A political lie about health insurance.

[Download]

5 minutes ago, TheSeeker said:

The entire point of the private sector is to extract profit at all cost

Without regulation we would have $10/month health care plans with $10,000 deductibles. That's optimal for the One Percent, but what about the rest of America?

If Americans had no medical debt and no student loan debt, they would be able to spend more. Wouldn't that help the free market?

It's almost like our bought and paid politicians on both sides want to keep the racket going so they can keep profiting from it

Do you understand how the free market works? Seriously? 

Of course people work to make a profit. You work (I assume) to make a profit. That’s the entire fucking point. The amount of government interference in healthcare is insane. The reason it’s an absolute dumpster fire is 100% at the feet of the government. They have fucked it up so bad for so long you guys actually believe they’re the good guys in this inferno.

im not saying the private sector is without faults or they’re not greedy. It’s easy to get greedy when the government is in bed with you and there’s no one able to compete for some of your profits. The free market is the ultimate judge and juror. Allow the free market to do what it does. Allow the people to make their own decisions. This shit is not that complicated. 

[downzy]

22 minutes ago, Download said:

Can anyone name a country with a higher population than the United States where single payer is better than what the private sector provides?

That’s asinine. The US is the third or fourth most populated country on the planet but also one of the richest. It’s GDP per capita higher than most other developed nations that provide universal coverage. 

It is an outright falsehood to claim that theUS can not afford to provide universal healthcare to its citizens. 

[Download]

1 minute ago, downzy said:

That’s asinine. The US is the third or fourth most populated country on the planet but also one of the richest. It’s GDP per capita higher than most other developed nations that provide universal coverage. 

It is an outright falsehood to claim that theUS can not afford to provide universal healthcare to its citizens. 

So you can’t? And why not? Probably because none exist. 

70% of the federal budget already goes to entitlements. 70 fucking percent. 

Tell me, on what magical tree are you pulling off this never ending supply of $100 bills? 

[downzy]

3 minutes ago, Download said:

The amount of government interference in healthcare is insane

The US healthcare system is one of the least regulated systems in the developed world. If what you claim were true (ie. less regulations = lower costs), the US would have the cheapest healthcare services in the world. But in reality it’s the opposite. 

Go back and take Econ 101 and look up the concept inelasticity with respect to a good or service. 

[downzy]

Just now, Download said:

So you can’t? And why not? Probably because none exist. 

I addressed both.  Population doesn’t matter. What matters is a nation’s wealth relative to its population. And by that measure the US could easily afford universal healthcare should it transform its system into a single payer system. Every other developed nation, even those less wealthy than the US, chooses to provide universal coverage. 

Again, a nation’s population is irrelevant. You’re choosing to ignore this very basic fact. 

[DeadSlash]

12 hours ago, TheSeeker said:

You're saying privately run Medicare Advantage plans with an out-of-pocket max of $7,000/year are better than the proposed Medicare for All plan with no deductibles, no copays, and no out-of-pocket max?

Get out of here. 

The average American can't come up with $500 in an emergency and you think everyone can afford $7000 if they get hospitalized? 

So to clarify on this, I think it's a combination of me explaining maximum out of pocket poorly, and some of that bad information from politicians that inspired this thread.

1. The $7k Maximum out of pocket is not a deductible, it's not paid before the insurance kicks in, and the vast majority of people will never ever pay the full $7k.  The maximum out of pocket of $7k is just a lid, a worse case scenario.  A good way to illustrate it would be a hospital stay:

On Original, government run Medicare, you pay $1,316 if you are admitted to the hospital.  This lasts for 60 days.  So if A Medicare recipient is in for 1 day, or 60, it's $1,316.  This is the part A deductible.  (Side note, after 60 days, if you go back, you pay it again.)  If you are in for more than 60 days in a row, the government charges about $250 from day 61 - 90, you are then out of coverage.  The government gives you 60 lifetime reserve days, at double, or $500 a day and if you exhaust those lifetime reserve days you are not covered at all, and 100% responsible for all costs. There is no cap or protection for seniors, if they run up $500k in bills, they owe $500k

