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This topic is not about the American Invasion of Iraq. Stop. - Page 23 |
On June 30 2012 10:25 STYDawn wrote:Show nested quote +On June 30 2012 10:13 mcc wrote:On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. Problem with this approach is twofold. How do you measure someone's value and how do you in general deal ethically with letting people die. It is much easier to just provide insurance for everyone and get the money from irresponsible people in different ways. You can just make all or most of tobacco taxes go into the healthcare system. But there is some evidence that long term smokers actually save system money as they die so much sooner, but I am not sure about credibility of that evidence even though it looked ok. measuring people's value: you take into account all knowledge you have about that person and you make a decision. Letting people die: You try not to let them die, but if you don't have money to give away then you don't
I was talking not about personal, but institutional approach. FabledIntegral was not against having institutions to handle healthcare, for example for children.
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On June 30 2012 10:24 farvacola wrote:Show nested quote +On June 30 2012 10:21 STYDawn wrote:On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. On June 30 2012 09:59 mcc wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable. Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost... Great post right there. Everything in essence society does should have a good probability on benifiting it. Helping a poor street performer/musician: if he/she is good then you donate. If not then you don't. Sponsoring a poor kid go to college: If he is promising, yes If you remember him as the kid who graffitied your window, no But what if you forget what he looked like, and all you can remember is that he was black. Yeah....great.
Honestly most humans are racist, but 99% do have the instinct to ignore their racism and try to see the kid for who he truely is. So if he is promising, then one will ignore the fact that he is black.
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On June 30 2012 10:31 STYDawn wrote:Show nested quote +On June 30 2012 10:24 farvacola wrote:On June 30 2012 10:21 STYDawn wrote:On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. On June 30 2012 09:59 mcc wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable. Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost... Great post right there. Everything in essence society does should have a good probability on benifiting it. Helping a poor street performer/musician: if he/she is good then you donate. If not then you don't. Sponsoring a poor kid go to college: If he is promising, yes If you remember him as the kid who graffitied your window, no But what if you forget what he looked like, and all you can remember is that he was black. Yeah....great. Honestly most humans are racist, but 99% do have the instinct to ignore their racism and try to see the kid for who he truely is. So if he is promising, then one will ignore the fact that he is black.
Yeah dude. Whoever heard of someone being discriminated against because they're black?
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On June 30 2012 10:29 mcc wrote:Show nested quote +On June 30 2012 10:25 STYDawn wrote:On June 30 2012 10:13 mcc wrote:On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. Problem with this approach is twofold. How do you measure someone's value and how do you in general deal ethically with letting people die. It is much easier to just provide insurance for everyone and get the money from irresponsible people in different ways. You can just make all or most of tobacco taxes go into the healthcare system. But there is some evidence that long term smokers actually save system money as they die so much sooner, but I am not sure about credibility of that evidence even though it looked ok. measuring people's value: you take into account all knowledge you have about that person and you make a decision. Letting people die: You try not to let them die, but if you don't have money to give away then you don't I was talking not about personal, but institutional approach. FabledIntegral was not against having institutions to handle healthcare, for example for children.
THAT'S WHY YOU GET RID OF THE PROBLEM ALTOGETHER AND NOT HAVE AN INSTITUTIONAL/Bureaucratic APPROACH UNLESS YOU WANT IT TO BENIFIT EVERY PERSON INCLUDED.
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On June 30 2012 10:34 rogzardo wrote:Show nested quote +On June 30 2012 10:31 STYDawn wrote:On June 30 2012 10:24 farvacola wrote:On June 30 2012 10:21 STYDawn wrote:On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. On June 30 2012 09:59 mcc wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable. Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost... Great post right there. Everything in essence society does should have a good probability on benifiting it. Helping a poor street performer/musician: if he/she is good then you donate. If not then you don't. Sponsoring a poor kid go to college: If he is promising, yes If you remember him as the kid who graffitied your window, no But what if you forget what he looked like, and all you can remember is that he was black. Yeah....great. Honestly most humans are racist, but 99% do have the instinct to ignore their racism and try to see the kid for who he truely is. So if he is promising, then one will ignore the fact that he is black. Yeah dude. Whoever heard of someone being discriminated against because they're black?
