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Author Topic: Obahmacare  (Read 1828 times)

Offline Acebird

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Re: Obahmacare
« Reply #20 on: March 26, 2017, 12:55:17 pm »
I'm for a Public Health Service that is free to all citizens.

Nothing is ever free.  Someone has to pay but the cost of basic health care and preventative medicine should be spread across the whole population.  If you can do something to improve your health and you chose not to then maybe you should pay a tax or a penalty to encourage you to do something on your own.  I think this would eliminate some of the cost.  Especially the ridiculous amount of pills this country consumes.
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Offline gww

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Re: Obahmacare
« Reply #21 on: March 26, 2017, 01:13:48 pm »
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If you can do something to improve your health and you chose not to then maybe you should pay a tax or a penalty to encourage you to do something on your own.

That is a bit too open ended for me cause everything causes cancer and all things are bad for you (like red meat and big gulps and bacon and and and)

I do think people would be more innovating in the work force if the healthcare was not such a big thing that stops many from trying risky endevers.  It would give more freedom to persue untested careers with out the worry of one misfortion taking all that they have built up or own.

It would be a differrent kind of freedom then the ones who think we are not free cause we have a health care system for everyone.
Cheers
gww

Offline Dallasbeek

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Re: Obahmacare
« Reply #22 on: March 26, 2017, 07:20:48 pm »
I'm for a Public Health Service that is free to all citizens.

Nothing is ever free.  Someone has to pay but the cost of basic health care and preventative medicine should be spread across the whole population.  If you can do something to improve your health and you chose not to then maybe you should pay a tax or a penalty to encourage you to do something on your own.  I think this would eliminate some of the cost.  Especially the ridiculous amount of pills this country consumes.

On the contrary, I think people should pay their own way for basic health care and preventive care.  It's cstastophic events and diseases that bankrupt people, not the incidental expenses.  Some people, however, ignore basid health care and preventive care, which leads to catastrophic disease.  If a person smokes, for example, he/she is likely to wind up with heart problems or cancer.  Poor choices in diet can contribute to health problems.  Should smokers or grossly obese individuals pay some kind of tax that would be used to help with their medical expenses? 

Well, it's easy for me to be critical of the drain on the treasury, I guess.  I'm on Medicare, but I recall not so long ago paying cash for medical services and those services were reasonable.  Now I look at the charges for medical services billed to Medicare and they are outrageously high.  Medicare has skewed medical costs so that everyone is forced to buy insurance (including) Medicare or be bankrupted by the system.
"Liberty lives in the hearts of men and women; when it dies there, no constitution, no laws, no court can save it." - Judge Learned Hand, 1944

Online iddee

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Re: Obahmacare
« Reply #23 on: March 26, 2017, 07:46:31 pm »
 ""Should smokers or grossly obese individuals pay some kind of tax   [They do. A big one. Check out the tobacco tax]   that would be used to help with their medical expenses?""  [Too bad all of it is wasted in general fund

I think you will find most grossly obese individuals are government fed with food stamps and other handouts. They don't have taxable incomes.
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Offline kathyp

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Re: Obahmacare
« Reply #24 on: March 26, 2017, 11:18:11 pm »
Some things to consider about single payer before you jump off that bridge.

We have around 125 million people paying federal taxes.  There are more that pay things like payroll taxes, but of those others they either get their money back because their income is low, or they get back more than they paid in earned income credit. (tax welfare)

We have well over 300 million in the country.  That population is aging or the part that is expanding tends to be lower-income immigrant or lower income no federal taxpayers.  Middle and upper income have quit having enough children to keep an even population count. 

No country has tried to do single payer on this scale and do it well.  India has universal health care, but it's not worth much if you are outside the big cities.  The next largest country to do it is Germany.  Germany has a really weird system where cost is completely controlled by the government but there are private insurance companies through which you are covered and you have to be wealthy to be allowed to buy insurance outside the government control...I hope I got the basics right.  Maybe we have a German on here who can let me know if I messed that up.
At any rate, I see no way that works here....ever.

England in next.  They have single payer, but the money is allocated to the medical trusts that cover various areas.  In theory, this gives more local control.  Whatever...there is never enough money for much of anything.  If you need an operation and don't live in one of a few major cities, you are going to have to travel for it.  If they are full or the surgeons are busy...too bad.

