The (un)Affordable Health Care Act & Debt Ceiling Controversies

[saevel25]

For the first sentence how about, please God I hope not

As for the 2nd, yea their needs to be a disconnect from the drug companies and doctors. A great movie with Jude Law, "Side Effects" goes into a bit of detail on the whole drug companies paying doctors to push their drugs. But that isn't spiking cost as much as overall health, its the number of people, or events occurring, between you and your own doctor. Every time a decision is made, a piece of paper sent, someone makes a call, negotiating prices, it adds to the cost, which is a lot more than the prescription drug problem.

I recently talked to an adequateness of mine, and his wife was stuck with no insurance, just a crack in the system between retiring and when his insurance picks her up. Well, he just told her to go to the doctor and say she'll pay in cash. She did, and she ended up paying about 50 dollars less for the check up because they didn't have to deal with the insurance companies.

So, overall the best scenario, majority of people need no insurance. Imagine the savings if the government just had critical health insurance, basically covering high end costs, which occur at a fraction of the time. So, you'll save money. Basically any routine should not be covered. This is were doctors get screwed over by the government and insurance companies, their margins for making money are so slim there.

This will free up money for those who really need it, those emergency room trips, surgeries, cancer treatments. We don't need insurance to get our vitals checked once a year. That is absurd.

[dsc123]

Absurd is arguing that most people don't need health insurance because you sort of know someone who got a $50 discount once.

[dsc123]

Saevel, is the mandate the only thing you have a problem with? Covering preexisting conditions and setting coverage standards doesn't seem so bad, right? Or requiring big companies to provide health insurance? I know you say you don't want the govt, involved, but I don't know what you mean. Insurance companies are still providing the insurance, the govt is just adding regulations and establishing exchanges to help people find and buy it. Other than the mandate, what is there to dislike?

[saevel25]

Saevel, is the mandate the only thing you have a problem with?

Covering preexisting conditions and setting coverage standards doesn't seem so bad, right? Or requiring big companies to provide health insurance?

I know you say you don't want the govt, involved, but I don't know what you mean. Insurance companies are still providing the insurance, the govt is just adding regulations and establishing exchanges to help people find and buy it. Other than the mandate, what is there to dislike?

I don't mind covering pre-existing conditions. I get why insurance companies don't want to cover them, it's a way of mitigating risk. Insurance makes money on the fact that they can charge you money for things you will hardly use. If they know you'll be sick, why cover you? I don't mind this, it will increase costs, but its not that big of a deal for me.

Companies offering health insurance is a nice option, but it shouldn't be required. It adds another complexity to the whole system. Now insurance companies have to negotiate with businesses, and that adds to the costs of the system. Every entity that gets a hand in the system adds cost. I never got that, why punish a business for not offering health care. Why should a business have to offer it. I kinda get the mandate for individual people, but punishing businesses is just stupid. All they did was force businesses to dump people onto the exchange.

Things I don't like,

1) they tax medial devices and research in the bill

2) the fine you if you are not on a plan (mandate)

3) they set up a board that has little oversight, that will make broad based decisions on how to cut costs. Meaning they can set up requirements for plans on the system, basically denying certain procedures and treatments. Meaning if you have a pre-existing condition, and your hope is their because of the exchange, what good does it do you if the procedure isn't offered?

Absurd is arguing that most people don't need health insurance because you sort of know someone who got a $50 discount once.

No I never said they didn't need health insurance, I mean they didn't need health insurance with a 100 things covered they will never use. For me, I would rather have health insurance that just covered something rare happening, like getting in a car accident, or coming down with some strange jungle fever because i walked through someone's cough at the airport after they got back from vacation to Brazil. Things like that. I can pay cash for standard doctors check ups and save them the head ache of running through the paper work, and negotiating with a middle man.

[Jakester23]

Its going to mandate certain coverage that not everyone wants or needs. For example a buddy of mine is 40 something and has 4 kids.  He is done having kids but Obamacare mandates him to carry maternity benefits. If he decides to stay on his current coverage his premiums will go up simply because he is required to carry coverage he doesnt need.