Yeah dude. Whoever heard of someone suing and winning a case because they got discriminated 'cuz they are black?
No one wants to get sued, so people develop the instinct to ignore their racist thoughts. This instinct carries on for decisions that won't negatively impact them.
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On June 30 2012 10:27 FabledIntegral wrote:Show nested quote +On June 30 2012 10:13 mcc wrote:On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. Problem with this approach is twofold. How do you measure someone's value and how do you in general deal ethically with letting people die. It is much easier to just provide insurance for everyone and get the money from irresponsible people in different ways. You can just make all or most of tobacco taxes go into the healthcare system. But there is some evidence that long term smokers actually save system money as they die so much sooner, but I am not sure about credibility of that evidence even though it looked ok. Yeah, I've heard that about smokers. But what I'm saying is that I don't think they deserve to be able to be insured. They shouldn't be 65, realize "oh fuck I need health insurance" and then be allowed to get it. In the current state, insurance companies can deny coverage, hence the "it's not a right" argument. Concerning the tax on tobacco, I definitely think that would be the most ideal. I think the sympathy is simply lacking from my part in many cases, but I meant to clarify that it doesn't have to revolve around death. The lack of sympathy is more so towards the person who isn't covered when they break their leg. They should just have to bear the costs of that type of thing. Addressing the dying issue in particular, I think possibly things classified as "life threatening" could be covered; my biggest issue are things that aren't life threatening, just costly. I think the best scenario, from my perspective, would be to tax everyone an equal percentage tax (rich still pay more since they make more) on their income, OR fund it through a federal sales tax. With my mentality, I would be completely fine with a person who wasn't covered who still received healthcare due to a lifethreatening cause to have the option of something like post treatment having their wages garnished by 10% for the next ten years, assuming they are above the poverty line. Probably won't pay it off, but I think the person receiving the treatment should have to bear a large portion of the cost.
Ah ok, you are still talking in the framework of current US system. That makes sense. The solution to the 65-year smoker getting insurance is of course in my view to have mandatory insurance from birth. So if he worked in his life he would have paid a lot into the single-payer system. In a system with multiple private insurers you are correct it is hard to make sensible solution where everyone can get insurance.
Most single-payer systems also have limits to what they cover. It is not limited to just life-threatening things, more like to significantly influencing quality of life. The reason, beside the ethical one, in my view is that it is socially beneficial to keep as many people productive member of society by giving them care they need to do so. Even if they actually cost society more money than they make by being productive, they would probably cost even more when not being productive with all the benefits state would have to provide, crime and eventual care for life-threatening condition that would have to be provided anyway.
The solution you provide at the end is so close to single-payer system, that due to the reasons above it would be just cheaper and more efficient to have mandatory single-payer system that would cover some set of basic care. The only problem might be for some that it needs to be mandatory to be really efficient, but it solves all the special cases that you need to handle with the non-mandatory one.
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On June 30 2012 10:37 STYDawn wrote:Show nested quote +On June 30 2012 10:34 rogzardo wrote:On June 30 2012 10:31 STYDawn wrote:On June 30 2012 10:24 farvacola wrote:On June 30 2012 10:21 STYDawn wrote:On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. On June 30 2012 09:59 mcc wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. Actual care in US is top notch. You are correct on that. However it is not true that private insurance companies are insanely efficient. They are inefficient compared to even US government run programs and extremely ineficient compared to many national insurance providers in countries with public healthcare. EDIT: Also if copays are necessary is debatable. Care to elaborate on why they're more inefficient than the U.S. government? And copays being necessary for insurance purposes is not debatable. However, with insurance you are supposed to generate long-term losses by purchasing them. You are insuring yourself against potential short term massive losses by transferring your individual risk to someone else. Having someone else take your individual risk comes at a cost... Great post right there. Everything in essence society does should have a good probability on benifiting it. Helping a poor street performer/musician: if he/she is good then you donate. If not then you don't. Sponsoring a poor kid go to college: If he is promising, yes If you remember him as the kid who graffitied your window, no But what if you forget what he looked like, and all you can remember is that he was black. Yeah....great. Honestly most humans are racist, but 99% do have the instinct to ignore their racism and try to see the kid for who he truely is. So if he is promising, then one will ignore the fact that he is black. Yeah dude. Whoever heard of someone being discriminated against because they're black? Yeah dude. Whoever heard of someone suing and winning a case because they got discriminated 'cuz they are black? No one wants to get sued, so people develop the instinct to ignore their racist thoughts. This instinct carries on for decisions that won't negatively impact them.
