to dissolve it entirely?

Yes. I would get rid of it entirely and start over.

If you think it doesn't do enough, wouldn't you support MORE regulation, a STRONGER obamacare?

No.

[Undertoad]

Ibs, just to be the devil's advocate:

When you are no longer covered by your parents, and the hardware store doesn't cover you, what will happen?

A) You'll be covered under Medicare and while you won't get routine maintenance, the govt plan will pay the expenses if you get hit by a bus

B) You'll personally buy the lowest possible level of insurance out of your own pocket; if you don't or can't, you'll pay penalties and fines, and you'll remain uninsured

C) You'll be put into a pool of uncovered individuals and your "premiums" will be paid by taxpayers

[Ibby]

Well, in VERMONT, the health care exchanges that Vermont was embracing before obamacare and the planned single-payer system already signed into law here put me in a pretty good position health-care wise. It'll be a few years before the exchanges are running but it'll be a few years before my Tricare coverage lapses.

[Ibby]

Originally Posted by TheMercenary

In name only, insurance companies already do that for you.

Except that wasn't even what the 'death panels' supposedly were. The bullshit started with the provision that the elderly be given access to end-of-life counselling to help them plan for their future care.

Originally Posted by TheMercenary

Oh I agree with that as well. But you don't need obamacare to do that.

Then what do we need? What is a practical credible alternative that's been proposed that would help like this provision did?

Originally Posted by TheMercenary

Yes. I would get rid of it entirely and start over.

Start over with WHAT? what goals would your program have, merc?

Originally Posted by TheMercenary

No.

Honestly, i've seen you railing against both the insurance industry and against obamacare. I assume that to indicate that you think something about the system needs to change. Do you think Obamacare too weak to stop the broken insurance companies and fix our broken health care system, or too strong and heavy-handed to do so? if it's too strong, what provisions go too far? if it's too weak, what would you add to it?

[Undertoad]

put me in a pretty good position health-care wise

Because there was a political battle to have Obamacare not apply to you.

[Lamplighter]

Originally Posted by TheMercenary

TheMercenary;788095]Sure there is, plenty.
http://www.cato.org/pubs/wtpapers/BadMedicineWP.pdf

Generally, as a liberal, I discount most everything that comes out of the Cato Institute
because it is almost completely business- and tax-reduction oriented.
But I'd like to thank you for this link because there is some information there.

So far I've read only the first 30 or so of the 60 pages, and want to finish it before
getting into the details.
My impression of the Tanner's coverage of The Patient Protection and
Affordable Care Act (Obamacare).
is broad and factual when citing information from the law, itself.
But, of course, he obviously inserts a very conservative view
when it comes to interpretation, implications, and politics.

Again, thanks for the link...

[Lamplighter]

Originally Posted by Undertoad

Ibs, just to be the devil's advocate:

When you are no longer covered by your parents, and the hardware store doesn't cover you, what will happen?

A) You'll be covered under Medicare and while you won't get routine maintenance, the govt plan will pay the expenses if you get hit by a bus

B) You'll personally buy the lowest possible level of insurance out of your own pocket; if you don't or can't, you'll pay penalties and fines, and you'll remain uninsured

C) You'll be put into a pool of uncovered individuals and your "premiums" will be paid by taxpayers

Here is a clip from Merc's link to the Cato Institute
Up to the age of 26, children can be added to their parents insurance.
After 26, they would be considered adults for health insurance purposes.
Essentially, a single male would be paying (only) $695 per year, but even that amount would be offset if the person's income were less than 133% of the poverty rate (~$14,000)


http://www.cato.org/pubs/wtpapers/BadMedicineWP.pdf

Bad Medicine
A Guide to the Real Costs and Consequences of the New Health Care Law
(Updated and Revised for 2011)
Michael D Tanner
CATO Institute
2011


Page 3

Under the law, beginning in 2014, those
who failed to obtain insurance would be
subject to a tax penalty. That penalty would
be quite mild at first, either $95 or one per-
cent of annual income in 2014, whichever is
greater.23 But it ramps up quickly after that,
the greater of $325 or 2 percent of annual
income in 2015, and the greater of $695 or
2.5 percent of annual income after that. In
calculating the total penalty for an unin-
sured family, children count as half an adult,
which means that in 2016 an uninsured
family of four would face a minimum penal-
ty of $2,085 ($695+$695+$347.50+$347.50),
pro-rated on the basis of the number of
months that the person was uninsured over
the course of the year.24 Individuals will be
exempt from the penalties if they earn less
than an income threshold to be determined
by the secretary of Health and Human Ser-
vices (but presumed to be roughly the pov-
erty level), or if they are unable to obtain
insurance that costs less than 8 percent of
their gross incomes.25
According to the CBO, roughly four mil-
lion Americans will be hit by penalties in
2016, with the penalties averaging slightly
more than $1,000.26 In fact, the federal gov-
ernment expects to raise $17 billion from
penalties by 2019.27

[Undertoad]

Yes, it was multiple choice, not essay, and the answer was "B".

[Clodfobble]

Unless, of course, it turns out next year that Ibram has lupus. Shitty lottery to win, but you can be sure after that that he will spend virtually anything on a good policy, because it will still be cheaper than his medical costs would be. Good thing he has that option now.

And he will be a walking, talking recommendation to his friends for buying good health coverage, not the cheapest they can get away with. He will say, "Hey, friend with a wife and baby. You see this shitty thing that happened to me out of nowhere? If it happens to you, your wife and baby will be living in a box on the street." And his friend might be smart enough to learn the lesson, and it might change his understanding of what he can and can't afford.

[ZenGum]

Remember Ibram used to live in Taiwan.

In Taiwan they have universal health coverage - all in one system so none of this "pre-existing condition" nonsense.

It is government run, thus eliminating the drive for profit.

Governments are inefficient, right? Not this time. The administration costs have been whittled down to ONE PERCENT of the total bill. For comparison, in the USA, admin is 28% of the helath care budget.

That's before we get to the malpractise insurance costs and the highly unlikely tests that docs have to do to cover themsleves.

[Ibby]

Originally Posted by Undertoad

Because there was a political battle to have Obamacare not apply to you.

Well, yes. A waiver has to be given to Vermont to let it opt out of Obamacare - a wavier the current administration has said they're going to give Vermont based on current information, as the VT healthcare bill would do more than Obamacare would. Obama has said, at least, that he doesn't plan to give waivers to states to implement less rather than more protection for its citizens. I'm all for having waivers to Obamacare for states that think it doesn't do enough - it's waiving it in states that want to do nothing instead that I have a problem with.

[DanaC]

Nicely put Ibica