On a Medicare Advantage plan, you'll have a daily deductible for your first 5 days of approximately $250 a day(it varies from plan to plan, some closer to $500)  Let's say it is $500 a day and take the above scenario^^  If you are in the hospital for 5 days, you owe $2,500 to the insurance company.  At day 60, nothing changes no additional money is owed, same with day 90, or even if you are in a coma and in the hospital for 365 days, you finished paying on day 5, and owe nothing additional.  Where the 7k limit would come into play, it let's say Mom or Dad has 10 separate 5 days stays in the hospital, they would reach their 7k out of pocket limit on the 3rd stay, and the remaining 7 stays would be 100% the insurance companies responsibility.  With a Medicare Advantage plan you are not guaranteed to PAY $7k in a calendar year, you are guaranteed to never pay MORE than $7k per year.  Does that make more sense?

 

2.  I'm not sure where you heard not deductibles and no out of pocket at all, but that isn't how Medicare works.  Medicare has a Hospital and a medical deductible, and thereafter has an 80/20 split on all part B charges(medical.)   Part A (Hospital) works differently and is explained above.  Medicare does NOT cover RX's.  Rx coverage is only available through private insurance.  Medicare does not have a maximum out of pocket.  IF you are talking about a promise from some politician that there will be no cost involved under "Medicare for all" we can objectively and with 100% certainty call that a disingenuous lie.  How?  How can we so positively make a bold claim that it's a lie "Medicare for all" would have no cost to the patient?  Because Congress LITERALLY just passed a law to eliminate Plan F Medicare supplement policies.  Plan F was/is the most comprehensive plan a senior can get, and it leaves them with little to NO out of pocket costs.  The government has concluded that when you have no risk, you use the plan more and drive up costs for the government.  To be very clear, the United Stated Congress has made it illegal for Medicare recipients to have a plan with "no costs" starting in 2020. The United States Congress passed a law making it MANDATORY that you have costs associated with going to the doctor or hospital.  Whatever politician promises no costs associated with your health care is they are elected is straight up lying to your face and has literally  contributed to eliminating that possibility for people currently on Medicare.

 

12 hours ago, Kasanova King said:

Pretty sure most of the folks trying to lower insurance rates are going after the price of medicines, healthcare costs themselves, which will in turn, eventually lower premiums.

For example, if said pharmaceutical company charges $500 for a medicine that costs them $25 to make, an insurance company can negotiate that price down to $200, etc.

Some already do that to an extent but from my understanding, they want it done more and across the board.

 

You're not wrong, but drug prices are a little different.  It's a different dynamic on their pricing etc.  IMO, the only kind of reform that makes sense is pretty hard to achieve, but determining actual costs of medical procedures.  It's problematic, and difficult to say "The price for an MRI should be XYZ, so the Dr. must charge XYZ and the insurance company must pay XYZ."  <----- that opens it's whole unique can of worms, but SOMETHING has to be done.  As it is, prices are like Monopoly money, with made up values.  The way it works is let's say the actual cost to a hospital for an MRI is $250, counting everything, money toward the machines purchase, paying the tech, the supplies and electricity etc...  When they bill $250, the insurance company is like "Ok, for a bill of $250 we will pay you $32."  This launches a stupid game of "What do we have to charge in order to get paid what we actually need?"  and the next thing you know, an MRI bill is $4,374 because that is the magic number they need to charge to get the insurance to pay $250.

If the rest of the world did business like Doctors, hospitals and insurance companies, when we bought the new Avengers DVD, it would have a price tag of $768 but we'd offer the cashier $29.99 and they would accept it.

10 hours ago, downzy said:

Yes and no.

As others have pointed out, reducing overall healthcare costs would reduce rates.  

Another way to reduce rates is to have more people insured.  Increase the size of the insurance pool and the average plan drops.  It's not universal, however.  If you're paying a bare-bones plan that covers only catastrophic care with high deductibles, you're probably paying lower rates than someone who is in a much larger pool that covers everyone, including elderly and more sick patients.  

That is what single payer does.  It puts everyone into one insurance pool, ensuring coverage for everyone and reducing rates for people who would be deemed as high-usage healthcare consumers.

