[Dusty]

(05-23-2014 07:15 PM)speakeasy Wrote:  

You can also say that Americans oppose any change in health care because they've never experienced anything differently.

Yes they have, and that's why it is probably impossible to get single-payer in the USA. Because we do have some gubmint healthcare in the USA, and people don't seem to like it that much (or only like it in theory).

For example, my parents are lifelong Democrats. They'd support programs like medicare stronger than anyone on this thread. My father was a veteran (he passed away a few years ago, my mum is still alive). My father was eligible to use the VA (veterans) system and medicare (because of his age) but always used the private insurance from his retirement. My mother too, who is eligible for medicare but uses her private insurance (and thus uses the doctors and hospitals she wants).

I know my fair share of very liberal people, who voted for Obama, but hate Obamacare.

Obamacare in general is very unpopular, expect the Dems to lose a lot of elections due to it, and expect a lot of Dems to run away from it.

The point is, many people including liberals who in theory support more socialized healthcare solutions like their private insurance and don't want to be forced onto something like Obamacare or a single-payer system.

[Samseau]

I don't know anyone whose healthcare costs went down after Obamacare, but a ton of people whose costs have gone up. Seems to be the general consensus on the internet as well.

It also unfairly taxes young men in order to pay for olds, women, and the poor. A young man used to be able to get health insurance for 50-80$ a month, now it's closer to $200 a month.

[speakeasy]

(05-23-2014 07:53 PM)Samseau Wrote:  

I don't know anyone whose healthcare costs went down after Obamacare, but a ton of people whose costs have gone up. Seems to be the general consensus on the internet as well.

Mine went from about $230/mo under Blue Cross to $183 for a comparable Blue Cross plan under the exchange. So I definitely saw a reduction. Though I must disclose that I live in a different state now so that could've been part of it as well. I can't be sure.

As to the claim that Obamacare is causing premiums to rise, it's dubious, but people will read into it however they choose depending on their partisan bias. Here are actual numbers: http://www.politifact.com/wisconsin/stat...t-gone-do/

Quote:

It also unfairly taxes young men in order to pay for olds, women, and the poor.

Well, that's kinda the point of taxes. People that don't have kids still pay for the education of those that don't. People that don't drive still pay for roads. People that hate the military still pay for defense. People that never have their house burn down still pay the fire department.

Quote:

A young man used to be able to get health insurance for 50-80$ a month, now it's closer to $200 a month.

You'd have to be nearly a teenager to get anything around $50-80. And that's probably for absolute minimal coverage.

[Wadsworth]

I was pro Obamacare before it was signed into law. Now I'm not so sure, it seems increasingly like a boondoggle. It may not be entirely Obama's fault, as the Republican-controlled house has insisted on a number of changes. I do think some healthcare costs should be covered by public spending, but that leaves a very wide latitude in terms of how we put that into action.

[kbell]

Mine went down from 900 a month to 380 a month. So that aspect is good. It was high due a pre-existing condition. However any non generic medicines which I take are not free after meeting my deductible which is now higher. They are 1/4 of the price which can get quite high if I need to add more medicines.

I'm not a fan of insurance in general since they stop the doctors and hospitals charging competitive low costs with low over head. Insurance themselves were a merger of a big government and big business going back since 1920s. You get rid of that the cost of medical would drop to much more reasonable levels.

A young doctor who goes through say 10 years of medical and several years internship is going to have massive debt. He needs to make a certain amount of money to pay off the debt and make a profit. How will he do this if there single payer insurance? There is a good chance the doctor will end up making only 15 an hour when the money runs low with Obamacare. And if you can make 15 an hour working at a fast food, why bother becoming a doctor. You might have the noble cause of saving lives at first, but you will get jaded over time working with entitled and neurotic patients.

[lurker]

(05-23-2014 07:53 PM)Samseau Wrote:  

I don't know anyone whose healthcare costs went down after Obamacare, but a ton of people whose costs have gone up. Seems to be the general consensus on the internet as well.

It also unfairly taxes young men in order to pay for olds, women, and the poor. A young man used to be able to get health insurance for 50-80$ a month, now it's closer to $200 a month.