http://en.wikipedia.org/wiki/Institutional_racism
Read it, know it, and then realize how incredibly simplistic your view on the matter is. If you think any of these topics (societal/cultural racism, public health policy, government entitlements) are "easily" solved from a singular vantage point, you are sorely mistaken and ill-equipped to participate in a discussion of them.
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On June 30 2012 10:43 mcc wrote:Show nested quote +On June 30 2012 10:27 FabledIntegral wrote:On June 30 2012 10:13 mcc wrote:On June 30 2012 10:02 FabledIntegral wrote:On June 30 2012 05:26 TheFrankOne wrote:On June 30 2012 04:48 FabledIntegral wrote:On June 29 2012 22:22 TheFrankOne wrote:On June 29 2012 14:27 FabledIntegral wrote:
Well they probably didn't have enough insurance! A huge factor to be considered, and is mentioned in that report, is that some bankruptcies were due in part not due to the medical costs, but the loss of income due to the hospitalization/medical issues. That's what really seems to get people. Also realize that statistic was taken in 2007 - it said it was either mainly due to loss of income or because they mortgaged their houses to pay the medical expenses. If you've done that, there is significant incentive to file bankruptcy after the housing crash during that year.
Of course, you could argue they shouldn't have to mortgage their houses in the first place. I was just commenting that's probably the reason for the abnormally high amount in 2007. The earliest estimates say the recession started at the very end of 2007 full blown crash got rolling in 2008, so that has little to do with this study. For the record I would, and will argue that medical bankruptcies should not be a thing. To those arguing about bureaucratic organizations being added to health care... what the hell do you call insurance companies? They nickel and dime their customers constantly. Forcing them to take on co-pays, get cheaper medications that may not be as effective, force pre-authorizations, only allow you to use certain health care providers, and generally provide unequal care. Sounds like we already have a health care system with a massive bureaucracy damaging our ability to receive the best health care, the only problem is it causes half of all bankruptcies in the country at the same time and we pay way more for it than other developed nations while the insurance companies refuse to help anyone who is sick and has no insurance (pre-existing conditions) until the government forced them. For people wondering what this means for people with pre-existing conditions, they are able to find insurance through a combination of government subsidization and the improved economies of scale from the mandate, 30 million people is a lot of new customers and most of them are healthy. The exchange pools help in terms of bargaining but the primary effect that makes it work is the subsidies and the mandate to make it finincially feasible for insurance companies who are now kind of regulated like utilities. That's not nickeling and diming your customers whatsoever. Copays are absolutely 100% necessary. This is something I think should be self-explanatory, but if you want me to go more into detail I can. Without things like copays insurance would not be able to function. If by cheaper medications by any chance do you mean generic? I'm honestly not super familiar with the health care industry, but from what aware by law, the insurance companies are not allowed to substitute with something that would be less effective. They are able to try to cut costs, but cutting costs can not result in less effective treatment. If you think it's less effective anyways, that's highly subjective and sounds more like a problem with whoever rates the potency/approvals of the medications rather than an issue with an insurance company. And what happens when insurance companies cut costs? They can charge lower premiums to all their customers, as well as increase the rate of the specific insured by a smaller margin. I don't understand why only using specific health care providers is an issue. They approve those that will give them deals, once again which results in lower premiums to the customers. For a lot of insurance companies, (and this is besides the fact it's NO insurance company anywhere in the U.S. is allowed to have excessive rates nor generate excessive profits), the excess profits are simply returned back to the policyholders. Usually health care insurance allows you to get access to the best health care in the world, not some second rate stuff. U.S. health care, while lacking in many fundamental areas, in terms of service is considered top notch, is it not? Once again, I'm not the most knowledgeable on this specifically, but I've always been under this assumption. Nickeling and diming... it's not unusual whatsoever for insurance companies to pay out significantly more than each premium dollar they take in as an aggregate amount. As a private companies, however, they are insanely efficient, and none of what you mentioned makes them any worse in terms of efficiency and wasting money. I'm not arguing about their efficiency