Then there are some politicians who want to do away with private insurance and regulate prices of both drug and healthcare providers.  This would certainly reduce healthcare costs and public insurance, but would also increase everyone's taxes.  Bernie Sanders makes no bones that if he were elected President your taxes would go up but you would gain more in net since you wouldn't be paying monthly insurance premiums.  This is what we have in Canada. We don't pay for healthcare insurance, but we do pay higher taxes.  Our costs for treating patients is dramatically lower than what we see south of the border.

What you're describing is essentially how single-payer operates, minus private insurance companies.  Mind you, it was a grossly unfunded policy roll out.  The government could have easily dictated terms to healthcare providers but they allowed private insurance to do that since all the leverage was provided by the government (healthcare providers get $8k - take it or leave it).  Single payer systems in other countries do the same, except they cut out private companies that include a profit margin.  

You're sacrificing the good for the perfect.  No government is going to run without waste or inefficiencies, just like no corporation does either.  

Moreover, as I explained earlier and as have other less than perfect governments accomplished, single-payer systems can work.  The U.S. is not a special case.  Any country that can deliver the level of military superiority and a $700 billion budget that comes with it can manage its own healthcare.  Other countries can and so to can the U.S. if it chose to.  The system will never be perfect, but it doesn't have to be to get better.  

We pretty much agree on a lot, a couple of points

1. It's correct for me to say they can't "decide" rates.  They can't, it has to be justified with the numbers.  You are correct that if everyone was insured, rates would go down.  That's still not an insurance company arbitrarily "deciding" to lower rates, more if more healthy people were insured and paying into the system that provides the money to pay out for the sick people, and we all pay a little bit less.  It's 100% correct, and one of the biggest challenges for the ACA.  We didn't get enough of those people who could have had insurance prior to the ACA (because they have no preexisting conditions) to get into the system.  All I'm saying by "decide" rates is that the legal process behind the system prevents an insurance company from charging rates that are higher or lower than the math says they need to charge.

2. I agree there is a massive different between single payer with private insurance, and single payer without it.  Medicare advantage plans actually show us that a single payer system can work out fine with private insurance backing, BUT most (if not all, I'm not sure) of the plans being floated eliminate private insurance.  That's why the Medicare example is so perfect, we can actually see how terrible Original Medicare (100% government run) is vs. Medicare Advantage (Private insurance working in conjunction with a single payer system.)

3.  I agree about your point that the Affordable Care Act is neither the devil, nor is it prefect.  I could do a whole thread on that thing but it's not the disaster or the savior that it is made out to be by whatever candidate it is politically expedient to in that moment.

 

I do strongly disagree with your point about sacrificing the good for the perfect, BUT I think the involvement of private insurance really steers that conversation.  A single payer, government only health care system is not a good vs. perfect scenario, it's a disaster vs. good scenario.  If private insurance remains involved, that helps a great deal, although I still think it would NOT be a great thing, we are closer to the "good vs. perfect." POV.

10 hours ago, 31illusions said:

I can see that. My issue, as I said in the political thread is I don't like the Government does nothing to lower healthcare costs. It just made sure you bought insurance. The cost is still to high. Who can afford a 2-3-4 thousand dollar deductible? It's letting Hospitals and others continue to charge whatever they want because everyone has insurance.

So here is what happened with that.  They tried to make coasts go down, but they needed something to happen, counted on it happening, but it didn't.  That "something" was young and healthy people buying insurance.  When you eliminate the ability for the insurance company to turn anyone away, sick people all sign up, and costs go up.  Everyone knew this, including Washington, but the goal/plan was to offset this by getting people who would normally not buy their own insurance to buy it and essentially not use it, offsetting the increased costs of all of the sick people.  They did it with a lot of education, PSAs, and (most importantly) the penalty.  This was supposed to motivate the 18-30 year olds to see the need/value in insurance where they previously hadn't.  It just didn't pan out like that, they didn't get a big influx of healthy people, and as a result, rates are where they are.