Example from family.  Older guy diagnosed with primary lung cancer that appears not to have spread.  Spot picked up on xray before Christmas.  No biopsy until after Christmas.  Surgery not scheduled until March.  He goes to hospital in another part of the country for surgery, and as they are about to take him down, the surgery is canceled.  No beds.  Week and 1/2 later.  Repeat.  canceled.  no surgeon.  no bed. 

So here we are months later with what might have been a curable cancer and still no surgery.  That is single payer in the UK.  Triage by age and usefulness.  There is never enough money.  Free to the Brits now means every drippy nose goes to the doc....to the point they run PSAs to tell people to stay home with their colds.....but IT'S FREE AND THEY PROMISED US and so it is abused just as Medicaid is abused in the US. 

So, before you jump on the single payer train, be aware that there are not enough people working to pay for all you want.  If you are old, sick, or otherwise useless to the future of society, you are not worth the dollars.  As Obama said...you might just need to be happy with a pill to keep you comfortable.
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Offline gww

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Re: Obahmacare
« Reply #25 on: March 27, 2017, 12:07:30 am »
Kathy
We have a single payer now, it is through those that have things and have insurance.  The ones that have nothing are going to be treated and the ones that have insurance is going to pay more for it so that the insurance and hospitals and such servive.  All those limmits put on treatment happen now but are done by insurance companies.  The only differrence is that in our system, a guy that is unlucky enough to get sick can lose all his stuff due to poor luck.  Plus a guy that could have bought insurance but did not can lose all his stuff but still get treated but not have to pay his fair share untill and if that happens and so the burden is even higher on the guy who is buying insurance.  Every body is worried about the guy who doesn't work getting something for free but they don't worry about the one who does work but and could do what the other people do and have insurance and then it would be a little fairer to the ones proping up the health care system now.  So it is ok to steal health care but not ok to have it if you have no means to get it. 

Every single thing that everyone says is going to happen if we had a single payer happens now through your insurance provider and doctors.  I haven't been to a doctor in proby seven years and if I tried to make an appointment, I might have to wait a month or two before a doctor will see me as a new patient if that doctor is even excepting new patiants.  Then when I am finaly seen and I try to bring up two issues that might be wrong with me. they are going to ask me to come at a differrent time and that I need to only ask about one problim in one visit.

All the stuff every one is afraid of is being done to them now unless you are the cash cow that goes weekly to a doctor.  Then there might be lots of room for you.

Nobody is going to convince me that americans system is so far ahead of all those other places that have universal coverage and our (good?) covearge cost us $5000 per person compared to $2000 per person in the health care system that everyone points to as being too big.
Cheers
gww

Offline kathyp

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Re: Obahmacare
« Reply #26 on: March 27, 2017, 12:35:47 am »
Let me stipulate first that the way we do insurance and cover our medical costs in this country is stupid.  We do it this way because somewhere along the line people became convinced that someone else should pay for health care and that getting insurance through work was a spiffy idea.

Both things are wrong.  both have led to the entitlement mentality we now suffer about medical care.  both have led to fewer choice and higher cost.  Both have removed market forces from insurance purchase and health care coverage.  We have now what we demanded...on steroids, further complicated by state and now federal mandates about what insurance must cover.

How much medical care you get will always be limited by money.  Your money, the insurance companies money, or the government funding.  It is no different that any other thing we pay for.  The question here is choice.  Do you want to turn every choice and every decision over to the government?  Would you rather be able to buy the insurance you want, for what you want, without the government interfering with what and how you purchase it?
Would you be willing to treat medical care as you do car care and pay for regular stuff out of pocket saving insurance for big things?

If the country decides to go with single payer and depending on the style they choose, you will have fewer choices.  An English style will allow for private insurance but it will be very expensive and probably won't take you if you have a preexisting condition.  A Canadian style and you have little to no choice but the government program.  We will be imposing a tremendous cost on the small number of taxpayers relative to the number we will cover and so you can expect, as they have in England, a degradation of facilities and slow updating of equipment with much less availability. 
There's no incentive for docs to go into specialties if income if limited.  You'll have fewer choices there.  Not all hospitals will survive and not all hospitals will be able to deliver the variety of treatments they do now. You can expect fewer choices, longer waits, and travel if you are lucky enough to make it to the head of the line.

Not all of these things will happen right away, but as tech outdates or machines break, choices have to be made between updating/replacing, and seeing patients and giving meds.  And those meds?  Expect fewer choices.   If the cheap drugs don't work, don't expect anything more expensive or experimental.  If pharmaceutical companies have to spend billions bringing drugs to market, but are not paid well by the government, they will not bother with anything the least bit marginal. 