This is what's bugging me about Obamacare. On the other hand, the prohibition on rate increases and mandates for 85% healthcare spending out of premiums mean that the increases are most likely a result of insurers stocking away cash now because they won't be able to later - i.e. that a decade down the line, we might see cost savings.

[Sawyer]

I'd hate going to a doctor who saw me as a government number and not a person. I assume all those who can use government care yet choose not to feel the same way.

There is still a (diminishing) plurality in the US that find it deeply shameful to use anything that might appear to be a government handout. And no, I'm not talking about government highways, forests or police. I'm talking about things that should be considered the domain of private charity.

What we need is tort reform and an unleashing of private charity on every level. The rich love to build and fund hospitals. So do the religious. Set them free. Let them be recognized.

Unfortunately that's not the Alinsky way. We've lost this country. Neither party is going to get it back for us either.

[speakeasy]

Honestly I wouldn't even care if the system is privatized or government run. I'm not ideological about this. All I actually care about in the end is that healthcare is affordable, widely available, effective and fiscally sustainable. If we can meet all four of those criteria, I'd be just fine with a 100% private system. I think Singapore is doing an excellent job at this and we may be able to learn something from them. Switzerland has the closest thing to the Obamacare system and it is successful.

http://nation.time.com/2012/08/16/health...-loves-it/

What we do in this country is not working. My main criticism isn't the ACA per se, it's that we haven't seen enough reform. How can we spend 17.6% percent of GDP on healthcare while France(top healthcare system in the world) spends 11.6% and get covered from cradle to grave. It happens because Big Pharma and insurance companies pull the strings in this country with their tremendous lobbying power. Power that they don't have in other countries.

[Christian McQueen]

It doesn't matter what WE want, because Obama does what he wants regardless of America's opinion.

He's established this quite clearly during his terms.

[kbell]

France has a lot population than the US, so it does not need to spend as much right from the start. If you increased the population and size of France to the US level, the gdp would be much higher the what we spend.

[MongolianAbroad]

(05-23-2014 09:32 PM)speakeasy Wrote:  

What we do in this country is not working. My main criticism isn't the ACA per se, it's that we haven't seen enough reform. How can we spend 17.6% percent of GDP on healthcare while France(top healthcare system in the world) spends 11.6% and get covered from cradle to grave. It happens because Big Pharma and insurance companies pull the strings in this country with their tremendous lobbying power. Power that they don't have in other countries.

You're missing the elephant in the room:

Obesity.

Our health care costs keep rising, and will continue to keep rising, because the more obese people a country has, the more demand there is for health care services, driving the price up. Supply and demand, guys. We spend much more of our GDP on health care than France, for example, a country with an economy at a level comparable to ours, because our obesity rates are much higher than theirs. Sure, there's mismanagement in both the public and the private realm, and sure, we can focus our efforts on creating improvement there, but let's not lose sight of the elephant in the room.

You want to lower the cost of medical services? I'll tell you how, it's the same as anything else, you either increase the supply (mint more doctors, mint more nurses, construct more hospitals, etc.) or decrease the demand (by making people adopt healthier behaviors).

The problem is neither is easy to do. So instead, the parties involved blame "big pharma," "government healthcare," "private healthcare," "insurance companies," or whatever other scapegoat happens to be popular within each party at the time.

Again, there's many factors causing the large health care costs, but THE elephant in the room is obesity. The problem is that telling Americans that they themselves are the problem is not politically viable. People don't want to take responsibility for their problems, it's much easier to place the blame on the "other," some large, impersonal entity in this case, than to look in the mirror. If every American led a healthy life, healthcare costs would diminish dramatically.

Let's stop beating around the bush.

[Sawyer]

I'd say the bigger elephant in the room is undocumented workers.

[speakeasy]

(05-23-2014 09:55 PM)kbell Wrote:  

France has a lot population than the US, so it does not need to spend as much right from the start. If you increased the population and size of France to the US level, the gdp would be much higher the what we spend.