In a nutshell, on January 1, 2014 when insurance companies could no longer turn people away for pre-existing conditions, nothing changed in the world of the average 25 year old who is 100% healthy.  It's not like they wanted insurance and just couldn't get it... they made a conscious decision to not get insurance because it's expensive as fuck and they never go to the doctor.  The penalty was tiny.  Take the average 25 year old that never goes to the doctor and doesn't WANT insurance and tell them "You can buy this insurance that you don't want and pay $900 a month, or if you elect not to do this, you will be punished with a penalty of $250.   Nobody is paying $11k to avoid a $250 fine.

Edited August 12, 2019 by DeadSlash

[Download]

6 minutes ago, downzy said:

The US healthcare system is one of the least regulated systems in the developed world. If what you claim were true (ie. less regulations = lower costs), the US would have the cheapest healthcare services in the world. But in reality it’s the opposite. 

Go back and take Econ 101 and look up the concept inelasticity with respect to a good or service. 

That’s why I’m here, Downzy, oh wise one. Teach me how a federal budget that already consists of 70% going to entitlements, teach me how we’re going to government regulate the Wild Wild West that is our current healthcare system and make it better? 

Im all ears

Edited August 12, 2019 by Download

[downzy]

6 minutes ago, Download said:

70% of the federal budget already goes to entitlements. 70 fucking percent

And?  

Most goes to social security.

Second, this speaks to a revenue issue, not a spending issue (though the $600 billion the US spends on its military speaks to a priorities issue). 

Third, if you examined most other developed nation, you’ll likely find similar outlay percentages. 

[Download]

3 minutes ago, downzy said:

And?  

Most goes to social security.

Second, this speaks to a revenue issue, not a spending issue (though the $600 billion the US spends on its military speaks to a priorities issue). 

Third, if you examined most other developed nation, you’ll likely find similar outlay percentages. 

Would the budget go up or down?

[TheSeeker]

11 minutes ago, DeadSlash said:

So to clarify on this, I think it's a combination of me explaining maximum out of pocket poorly, and some of that bad information from politicians that inspired this thread.

1. The $7k Maximum out of pocket is not a deductible, it's not paid before the insurance kicks in, and the vast majority of people will never ever pay the full $7k.  The maximum out of pocket of $7k is just a lid, a worse case scenario.  A good way to illustrate it would be a hospital stay:

On Original, government run Medicare, you pay $1,316 if you are admitted to the hospital.  This lasts for 60 days.  So if A Medicare recipient is in for 1 day, or 60, it's $1,316.  This is the part A deductible.  (Side note, after 60 days, if you go back, you pay it again.)  If you are in for more than 60 days in a row, the government charges about $250 from day 61 - 90, you are then out of coverage.  The government gives you 60 lifetime reserve days, at double, or $500 a day and if you exhaust those lifetime reserve days you are not covered at all, and 100% responsible for all costs. There is no cap or protection for seniors, if they run up $500k in bills, they owe $500k

On a Medicare Advantage plan, you'll have a daily deductible for your first 5 days of approximately $250 a day(it varies from plan to plan, some closer to $500)  Let's say it is $500 a day and take the above scenario^^  If you are in the hospital for 5 days, you owe $2,500 to the insurance company.  At day 60, nothing changes no additional money is owed, same with day 90, or even if you are in a coma and in the hospital for 365 days, you finished paying on day 5, and owe nothing additional.  Where the 7k limit would come into play, it let's say Mom or Dad has 10 separate 5 days stays in the hospital, they would reach their 7k out of pocket limit on the 3rd stay, and the remaining 7 stays would be 100% the insurance companies responsibility.  With a Medicare Advantage plan you are not guaranteed to PAY $7k in a calendar year, you are guaranteed to never pay MORE than $7k per year.  Does that make more sense?