I don't have any doubt we are headed for single payer.  It has been the dream of the left for decades.  Pretty sure it's not because they care about you, so you might want to think about why the love the idea so much....might have something to do with all the other entitlements they love and use in every election to convince the sheep that someone is out to take their "free" stuff from them!!!

hey...population control.  Two birds with one stone   :wink:



One could not learn history from architecture any more than one could learn it from books. Statues, inscriptions, memorial stones, the names of streets ? anything that might throw light upon the past had been systematically altered. (1.8.85)

George Orwell  "1984"

Offline Acebird

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Re: Obahmacare
« Reply #27 on: March 27, 2017, 09:17:01 am »
Would you be willing to treat medical care as you do car care and pay for regular stuff out of pocket saving insurance for big things?

The government is involved and always has been.  Most states require insurance to register a motor vehicle.  Now the federal government requires you to have medical insurance.  It was common practice for younger folks to not get medical insurance because quite frankly they have very low risk of ever needing it.  The burden on any system is the old farts.  And because there are more and more old farts and less and less young snots any system will be suffer in the future.

Explain to me how drugs are cheaper in these other countries.  Never mind I already know.  What happens when you have a government medical provider is that you now have guinea pigs at the bottom of the spectrum for trials.  Regulation goes away.  So drugs become available much sooner and the cost to market becomes much much less.  Those with means will pay the premiums to get better care.  They won't be part of the guinea pig pool.  And research will still go on because it is driven by the well to do, not by the guinea pig pool.

What is killing our medical system is we are not just a country we are a country with independent states.  Some are wealthy and some are poor.  Pushing responsibility on the states makes the separation even greater.  Our medical system, what ever it becomes, needs to be for the whole of the country not segmented into pockets of poor and well to do.  That is why a single payer system is the only fair thing to do.
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Offline kathyp

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Re: Obahmacare
« Reply #28 on: March 27, 2017, 01:32:30 pm »
Quote
That is why a single payer system is the only fair thing to do.

I'm sure it seems fair to those who will not be paying for it.  For everyone else, it's just another entitlement that puts more burden on the taxpayer and gives more stuff to the non-producer.
One could not learn history from architecture any more than one could learn it from books. Statues, inscriptions, memorial stones, the names of streets ? anything that might throw light upon the past had been systematically altered. (1.8.85)

George Orwell  "1984"

Offline kathyp

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Re: Obahmacare
« Reply #29 on: March 27, 2017, 01:35:41 pm »
I don't have a problem taking care of those who can't take care of themselves.  I don't have a problem taking care of poor elderly.  anyone else should take care of themselves and getting government out of it so that we have a real market to work with makes that doable. 

Fairness should never be the goal.  You can't force things to be fair.  Opportunity should be the goal and then it is up to people to take it or leave it.
One could not learn history from architecture any more than one could learn it from books. Statues, inscriptions, memorial stones, the names of streets ? anything that might throw light upon the past had been systematically altered. (1.8.85)

George Orwell  "1984"

Offline Acebird

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Re: Obahmacare
« Reply #30 on: March 27, 2017, 02:03:37 pm »
Kathy, people who have worked all their lives and get laid off because a company ships their operations off shore should take care of themselves?  I know how that works.  I also know that I was much luckier than most that had to deal with it.
I don't like people sitting on their butts collection welfare when they could do something productive but that is a hard one to solve.  If they work they loose the welfare and if they work they will end up with less then if they don't.  So I am all for ideas on how to fix that.  Raising minimum wage puts a dent in it but it also causes other problems.  Leaving it up to a capitalistic system means these people and those that are borderline will get left out in the cold.  And that is exactly what will happen to a medical program that relies on profits.  Because that is what we had before ACA.
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Offline Acebird

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Re: Obahmacare
« Reply #31 on: March 27, 2017, 02:13:14 pm »
You can't force things to be fair.

I probably shouldn't have used that word because I laugh at some of my family members when they use it.  I think it is smart, I think it is right when a country promotes the basic health of its citizens.  On the flip side I think people should bare some burden for self inflected health issues.
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Offline kathyp

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Re: Obahmacare
« Reply #32 on: March 27, 2017, 02:51:33 pm »
Quote
And that is exactly what will happen to a medical program that relies on profits.  Because that is what we had before ACA.