I'm calling them a massive bureaucratic organization that stands between you and the optimal level of health care. Some of my language was not truly called for but you seemed to have missed my argument. Though I would say the rebates that they are sending out under obomacare suggests that maybe they aren't amazingly efficient as you think with their costs other than payments over 15%. The amount of revenues in premiums is not really that relevant, insurance companies have vast investment portfolios and expect to do exactly that, its part of their business models: "The insurance business has been described by Warren Buffett (who knows the insurance business extremely well) in his legendary annual reports as follows (here paraphrased): an insurer collects funds from policy holders, invests those funds, and then over time pays claims to policy holders from its received funds. And, as usually over time competition drives the sum of payments for claims to equal or exceed the total amount of funds received from policy payments (ie the "Combined Ratio" tends to trend towards 100), the rate of return on the funds is a key driver of the overall earnings for an insurance company." http://stockmarketnotes.blogspot.com/2007/05/insurance-sector-value-abroad.html (I know its a blog but I feel lazy and it makes the point pretty well if you read it.) Our system is responsive, thats about it, its stupid and broken from a broader societal standpoint. It would never be designed this way intentionally, it just sort of fell together as this weird, employer based thing that only does a couple things well but is bad at keeping society healthy which is a public good. My argument was simply that there is already a huge organization that interferes with consumers efforts at receiving ideal health care, if you've never had to argue with an insurance company than I'm just jealous of you. Regardless of if the individual companies are efficient, the system as a whole is insanely expensive and we do not get a fair return in almost anything but responsiveness. As a side note on co-pays, they are a detterent against preventative care, regardless of their necessity. Yeah I know how the system works. Combined ratio is usually above 1.00 in good economies (up to around 1.15) and down to about 0.80 in shitty economies, simply because it depends how much they can get out of their investments (and overall trends around 1.00 as you stated). Thing is, this only benefits society. About as much money paid in, is on average, paid out. In the meantime, the money is invested back into the United States economy, spurring growth, etc. And it's hard to argue that investment in the economy is bad at the moment. It's not like those funds individually would be invested in the economy, it's only when accumulated. When you say a massive bureaucratic organization that stands in your way... I think I'm misinterpreting the issue here because I've simply grown up on associating "massive bureaucracy" and "inefficiency." That's why I brought it up. I just don't think health insurance is a right. Do I think the 40+ year smoker is entitled to treatment if he gets lung cancer? In all honesty, I would say no, he doesn't. He can go to the private market and try to get it himself, but no, he doesn't deserve any treatment himself. Same with the 25 year old skateboarder who doesn't have a job and then breaks his leg. It's a morale hazard dilemma. On a different note, I personally am for ALL minors being given healthcare for free. That's because at that point your life has been largely driven by your parents. I haven't though it out extensively, but it's kinda what I've arrived at in thinking about it in my free time. Why exactly do you deserve to be covered when society won't benefit as a whole from it? Your contributions to society, in short aren't worth your costs. Brutal but just my view. Problem with this approach is twofold. How do you measure someone's value and how do you in general deal ethically with letting people die. It is much easier to just provide insurance for everyone and get the money from irresponsible people in different ways. You can just make all or most of tobacco taxes go into the healthcare system. But there is some evidence that long term smokers actually save system money as they die so much sooner, but I am not sure about credibility of that evidence even though it looked ok. Yeah, I've heard that about smokers. But what I'm saying is that I don't think they deserve to be able to be insured. They shouldn't be 65, realize "oh fuck I need health insurance" and then be allowed to get it. In the current state, insurance companies can deny coverage, hence the "it's not a right" argument. Concerning the tax on tobacco, I definitely think that would be the most ideal. I think the sympathy is simply lacking from my part in many cases, but I meant to clarify that it doesn't have to revolve around death. The lack of sympathy is more so towards the person who isn't covered when they break their leg. They should just have to bear the costs of that type of thing. Addressing the dying issue in particular, I think possibly things classified as "life threatening" could