Why would increasing the population of France increase the percentage of GDP spent on healthcare? I'm not talking gross aggregate spending, I'm talking spending as a proportion of the economy.

(05-23-2014 10:01 PM)Spaniard88 Wrote:  

(05-23-2014 09:32 PM)speakeasy Wrote:  

What we do in this country is not working. My main criticism isn't the ACA per se, it's that we haven't seen enough reform. How can we spend 17.6% percent of GDP on healthcare while France(top healthcare system in the world) spends 11.6% and get covered from cradle to grave. It happens because Big Pharma and insurance companies pull the strings in this country with their tremendous lobbying power. Power that they don't have in other countries.

You're missing the elephant in the room:

Obesity.

Our health care costs keep rising, and will continue to keep rising, because the more obese people a country has, the more demand there is for health care services, driving the price up. Supply and demand, guys. We spend much more of our GDP on health care than France, for example, a country with an economy at a level comparable to ours, because our obesity rates are much higher than theirs. Sure, there's mismanagement in both the public and the private realm, and sure, we can focus our efforts on creating improvement there, but let's not lose sight of the elephant in the room.

The UK is just as obese as the USA and they spend less than half of what we do on healthcare. 8.4% of GDP versus 17.6% for the USA. So I don't think obesity explains it.

Quote:

You want to lower the cost of medical services? I'll tell you how, it's the same as anything else, you either increase the supply (mint more doctors, mint more nurses, construct more hospitals, etc.) or decrease the demand (by making people adopt healthier behaviors).

I'm not so sure healthcare works that way. When you need to buy an appliance, you can walk from store to store to see who has the cheapest price. The free market at work. If you need an appendix removed, you don't go from hospital to hospital asking which surgeon charges the cheapest. In fact when I got my spine surgery last year, I asked the accountant and the insurance company what this was going to cost me. You know what? Neither knew. You only find out what something is going to cost you after it's done. Because medical billing is ridiculously complicated. The doctor might bill the insurance company $60,000, but the insurance company may only agree to pay a portion of that. Then your anesthesiologist has a completely different bill, and your physical therapy, and facility charges, etc. All of them trying to get the highest compensation possible from the insurance company, while the insurance company is trying to figure out a way to pass as much on to you as possible. So nobody can even tell you what something is going to cost. You just go in blind and cross your fingers that whatever they do isn't going to bankrupt you. That's the American health care system. And keep in mind this is with Blue Shield PPO. It turned out I paid more than I should have when all the nickle and dime charges were put together. I'm over my deductible. So I had to sit on the phone for an hour Blue Shield waiting so I can speak to an auditor. They told me they were going to investigate my billing and get back to me within a month. Never heard back from them. Now I have to go through this fucking process again. Anyway, I'm getting off track and ranting a bit. But my point is, I'm skeptical that supply and demand in healthcare will work the same way it does in other markets because the costs are invisible to you. Plus if wages for doctors fell due to oversupply, medical schools might lower their rate of acceptance. How would new doctors be able to pay off six figure debts if they didn't make high salaries? What incentive would medical schools have to churn out a bunch of cheap doctors that will never be able to pay back their tuition on what they make?

Quote:

The problem is neither is easy to do. So instead, the parties involved blame "big pharma," "government healthcare," "private healthcare," "insurance companies," or whatever other scapegoat happens to be popular within each party at the time.

Cost controls seem to be the only explanation as to the huge gap you see between us and other industrial nations. That's the elephant in the room right there. Other countries regulate the costs of things. We don't. And we don't because of powerful lobbies. That's why Obama ditched the public option in favor of the mandate. It was payday for insurance companies and Pharma. That's why I'm not rah rah about Obamacare. It was a tepid step in the right direction, but it wasn't done appropriately. Part of that is Obama's fault, part of that is prevailing ultra-polarized political climate we are in this last decade.

[kbell]

I could be wrong, but I would think if the population increased, more people would need care. As a result more money would need to be used to pay for the increased care, and the proportions would change.

[PowderdToastMan]

http://thehud.com/essays/the-new-fascists/
This is the best explanation I have ever fount when it comes to understanding government.