You are not entirely wrong, but you are kinda wrong.   :wink:

Before ACA we had profit based insurance but there were still some market forces in it.  Not many because most people relied on getting insurance through work, and there were state mandates and restrictions on where you could buy insurance. After ACA almost all market forces that did exist were removed and all that was left was profit.  Becuase if this, insurance companies that could not profit under ACA withdrew from those unprofitable places and reduced choice..increasing cost for what was left.  This was in part because of the onerous mandates in ACA, and lack of choice always raises prices.  Many people do not realize the increase prices because they don't understand what a 10,000 dollar deductible means until they go to use the insurance.  Their premiums, especially if they are getting a subsidized policy, may not have gone up much, but the policy is useless to them until they meet that 10,000 dollar deductible. 

If you want to increase choice, lower cost, and cover more people, you have to have competition..  You have competition when the government gets out of it and the companies have to directly compete for buyers.  For companies to compete, they have to offer what people want at a price they can afford.

I would take a lower cost policy with a big deductible because I can afford that.  I'd be happy with catastrophic care.  other people might want to pay more per month to have more covered.....we do this with car insurance.  I have a high deductible on some of my cars and full coverage on others. 
People need to be able to buy what they want from whom they want and not be stuck with what they are getting through work.  This can be done in a number of ways and some companies already do it.  My DIL works for a company that gives employees a HSA each year and insurance that covers more expensive stuff like cancer treatment.  For everyday stuff she could buy a policy she likes (if not for ACA), or she can pay cash out of her HSA. 

We already cover the poor.  We already cover the old.  There is a small set that is the working poor and they need to be able to get policies they can afford from whomever.  Walmart actually offers these kinds of policies their employees, although they are more expensive and with fewer choices because of ACA. 

Market solutions are the answer, not more government mandates or government control that will drive up prices and reduce choice. 



One could not learn history from architecture any more than one could learn it from books. Statues, inscriptions, memorial stones, the names of streets ? anything that might throw light upon the past had been systematically altered. (1.8.85)

George Orwell  "1984"

Offline Acebird

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Re: Obahmacare
« Reply #33 on: March 27, 2017, 05:48:14 pm »
Explain to me why it can't work like Medicare?  Everyone has to get Medicare after 65 and if you want more coverage you can get it on your own.  There is your choice.   The problem with profits and work based insurance is that when an area in not profitable then there is NO choice.  You get nothing.  And the same thing happens when you lose your job even for a short period of time.  COBRA is a joke.  The premiums are more than double at a time when you have no income.  HOW do you do that?  It is ridiculous.  The other problem with work based insurance is it favors Corporate America and screws the small business man.  It is the small businesses that pay taxes not Corporate America.  I never had a choice of insurance companies.  The company pick the policy.  Which means the coverage is based on what they wanted to offer.
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Offline kathyp

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Re: Obahmacare
« Reply #34 on: March 27, 2017, 07:07:20 pm »
Quote
The problem with profits and work based insurance is that when an area in not profitable then there is NO choice.  You get nothing.  And the same thing happens when you lose your job even for a short period of time.  COBRA is a joke.  The premiums are more than double at a time when you have no income.  HOW do you do that?  It is ridiculous.  The other problem with work based insurance is it favors Corporate America and screws the small business man.  It is the small businesses that pay taxes not Corporate America.  I never had a choice of insurance companies.  The company pick the policy.  Which means the coverage is based on what they wanted to offer.

You miss my main point.  Work based insurance is a big part of the problem.  We have it because we demanded it, but it increases cost and decreases choice.  It is a stupid way to be insured.

People have gotten so used to it it does not occur to them that they would do better on their own with HSAs and a free market so that the could buy what they want instead of being stuck with what is offered.

Medicare is a snapshot of what we face in cost and availability if we go single payer.  Single payer would be worse in that you would have few people paying in to cover everyone in the country.  We can do a medicare type thing but if people still need to buy insurance to cover what they need why not just do a real free market thing and let people get what they want from the beginning? 

I don't know anyone on Medicare that doesn't buy supplemental prescription or care coverage.
One could not learn history from architecture any more than one could learn it from books. Statues, inscriptions, memorial stones, the names of streets ? anything that might throw light upon the past had been systematically altered. (1.8.85)

George Orwell  "1984"

Offline Michael Bush

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Re: Obahmacare
« Reply #35 on: March 27, 2017, 11:00:46 pm »
Now that we have "the affordable care act" I pay twice the premiums as before and I went from a $0 deductible to $10,000 deductible if I use "in network" doctors etc. Otherwise it's $30,000 a year.  I don't see that as "affordable"...