 

2.  I'm not sure where you heard not deductibles and no out of pocket at all, but that isn't how Medicare works.  Medicare has a Hospital and a medical deductible, and thereafter has an 80/20 split on all part B charges(medical.)   Part A (Hospital) works differently and is explained above.  Medicare does NOT cover RX's.  Rx coverage is only available through private insurance.  Medicare does not have a maximum out of pocket.  IF you are talking about a promise from some politician that there will be no cost involved under "Medicare for all" we can objectively and with 100% certainty call that a disingenuous lie.  How?  How can we so positively make a bold claim that it's a lie "Medicare for all" would have no cost to the patient?  Because Congress LITERALLY just passed a law to eliminate Plan F Medicare supplement policies.  Plan F was/is the most comprehensive plan a senior can get, and it leaves them with little to NO out of pocket costs.  The government has concluded that when you have no risk, you use the plan more and drive up costs for the government.  To be very clear, the United Stated Congress has made it illegal for Medicare recipients to have a plan with "no costs" starting in 2020. The United States Congress passed a law making it MANDATORY that you have costs associated with going to the doctor or hospital.  Whatever politician promises no costs associated with your health care is they are elected is straight up lying to your face and has literally  contributed to eliminating that possibility for people currently on Medicare.

 

[downzy]

5 minutes ago, DeadSlash said:

It's correct for me to say they can't "decide" rates.

Well, no one is saying they will "decide" rates.  They're making claims that they will lower rates by doing a, b, c, and d.  It's fair to disagree whether their policy prescriptions will bring about the change they suggest, but I don't begrudge candidates for stating their case on how their plans and strategies will lower healthcare costs, and by proxy, insurance rates.

7 minutes ago, DeadSlash said:

That's still not an insurance company arbitrarily "deciding" to lower rates, more if more healthy people were insured and paying into the system that provides the money to pay out for the sick people, and we all pay a little bit less.

Again, I'm not sure why you're so hung up on the word "deciding."  Obama decided to pursue a policy whereby more people would be insured, which brought insurance rates down for those with pre-existing conditions (and could conceivably buy insurance).  Policies are political choices.  No one is suggesting that they will unilaterally lower rates by decree.  Every politician, both Republican and Democrat, put forward their plans that they believe will lower costs and rates.  The math can be changed through policy.  I don't see the problem.  

11 minutes ago, DeadSlash said:

Medicare advantage plans actually show us that a single payer system can work out fine with private insurance backing, BUT most (if not all, I'm not sure) of the plans being floated eliminate private insurance.  That's why the Medicare example is so perfect, we can actually see how terrible Original Medicare (100% government run) is vs. Medicare Advantage (Private insurance working in conjunction with a single payer system.)

I'm not sure why it has to be an either or proposition?  Private insurance companies are simply applying their own cost controls to medical or prescription providers.  In a sense they're saying to hospitals, doctors, and pharma "if you want our business, this is what we'll pay."  This is the basis for how single-payer systems operate.  The problem isn't necessarily with the single-payer model, but with how it was managed in the U.S.  Here in Canada, provincially run health insurance corporations dictate terms to medical practitioners and suppliers as to why they will accept.  It's how Canadians pay significantly less for operations and drugs compared to our American counterparts.  It's why thousands of Americans buy their insulin and other drugs from Canada because prices are dramatically cheaper.  It's the power of bulk-purchasing.  This can be done within the single-payer system in the U.S.  In fact we're seeing movement in that direction in California, with efforts to impose an all-payer system where by the state government sets prices and all insurance companies, and by proxy healthcare providers, have to adhere to if they wish to operate in the state.  

In other words, you're example of the old form of Medicare is just an example of the federal government not imposing the kind of costs controls itself.  It doesn't need the private industry.  Moreover, it's usually Republican law makers that pass (or attempt to) legislation that specifically bans government run plans from using its buying power to lower prices. 

19 minutes ago, DeadSlash said:

I could do a whole thread on that thing but it's not the disaster or the savior that it is made out to be by whatever candidate it is politically expedient to in that moment.

The problem with the ACA is that it was too concerned with its overall cost.  At the time of its passage Republicans pretended to give a shit about deficits and the debt, so the ACA was crafted in a way that left subsidies too low to entice the number of health Americans insurance pools needed to be viable.  It still works, but it could have worked a whole lot better had Obama and the Democrats gave less credence to insincere and cynical debt concerns.

22 minutes ago, DeadSlash said:

A single payer, government only health care system is not a good vs. perfect scenario, it's a disaster vs. good scenario.

Every other developed nation with a single payer system would disagree with your assessment.  Medicare was just run poorly.  That's not indicative of single-payer.  It's just an indictment against how the federal government chose to run Medicare.  