Very against and this explains why.

[speakeasy]

(05-23-2014 10:37 PM)kbell Wrote:  

I could be wrong, but I would think if the population increased, more people would need care. As a result more money would need to be used to pay for the increased care, and the proportions would change.

If a population doubled, the percentage of people on healthcare would double and the GDP would be double as well. So healthcare spending as a percentage of GDP should not change based on population size.

[ElBorrachoInfamoso]

I know I've posted this before on other healthcare related threads.

The Concord Study tracked cancer survival rates in dozens of countries. They found that the US and Canada had much higher cancer survival rates than Western Europe and the rest of the world. The US was slightly higher than Canada overall, and the US advantage in cancer survival increased when looking at only white North Americans. They also controlled for the stage of the cancer at diagnosis so that the US would not get an artificial advantage for all the early diagnosis that happens here.

Healthcare outcomes are great in the US. Health outcomes (life expectancy) are not. The US needs a better system to keep down costs but anyone who tells you we need a single-payer or universal coverage system to improve healthcare outcomes is either ignorant, stupid or a liar.

(05-23-2014 10:11 PM)Sawyer Wrote:  

I'd say the bigger elephant in the room is undocumented workers.

Do you mean undocumented workers are the elephant in the room with respect to healthcare? How so?

Undocumented workers tend to be younger and have less health problems. Even if they do end up getting government to pay for their care, it's a relatively small expense compared to older native-born Americans on Medicare.

[Sp5]

The healthcare system in the USA is so fucked up and expensive, it will probably take a fiscal collapse to sort it out.

Unless you're a Social Darwinist, you probably agree that people should get health care, even if they are too old, retarded, crazy or crippled to work. It would seem to be a step backwards in human development to have people dying of appendicitis because they could not pay for the surgery. On the other hand, why pay $500,000 for a heart transplant for an 85 year old guy?

Since Obama is a tool of special interests of many types, he promoted a system where the hogs will keep skimming and feeding out of the trough. Of course the Congress demanded the same thing.

While Europeans and Americans both pay a lot of taxes, it seems that Europeans get more for their money in the way of health care and infrastructure.

[Samseau]

(05-24-2014 04:50 AM)Sp5 Wrote:  

Unless you're a Social Darwinist, you probably agree that people should get health care, even if they are too old, retarded, crazy or crippled to work. It would seem to be a step backwards in human development to have people dying of appendicitis because they could not pay for the surgery. On the other hand, why pay $500,000 for a heart transplant for an 85 year old guy?

Social Darwinism is necessary to a certain extent. You cannot forever use the strong to support the weak.

Eventually the strong run out of resources or fail to breed in sufficient numbers to support the weak, or the weak simply outbreed the strong.

Dysgenics is real and it's happening at a breakneck pace in America. It is part of the reason America is doomed to go broke at current trends.

I support free healthcare for children, which is really cheap and has a large return on investment, but to say older people have some kind of right to healthcare is just nonsense. Fully functional adults should be expected to take care of themselves.

What perplexes me more than anything is that you have people who claim to be atheists running our government, yet they also claim people have fundamental rights. What are they talking about?

Without God, the only policy that makes sense is utilitarianism. Maximize pleasure, minimize pain. Giving healthcare only to children accomplishes this, because children just need some vaccines, a bit of care from the mother, and bam they are good to go for nearly 60 years after reaching adulthood.

Supporting some guy with 1 million dollar treatments so he can live for another 2 years is an absurd waste of public resources.

[Samseau]

Additionally, if you truly believe that men should be in control of a country, universal healthcare for everyone just means women need men even less. Women should be expected to pay for their own shit or find a man who will pay for them.

[Sawyer]

Re: Undocumented workers and the medical system

"Under the Emergency Medical Treatment and Active Labor Act of 1985, hospitals are obligated to treat the uninsured without reimbursement."

"According to the report, between 1993 and 2003, 60 California hospitals closed because half their services became unpaid. Another 24 California hospitals verge on closure, the author writes."

Link

[The_CEO]

For the entrepreneurs, self-employed, and location independent RFV'ers the ACA is a positive in that you don't have to be chained to a "9-5" and a specific location, solely for health benefits.