I agree that it's a bad system that I can't reasonably negotiate my own health insurance.  I've tried.  Due to being a contractor and between expired contracts, companies bought out or split, companies changing plans, etc. since 2009 I've had nine different insurance companies for health and nine different insurance companies for dental.  I was so sick of it I tried to just buy my own, but I couldn't negotiate as good of a price as a company can negotiate.
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Offline gww

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Re: Obahmacare
« Reply #36 on: March 27, 2017, 11:41:31 pm »
Michael
Quote
Now that we have "the affordable care act" I pay twice the premiums as before and I went from a $0 deductible to $10,000 deductible if I use "in network" doctors etc. Otherwise it's $30,000 a year.  I don't see that as "affordable"...

I agree that it's a bad system that I can't reasonably negotiate my own health insurance.  I've tried.  Due to being a contractor and between expired contracts, companies bought out or split, companies changing plans, etc. since 2009 I've had nine different insurance companies for health and nine different insurance companies for dental.  I was so sick of it I tried to just buy my own, but I couldn't negotiate as good of a price as a company can negotiate.

I had company insurance also but all the copay changes and insurance changes anc coverage changes started reflecting what you are saying way back in the late 90s and just seemed to get worse and was definatly getting worse way before the affordable care was passed.  And to aces point when companys left for other places, cobra coverage was a joke.

And all the companys makeing efforts to shift the cost of coverred bennifits back to the employees was not a good thing if you were an employee.

I personally think that the actual inflation cost of health care has slowed since the affordable care act cause it was going up drastically before it was passed also.

Things in health care have gotten lots worse but that getting worse was happening way before the affordable care act.
It was already a stacked deck against the middle class and trying to fix it was not bad.  Now they need to fix even more of it.
Cheers
gww

Ps I heard on the news today some proffessor saying that with single payer and cutting out insurance it would add four hundred billion a year to the kitty which would pay for everyone and get rid of the problim of high copays.  Her words not mine.  Of course she also said that would destroy that portion of the insurance industery.  Not so sure that bothers me very bad.
« Last Edit: March 28, 2017, 08:37:19 am by gww »

Offline Acebird

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Re: Obahmacare
« Reply #37 on: March 28, 2017, 08:40:09 am »
We can do a medicare type thing but if people still need to buy insurance to cover what they need why not just do a real free market thing and let people get what they want from the beginning? 

One very easy answer to your question.  The young low risk group will not buy insurance and the old high risk group who make most of the claims will not be able to pay the premiums or the insurance companies will not offer insurance at all because it is not profitable.  For some reason you are not seeing the problem that existed before the ACA.

Medicare forces everyone in, high risk and low risk.  The only thing they don't do is force people to not engage in an unhealthy lifestyle.
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Offline gww

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Re: Obahmacare
« Reply #38 on: March 28, 2017, 09:07:46 am »
Ace
Quote
Medicare forces everyone in, high risk and low risk.  The only thing they don't do is force people to not engage in an unhealthy lifestyle.

The only thing I can say about this is that I don't believe there is any studie that has shown that it is really cheaper for people to stay healthy longer rather then getting sick earlier. 

In the end everyone is going to die of something and is probly going to get some treatment for that.  Nobody has convinced me that it is more expensive to do heart surgery when a person is 45 and then that person dies of a heart attack at 55 compared to the person who lives to 100 but spent the last 20 years in a home with all kinds of health issues and care given.

You keep putting out that controling the bad things that people do to themselfs is going to be cheaper on the system, but I am not sure that is the truth or even something I would want.  I only want to live so long as life is worth living.  I know I am going to die and if I had something incurable and I could go through hell just to gain a couple of years of life, I can not honestly say that I would take the option to do that.  I might.

In the end, almost every person is going to need a treatment and if it happens at 50 or 90 years old, I am not sure how the money truly adds up.  So I think education is immportant but the final decision comes down to the person who has to live the life and I am not sure I buy into the arguement that they are harming the whole system and not just themselves as some try to proclaim.
Cheers
gww

Offline sawdstmakr

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Re: Obahmacare
« Reply #39 on: March 28, 2017, 12:50:16 pm »
Ace,
Where in the Constitution does it give the federal government the right to tell us what insurance we have to buy?
Jim
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