[DeadSlash]

1 minute ago, TheSeeker said:

 

To each their own, I guess.  I see someone telling me that if I vote for them I get a magic unicorn, and I say "There are no unicorns, and there is no magic."  and you conclude that I'm the asshole in that interaction.

[downzy]

23 minutes ago, Download said:

That’s why I’m here, Downzy, oh wise one. Teach me how a federal budget that already consists of 70% going to entitlements, teach me how we’re going to government regulate the Wild Wild West that is our current healthcare system and make it better? 

I ask this in all sincerity: are you really that thick or do you just not give a fuck enough to discuss this matter genuinely?

Look at how every other developed nation does it.  

Pay a bit more in taxes, re-prioritize spending (i.e., less for military, more for healthcare), allow governments to set and negotiate healthcare service and procedure costs, and the system could easily be paid for.  Again, every other developed nation does this.  

[DeadSlash]

2 minutes ago, downzy said:

Well, no one is saying they will "decide" rates.  They're making claims that they will lower rates by doing a, b, c, and d.  It's fair to disagree whether their policy prescriptions will bring about the change they suggest, but I don't begrudge candidates for stating their case on how their plans and strategies will lower healthcare costs, and by proxy, insurance rates.

Again, I'm not sure why you're so hung up on the word "deciding."  Obama decided to pursue a policy whereby more people would be insured, which brought insurance rates down for those with pre-existing conditions (and could conceivably buy insurance).  Policies are political choices.  No one is suggesting that they will unilaterally lower rates by decree.  Every politician, both Republican and Democrat, put forward their plans that they believe will lower costs and rates.  The math can be changed through policy.  I don't see the problem.  

I'm not sure why it has to be an either or proposition?  Private insurance companies are simply applying their own cost controls to medical or prescription providers.  In a sense they're saying to hospitals, doctors, and pharma "if you want our business, this is what we'll pay."  This is the basis for how single-payer systems operate.  The problem isn't necessarily with the single-payer model, but with how it was managed in the U.S.  Here in Canada, provincially run health insurance corporations dictate terms to medical practitioners and suppliers as to why they will accept.  It's how Canadians pay significantly less for operations and drugs compared to our American counterparts.  It's why thousands of Americans buy their insulin and other drugs from Canada because prices are dramatically cheaper.  It's the power of bulk-purchasing.  This can be done within the single-payer system in the U.S.  In fact we're seeing movement in that direction in California, with efforts to impose an all-payer system where by the state government sets prices and all insurance companies, and by proxy healthcare providers, have to adhere to if they wish to operate in the state.  

In other words, you're example of the old form of Medicare is just an example of the federal government not imposing the kind of costs controls itself.  It doesn't need the private industry.  Moreover, it's usually Republican law makers that pass (or attempt to) legislation that specifically bans government run plans from using its buying power to lower prices. 

The problem with the ACA is that it was too concerned with its overall cost.  At the time of its passage Republicans pretended to give a shit about deficits and the debt, so the ACA was crafted in a way that left subsidies too low to entice the number of health Americans insurance pools needed to be viable.  It still works, but it could have worked a whole lot better had Obama and the Democrats gave less credence to insincere and cynical debt concerns.

Every other developed nation with a single payer system would disagree with your assessment.  Medicare was just run poorly.  That's not indicative of single-payer.  It's just an indictment against how the federal government chose to run Medicare.  

I was hung up on the word "decide" because that was the point of my original post I thought you were directly saying "Yes and no" to my assertion they could just choose to lower rates.  sounds like I just misread your reply.

All of your comments about how it's managed we agree on, it's just a semantical difference.  You're saying other countries do a better job with it I'm saying the US does a terrible job with it.  We're basically in agreement here.

 

Your comment on Obama and the ACA is something I don't disagree with.  The ACA lowered costs in theory, it was sound logic, but in practice, it panned out differently and now rates are higher.  That doesn't endorse or condemn the ACA, it's just how it worked out.  I can tell you from when it rolled out, the sheer number of people getting insurance for the first time in their entire life at the age of 30 or 40+ clearly demonstrated we needed something to change.  There are many awesome changes brought on by the ACA, but lower prices wasn't one of them.