[saevel25]

I get that, but if you have an abundance of different plans, allow people to shop for plans at every possible insurance agency that wants to branch out nationally, there will be many more plans available. You will also drive up competition, which naturally lower prices. Instead of being stuck with only 3-4 options in a geographical area, you will have many more options.

If Obama care wanted to do this right, they should bring every plan in the nation under their umbrella, and say, "Here you go, pick the one you want". Their should be hundreds of options to choose from.

[Jakester23]

I get that, but if you have an abundance of different plans, allow people to shop for plans at every possible insurance agency that wants to branch out nationally, there will be many more plans available. You will also drive up competition, which naturally lower prices. Instead of being stuck with only 3-4 options in a geographical area, you will have many more options.

If Obama care wanted to do this right, they should bring every plan in the nation under their umbrella, and say, "Here you go, pick the one you want". Their should be hundreds of options to choose from.

Ive never heard it put like this but its a much better idea then what is being shoved down our throat.

[mmoan2]

http://www.upworthy.com/congress-did-something-so-spectacularly-creepy-that-its-too-unbelievable-to-make-up

I saw that today.

Although this seems like a big deal because of what's going on right now, these kinds of things happen all the time. It's why I really have problems with the media. Sensationalism at the sound bite. Try showing the preceding 5 hours to see what led up to this.

[Mr. Desmond]

I get that, but if you have an abundance of different plans, allow people to shop for plans at every possible insurance agency that wants to branch out nationally, there will be many more plans available. You will also drive up competition, which naturally lower prices. Instead of being stuck with only 3-4 options in a geographical area, you will have many more options.

If Obama care wanted to do this right, they should bring every plan in the nation under their umbrella, and say, "Here you go, pick the one you want". Their should be hundreds of options to choose from.

From what little I understand, insurance companies can enter the exchange and submit various plans with different benefits. So can other companies. It's competition and the free market. Nothing is shoved down ... it's whether the private companies want to enter the market.

[nick1998bunker]

I don't think making companies provide health insurance is the way to do it. I think simple survival of the fittest will do. Natural selection

[saevel25]

[COLOR=FF00AA][/COLOR][quote name="nick1998bunker" url="/t/70579/the-un-affordable-health-care-act-debt-ceiling-controversies/108#post_909581"]I don't think making companies provide health insurance is the way to do it. I think simple survival of the fittest will do. Natural selection[/quote] And I think I am bowing out.:-P This is going to bring in the bleeding heart, how can you think that, liberals. I tend to run away from them, you just can't argue with the guilty trippers. :-P

[Mr. Desmond]

I don't think making companies provide health insurance is the way to do it. I think simple survival of the fittest will do. Natural selection

It is the duty of government to protect its people. The degree of protection, what is protected, and whom is protected is always under discussion.

In fact, it's been decided in the case of health care.

It's the law.

[Lihu]

It is the duty of government to protect its people. The degree of protection, what is protected, and whom is protected is always under discussion. In fact, it's been decided in the case of health care. It's the law.

Protect the people, yes, but to provide medical coverage? This gets ambiguous. I would agree with ER services, but many non essential services are included. The heart of the problem is that medical help is so expensive due to many non-medical related expenses related to running the health care businesses. No one should become financially ruined because of medical services. The ACA solution is to throw more of our money into the non medical related portion, and increase health care coverage for everyone. Does this make sense? It will help many people in the short term, but the industry will adjust the prices in due time to make up for the additional costs associated with complying to the new law. You don't fix a flat tire by wrapping another tire around it, do you?

[mmoan2]

Protect the people, yes, but to provide medical coverage? This gets ambiguous. I would agree with ER services, but many non essential services are included.

The heart of the problem is that medical help is so expensive due to many non-medical related expenses related to running the health care businesses.

No one should become financially ruined because of medical services.

The ACA solution is to throw more of our money into the non medical related portion, and increase health care coverage for everyone. Does this make sense?

It will help many people in the short term, but the industry will adjust the prices in due time to make up for the additional costs associated with complying to the new law.

You don't fix a flat tire by wrapping another tire around it, do you?