Prior to the ACA, individual policy rates were higher (and would get jacked exorbitantly each year) and people would get stuck in a job/location just to keep their insurance, which in and of itself stifles innovation.

In that scenario if you left or loss your job, you could get coverage through COBRA which costed much more than a good plan under the ACA, and it was only temporary anyway.

[Samseau]

(05-24-2014 10:31 AM)The_CEO Wrote:  

For the entrepreneurs, self-employed, and location independent RFV'ers the ACA is a positive in that you don't have to be chained to a "9-5" and a specific location, solely for health benefits.

Prior to the ACA, individual policy rates were higher (and would get jacked exorbitantly each year) and people would get stuck in a job/location just to keep their insurance, which in and of itself stifles innovation.

In that scenario if you left or loss your job, you could get coverage through COBRA which costed much more than a good plan under the ACA, and it was only temporary anyway.

That opposite of what you said is true.

In the old days, only the most pussy of men kept a job for the health insurance. Women are the ones who need healthcare the most, which means they would keep the job for the health insurance.

In Obama's new America, now EVERYONE needs to keep their job, because healthcare is insanely expensive, and you get fined for not having health insurance. Paying for health insurance on your own costs most people 20%-100% more, so finding a job with health insurance is key.

However, getting a full-time job with benefits is now harder than ever, thanks to Obama's anti-business policies, plus the fact that most companies are keeping workers part-time so they do not need to pay for the ACA's ridiculous premiums.

[The_CEO]

(05-24-2014 10:50 AM)Samseau Wrote:  

(05-24-2014 10:31 AM)The_CEO Wrote:  

For the entrepreneurs, self-employed, and location independent RFV'ers the ACA is a positive in that you don't have to be chained to a "9-5" and a specific location, solely for health benefits.

Prior to the ACA, individual policy rates were higher (and would get jacked exorbitantly each year) and people would get stuck in a job/location just to keep their insurance, which in and of itself stifles innovation.

In that scenario if you left or loss your job, you could get coverage through COBRA which costed much more than a good plan under the ACA, and it was only temporary anyway.

That opposite of what you said is true.

In the old days, only the most pussy of men kept a job for the health insurance. Women are the ones who need healthcare the most, which means they would keep the job for the health insurance.

In Obama's new America, now EVERYONE needs to keep their job, because healthcare is insanely expensive, and you get fined for not having health insurance. Paying for health insurance on your own costs most people 20%-100% more, so finding a job with health insurance is key.

However, getting a full-time job with benefits is now harder than ever, thanks to Obama's anti-business policies, plus the fact that most companies are keeping workers part-time so they do not need to pay for the ACA's ridiculous premiums.

You are right that in the "old days", maybe in the 50's and 60's the employer-provided health insurance model worked ok. Most people worked at one company for decades, and weren't changing jobs every few years or so like they do now.

Or, in the modern economy, where you have workers that are freelance or contract workers.

That model (employer supplied insurance) was obsolete, a relic from another era, left millions uninsured - hence Romneycare, Obamacare or whatever you call it, to address this.

In any case, that's not true about people needing to keep their job now.

Obamacare has allowed people who want to, to be more mobile. E.g. You quit your job and move to another state, or quit your job to start your business, b/c you're no longer dependent on your job for health insurance.

As far as rates, that's not true either. You have a range of rates to choose from, from Bronze - Platinum (Bronze being basic and more inexpensive, to Platinum being premium coverage). These rates are also subsidized based on your income.

Also, due to Obamacare, anyone 26 and younger can now stay on their parent's plan.

It's definitely not perfect, but pre-Obamacare, the system penalized anyone who was self-employed or freelance. A good (gold/platinum) individual plan that now costs around $200-300/month, cost around $500+ pre-Obamacare.

Anyone who wants to can cost compare here:

https://www.healthsherpa.com/

[It_is_my_time]

Obamacare is just an extension of feminism. It raises men's insurance rates to subsidize women's insurance rates.

I want less feminism in our country, not more.