The part about the US government buying power not being utilized, I'm might not understand what you are saying, but in general, Medicare is actually really heavy handed.  One of the major challenges to Medicare recipients right now is that Medicare actually pays so little that more and more doctors are opting to simply not treat Medicare recipients.  There certainly isn't a situation where Medicare is paying more than it has to. Except in a handful of states where it is illegal to do so, most Doctors that accept Medicare charge and additional "Medicare excess fee" of 15% (that the patient is responsible for) to make Medicare patients worth while.  

 

Personally, I'd leave the republican vs. Democrat out of this discussion.  Politicians fuck this up, from both sides, and while most people are probably thinking of Donald Trump talking about magically making insurance cheaper so are all of the candidates on the democratic side.  When Obama was president, all of the republican hopefuls were dangling the same bullshit.  No party is exempt from lying about insurance in order to secure votes.  This really isn't a democrat or republican thing.

[Swampfox]

1 hour ago, 31illusions said:

That's very harsh, especially if you're talking about American citizens. Everybody deserves healthcare. I don't agree with it being free for some and others have to pay (referring  to illegals) of course.

I don't think it's harsh at all.  Healthcare should not be an entitlement.  Anyone who wants healthcare can go out and buy health insurance.  I pay 20% of my health insurance premium and my employer pays the rest.  Even Obamacare wasn't free.  Those who signed up for it had to pay for it.  Thankfully the individual mandate was removed under the  new tax reform so people have a choice again whether they want it or not.

[Ace Nova]

4 hours ago, Swampfox said:

I don't think it's harsh at all.  Healthcare should not be an entitlement.  Anyone who wants healthcare can go out and buy health insurance.  I pay 20% of my health insurance premium and my employer pays the rest.  Even Obamacare wasn't free.  Those who signed up for it had to pay for it.  Thankfully the individual mandate was removed under the  new tax reform so people have a choice again whether they want it or not.

For starters, anyone in the U.S. that goes to a hospital will get treated.  I's one of the reasons our costs are so high.  Instead of going to a clinic or local doctor folks go to the Emergency Room because they know they will be treated.  That's about 10x the cost.

We have among the best doctors and hospitals in the world.  That's thanks to competition, good education, etc.

[TheSeeker]

2 hours ago, Kasanova King said:

For starters, anyone in the U.S. that goes to a hospital will get treated.  I's one of the reasons our costs are so high.  Instead of going to a clinic or local doctor folks go to the Emergency Room because they know they will be treated.  That's about 10x the cost.

We have among the best doctors and hospitals in the world.  That's thanks to competition, good education, etc.

Many doctors won’t take new Medicaid patients

Where else then can they go besides the ER? 

UrgentCares don’t operate in impoverished neighborhoods:

https://www.google.com/url?sa=i&source=web&cd=&ved=2ahUKEwj8rM32iP3jAhVLdt8KHdrBAcQQzPwBegQIARAC&url=https%3A%2F%2Fwww.bostonglobe.com%2Fmetro%2F2019%2F01%2F12%2Furgent-care-centers-proliferate-mass-but-fewer-low-income-patients-have-access%2FFATkqt7OtDc0sHFupk7eSJ%2Fstory.html&psig=AOvVaw0_oOKfSI95LvO1x_DuLTS_&ust=1565690274964095

Edited August 12, 2019 by TheSeeker

[Ace Nova]

7 minutes ago, TheSeeker said:

Many doctors won’t take new Medicaid patients

Where else then can they go besides the ER? 

UrgentCares don’t operate in impoverished neighborhoods:

https://www.google.com/url?sa=i&source=web&cd=&ved=2ahUKEwj8rM32iP3jAhVLdt8KHdrBAcQQzPwBegQIARAC&url=https%3A%2F%2Fwww.bostonglobe.com%2Fmetro%2F2019%2F01%2F12%2Furgent-care-centers-proliferate-mass-but-fewer-low-income-patients-have-access%2FFATkqt7OtDc0sHFupk7eSJ%2Fstory.html&psig=AOvVaw0_oOKfSI95LvO1x_DuLTS_&ust=1565690274964095

That's the point, Sherlock.  If folks had quality healthcare, we could drive down costs.  Folks wouldn't need to go the ER (and a $2000 bill) for a fucking scratch on their knee. 