be covered; my biggest issue are things that aren't life threatening, just costly. I think the best scenario, from my perspective, would be to tax everyone an equal percentage tax (rich still pay more since they make more) on their income, OR fund it through a federal sales tax. With my mentality, I would be completely fine with a person who wasn't covered who still received healthcare due to a lifethreatening cause to have the option of something like post treatment having their wages garnished by 10% for the next ten years, assuming they are above the poverty line. Probably won't pay it off, but I think the person receiving the treatment should have to bear a large portion of the cost. Ah ok, you are still talking in the framework of current US system. That makes sense. The solution to the 65-year smoker getting insurance is of course in my view to have mandatory insurance from birth. So if he worked in his life he would have paid a lot into the single-payer system. In a system with multiple private insurers you are correct it is hard to make sensible solution where everyone can get insurance. Most single-payer systems also have limits to what they cover. It is not limited to just life-threatening things, more like to significantly influencing quality of life. The reason, beside the ethical one, in my view is that it is socially beneficial to keep as many people productive member of society by giving them care they need to do so. Even if they actually cost society more money than they make by being productive, they would probably cost even more when not being productive with all the benefits state would have to provide, crime and eventual care for life-threatening condition that would have to be provided anyway. The solution you provide at the end is so close to single-payer system, that due to the reasons above it would be just cheaper and more efficient to have mandatory single-payer system that would cover some set of basic care. The only problem might be for some that it needs to be mandatory to be really efficient, but it solves all the special cases that you need to handle with the non-mandatory one.
Cost to society from not being productive is a good point. I just think, personally, if you have something that happens to you, you should have to bear the costs, not the rest of society. How you go about making sure you can bear the costs is up to the individual (choose to buy insurance or not). If you can't buy insurance, then you should still be saved, sure, but expect your future income to suffer dramatically from it. I don't believe wage garnishing is very expensive to administer, my roommate last year specifically worked at a law firm that's sole purpose was collections/wage garnishing.
Maybe you don't ever pay it back, but place like a 10-year period of 10% like I said, or something like that. At the very least it would reduce moral hazard.
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On June 30 2012 10:27 FabledIntegral wrote:
There has to always be some sort of deterrence from making a claim (or in this case, using any part of it). Part of the principle of insurance itself is that the insured has to be financially worse off, there should never be any incentive to actually use it. It's to protect against uncertainty, not to benefit from regular use. Overall, the insured is supposed to be indemnified, but indemnification, despite its definition, is actually supposed to be *just less* than the previous financial situation, otherwise everything falls apart due to moral hazard.
If you take an insurance course, it's one of the first things you'll learn in "in order for something to be considered insurance, these particular principles MUST occur." Without it, I don't believe it's actually considered insurance, although that might be semantics.
Well I consider insurance something where people pool resources to pay for unexpected costs. And the only reasonable requirement is that the pool has to statistically cover all those unexpected events over all the people participating.
It is true that paying for things like regular checkups, vaccinations,... is stretching even my definition, but those are minor issues. You could split what is here called medical insurance into two parts, one would be actual insurance and second one would be some tax to cover the "expected" regular expenses. But in the end even if those are covered it is still insurance as it still covers also the unexpected.
As for copays, our system worked pretty well without copays for a long time. The reason is that moral hazard in healthcare is really low compared to other fields as people do not willingly want to actually use it and because the care provided is also controlled by doctors and not easily on demand. Lately our politicians decided that some copays would be good idea, but introduced them in only symbolic form. They are claiming there was some positive effect, which might be, the system might be better with them, but they are definitely not necessary for the system to work as the only necessary thing is that the insurance provider can pay for all the costs which can be achieved easily by having high enough monthly payments.