You are right about the ACA solution, but it was a necessary compromise that the Democrats settled on hoping that it will foment a future shift toward a more European, universal model of health care. If Obama and most Democrats had their way, single payer would have been included, but in the U.S. the term "socialized medicine" is a political death sentence, so that never would've made it unless both houses of Congress were overwhelmingly liberal Dems. I think the ACA is flawed for so many reasons I could be up all night discussing it, but I have never seen a comprehensive free-market solution presented by the GOP to cut costs and provide full health care access. I think health care is a "right," in this country, and there are ways to do it. France, for example, has a hybrid single-payer system where the government covers basic needs, but you can purchase private insurance for more "exotic" needs. I'm generally a free-market person at heart, but "health" is not a commodity, and I think the non-medical-related expenses you refer to - malpractice insurance, enormous spending on back office staff, cost of medical school, etc. - coupled with an insatiable profit motive on the part of insurance companies drives costs sky high.

All I know is that the U.S. has the highest health care spending per capita by over double what most other industrialized nations spend, and the results are not more than two times better. It's only been in the past 15 years where this discrepancy has occurred. It's a monumental task that needs to be worked on for a long time.

[saevel25]

You are right about the ACA solution, but it was a necessary compromise that the Democrats settled on hoping that it will foment a future shift toward a more European, universal model of health care. If Obama and most Democrats had their way, single payer would have been included, but in the U.S. the term "socialized medicine" is a political death sentence, so that never would've made it unless both houses of Congress were overwhelmingly liberal Dems. I think the ACA is flawed for so many reasons I could be up all night discussing it, but I have never seen a comprehensive free-market solution presented by the GOP to cut costs and provide full health care access. I think health care is a "right," in this country, and there are ways to do it. France, for example, has a hybrid single-payer system where the government covers basic needs, but you can purchase private insurance for more "exotic" needs. I'm generally a free-market person at heart, but "health" is not a commodity, and I think the non-medical-related expenses you refer to - malpractice insurance, enormous spending on back office staff, cost of medical school, etc. - coupled with an insatiable profit motive on the part of insurance companies drives costs sky high.

All I know is that the U.S. has the highest health care spending per capita by over double what most other industrialized nations spend, and the results are not more than two times better. It's only been in the past 15 years where this discrepancy has occurred. It's a monumental task that needs to be worked on for a long time.

Shopping around for health care wont lower costs to much, because of how insurance companies work. What lowers costs is if you get rid of health care. Look at cosmetic surgery. Compared to other surgeries, these procedures are one of the least expensive out there (just talking about those who go under the knife). Why, because it isn't covered by health insurance plans, which means people have to go around and shop for doctors. This pits doctors versus doctor for the right to perform the procedure. That lowers the costs.

What we can't do is shop around for hospitals. This is why I think there should be no insurance for anything basic. This will allow people to go to any doctor they want, shop around, and the doctors will have to be cost effective. Doctors can't be cost effective now because they either have to abide by what insurance agencies tell them they get, or they are not in network. So this sticks doctors in a pricing range. Also it limits the amount of patients they see as well, so it decreases possible income for the doctor. This also decreases the ability for patients to find the doctor they want, and at the price they want. Though this is mostly covered by health insurance reimbursements.

But that is just what I think should happen, probably wont ever happen.

Well the big thing in the last 15 years is the rise in Cancer and Obesity in the USA. Basically Americans have become more expensive to insure because we are unhealthy.

[mmoan2]

Shopping around for health care wont lower costs to much, because of how insurance companies work. What lowers costs is if you get rid of health care. Look at cosmetic surgery. Compared to other surgeries, these procedures are one of the least expensive out there (just talking about those who go under the knife). Why, because it isn't covered by health insurance plans, which means people have to go around and shop for doctors. This pits doctors versus doctor for the right to perform the procedure. That lowers the costs.

What we can't do is shop around for hospitals. This is why I think there should be no insurance for anything basic. This will allow people to go to any doctor they want, shop around, and the doctors will have to be cost effective. Doctors can't be cost effective now because they either have to abide by what insurance agencies tell them they get, or they are not in network. So this sticks doctors in a pricing range. Also it limits the amount of patients they see as well, so it decreases possible income for the doctor. This also decreases the ability for patients to find the doctor they want, and at the price they want. Though this is mostly covered by health insurance reimbursements.

But that is just what I think should happen, probably wont ever happen.