[Basic_GnR_Fan]

The problem the mainstream right has is their lack of an answer to Medicare for all, they simply say, fuck you get a job! Something has to be done about the cost of healthcare, and right now the US has a frankensystem which combines the worst aspects of capitalism with government intervention. Either go one way or the other, go full competition, or go single payer and have the government negotiate down the costs.

[DeadSlash]

17 hours ago, Kasanova King said:

For starters, anyone in the U.S. that goes to a hospital will get treated.  I's one of the reasons our costs are so high.  Instead of going to a clinic or local doctor folks go to the Emergency Room because they know they will be treated.  That's about 10x the cost.

We have among the best doctors and hospitals in the world.  That's thanks to competition, good education, etc.

An often overlooked and 100% correct.  You won't be turned away, and the main engine behind the ACA lowering government overspending was if people have insurance, then that bill doesn't fall on the government, it falls on the their private insurance company.   

A common misconception is that in America, people without insurance die in the street outside the hospital.  This was true in the past actually, but it hasn't been for a  long while.  I don't actually know when care became mandated (it was before my time) but I know that in NJ, it was still legal to turn people away as recently as 1987.  My grandfather died from a heart attack, and (if this made the difference, we'll never know) spent an extra 25 minutes in route because the closest hospital didn't accept his insurance, and wouldn't let them take him there.

(The ACA federally ended this, but all states had addressed it at different times on a state level well before the Federal mandate.) 

 

That part about competition raising the bar on care, you would be shocked at how many people do not see the logical tie between competition and quality.  I've been teaching for over a decade, and it's a frequent question/topic in the 24h-40h prep class.  One of the ways I used to explain it was by asking "Do you think that there would be brand new phones with major improvement every year if the government mandated that Phones be priced no more than $100 and made Apple or Samsung the official producer of the government phone?"  around 2016, the reaction started moving from "Oh, ok, yeah that makes sense." to "Of course they would, why wouldn't they?"  from the 20 something crowd, I've even had people argue in the past year that phone tech would actually be further along if it was mandated and competition removed.  It's a different logic, and I don't know where it comes from, but it's prevalent.

14 hours ago, TheSeeker said:

Many doctors won’t take new Medicaid patients

Where else then can they go besides the ER? 

UrgentCares don’t operate in impoverished neighborhoods:

https://www.google.com/url?sa=i&source=web&cd=&ved=2ahUKEwj8rM32iP3jAhVLdt8KHdrBAcQQzPwBegQIARAC&url=https%3A%2F%2Fwww.bostonglobe.com%2Fmetro%2F2019%2F01%2F12%2Furgent-care-centers-proliferate-mass-but-fewer-low-income-patients-have-access%2FFATkqt7OtDc0sHFupk7eSJ%2Fstory.html&psig=AOvVaw0_oOKfSI95LvO1x_DuLTS_&ust=1565690274964095

Trueish.  A large part of the ACA was funding for the creation of Urgent care centers in depressed areas, and a lot of public education on utilizing them.  Since the ACA, some may have been built and closed their doors, although, to my understanding, this is not an epidemic as said Urgent Care facilities are Federally subsidized in depressed areas.  The bigger issue was getting people to go there.  People just got to the ER anyway/  In a way, the fact that these are impoverished areas is actually a big factor, they had never seen an Urgent care, and don't think to go to them for anything.  Had Urgent Care been something they grew up with, they would probably use them more readily.

The other part, and I feel like you will yell at me for saying this (but it's a factual statement)  people on 100% subsidy have no costs, and therefore no incentive to go to a more cost efficient option of Urgent Care.  So the ACA brought Urgent Care to impoverished areas, but the challenge is making people actually use them.  This is not a social commentary, or a slam on poor people.  It's just what is happening.  Not understanding what an Urgent Care facility can do is not a result of poor people being stupid, it's a result of them not having access to one for far too long.  It's a slam on society, not poor people.

 

The part about doctors not taking new Medicare patients is 100% true, and a major issue.

Edited August 13, 2019 by DeadSlash