Well the big thing in the last 15 years is the rise in Cancer and Obesity in the USA. Basically Americans have become more expensive to insure because we are unhealthy.

If you mean by "getting rid of health care" removing health insurance coverage for basic needs, I don't see this as possible. Private, for-profit insurance (and Big Pharma) clearly are largely responsible for inflated health care costs, which is why they need to become either public or not-for-profit entities. We can't just dismantle the system though. Most of "the 99%" would not be able to afford any acute medical care, even if costs were cut in half overnight. Without medical insurance, one trip to the ER for a broken leg would bankrupt a family living check-to-check after the cost of the hospital stay, X-rays, pills, DME, etc. Although it's easy to say how irresponsible it is for folks to be living check-to-check, almost half of the nation doesn't have enough savings to match a month's worth of wages.

I do agree with the obesity and cancer comment though. I have no problem means-testing people for health when determining their premium rates.

[mmoan2]

Shopping around for health care wont lower costs to much, because of how insurance companies work. What lowers costs is if you get rid of health care. Look at cosmetic surgery. Compared to other surgeries, these procedures are one of the least expensive out there (just talking about those who go under the knife). Why, because it isn't covered by health insurance plans, which means people have to go around and shop for doctors. This pits doctors versus doctor for the right to perform the procedure. That lowers the costs.

What we can't do is shop around for hospitals. This is why I think there should be no insurance for anything basic. This will allow people to go to any doctor they want, shop around, and the doctors will have to be cost effective. Doctors can't be cost effective now because they either have to abide by what insurance agencies tell them they get, or they are not in network. So this sticks doctors in a pricing range. Also it limits the amount of patients they see as well, so it decreases possible income for the doctor. This also decreases the ability for patients to find the doctor they want, and at the price they want. Though this is mostly covered by health insurance reimbursements.

But that is just what I think should happen, probably wont ever happen.

Well the big thing in the last 15 years is the rise in Cancer and Obesity in the USA. Basically Americans have become more expensive to insure because we are unhealthy.

I also don't think it's certain that cosmetic surgery is cheaper solely because it's not covered by insurance, although that is a part of it. It's not even that cheap - a simple breast augmentation is like $4000 in the Medical Blue Book (of course, you can probably find Dr. Strangelove on the street to do it for $1500) while removal of a malignant skin lesion is only $750. Cosmetic surgery is also far less dangerous than anything involving vital organs, so of course the prices will be much higher.

[saevel25]

If you mean by "getting rid of health care" removing health insurance coverage for basic needs, I don't see this as possible. Private, for-profit insurance (and Big Pharma) clearly are largely responsible for inflated health care costs, which is why they need to become either public or not-for-profit entities. We can't just dismantle the system though. Most of "the 99%" would not be able to afford any acute medical care, even if costs were cut in half overnight. Without medical insurance, one trip to the ER for a broken leg would bankrupt a family living check-to-check after the cost of the hospital stay, X-rays, pills, DME, etc. Although it's easy to say how irresponsible it is for folks to be living check-to-check, almost half of the nation doesn't have enough savings to match a month's worth of wages.

I do agree with the obesity and cancer comment though. I have no problem means-testing people for health when determining their premium rates.

that is true, that is why the best thing would be allowing everyone to have a health savings account when they are born. Then the government can just put the subsidy there. So by the time they reach adult hood, they have a buffer for basic needs care. Like I said, I don't mind insurance to cover rare injuries or diseases. But basic needs can easily be covered through other methods. This would allow the patient to control the money, and to shop around. The odds of someone breaking a bone is so much less than getting a common cold. You don't need a 200-500 dollar fee to get checked for a common cold.

Yes part of the problem is living pay check to pay check, but here's a question. Should we be basically supporting this mentality by covering the problems they never seem to want to save for. Meaning, why should we keep covering people's debts so they can buy huge houses, cars, TV's, ect... If people just lived with in their means and saved, they wouldn't be going into bankruptcy as often. Having the government cover their issues allows them to be reckless. Lets take it to golf, what if we say for a round of golf that all water hazards are not hazards, just drop a ball no penalty. How much more reckless would you be.

I agree, there should be a means-testing.