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On June 30 2012 10:27 FabledIntegral wrote:
Yeah, I've heard that about smokers. But what I'm saying is that I don't think they deserve to be able to be insured. They shouldn't be 65, realize "oh fuck I need health insurance" and then be allowed to get it. In the current state, insurance companies can deny coverage, hence the "it's not a right" argument.
Concerning the tax on tobacco, I definitely think that would be the most ideal. I think the sympathy is simply lacking from my part in many cases, but I meant to clarify that it doesn't have to revolve around death. The lack of sympathy is more so towards the person who isn't covered when they break their leg. They should just have to bear the costs of that type of thing.
Addressing the dying issue in particular, I think possibly things classified as "life threatening" could be covered; my biggest issue are things that aren't life threatening, just costly. I think the best scenario, from my perspective, would be to tax everyone an equal percentage tax (rich still pay more since they make more) on their income, OR fund it through a federal sales tax.
With my mentality, I would be completely fine with a person who wasn't covered who still received healthcare due to a lifethreatening cause to have the option of something like post treatment having their wages garnished by 10% for the next ten years, assuming they are above the poverty line. Probably won't pay it off, but I think the person receiving the treatment should have to bear a large portion of the cost.
Here's how I think we should handle the 'smoker' situation. Require a permit to purchase tobacco products. In order to obtain a permit, someone is automatically registered as being no longer covered for cancer-related illnesses at any point in their life. Nobody can claim they didn't know it was harmful. Everybody knows they won't get treatment for cancer. The amount of smokers drops like a rock. Society doesn't have to fund smoker's bad habit. Everybody's happy.
Oh, and to address the need for a copay from previous posts. The patient needs to be the consumer. As it is now, patients have virtually no idea how much their health care services cost, nor do they care, as they are not bearing the costs. It's like if I'm getting a car, and somebody else is paying for it, I'm getting a Ferrari. If I'm paying for it, I'm probably not getting that Ferrari. Make patients bare enough of the burden so that they are aware and a part of the decision of what the costs will be. If I have a cold, I don't want to go to the doctor if I have to pay for it, and run up $100's for something so minor, but if it's free to me, fuck it, I'd rather get over it sooner rather than later, no matter the cost.
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I really think the smoker situation is a bizarre turn of events. You don't deserve to get cancer if you smoke. What kind of weird system of ideas are we talking about?
Besides, nobody says "Yes, being unhealthy is totally fine because I have insurance." This is ridiculous. Being unhealthy is already its own consequence. People don't want to live in hospital or undergo whatever treatments.
Can't we just forget about this weird system of blaming the victim for illnesses and just take care of people? I mean seriously, I've never understood this point of view where "we can't pay for smokers getting lung cancer!" What a bizarre idea. They're sick and dying, and you're answer is "Well fuck, I'm not paying for that!" <-- THIS IS STRANGE! THIS IS NOT NORMAL!
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On June 30 2012 11:26 DoubleReed wrote:
I really think the smoker situation is a bizarre turn of events. You don't deserve to get cancer if you smoke. What kind of weird system of ideas are we talking about?
Besides, nobody says "Yes, being unhealthy is totally fine because I have insurance." This is ridiculous. Being unhealthy is already its own consequence. People don't want to live in hospital or undergo whatever treatments.
Can't we just forget about this weird system of blaming the victim for illnesses and just take care of people? I mean seriously, I've never understood this point of view where "we can't pay for smokers getting lung cancer!" What a bizarre idea. They're sick and dying, and you're answer is "Well fuck, I'm not paying for that!" <-- THIS IS STRANGE! THIS IS NOT NORMAL!
I don't think smokers deserve to get cancer. But at the same time, I don't feel bad for a smoker with lung cancer. On the other hand, I would feel bad for someone who got, say, breast cancer.
A smoker made a decision which is known to create a HUGE increase in medical risk. I think they should live with it.
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On June 30 2012 12:17 BluePanther wrote:Show nested quote +On June 30 2012 11:26 DoubleReed wrote:
I really think the smoker situation is a bizarre turn of events. You don't deserve to get cancer if you smoke. What kind of weird system of ideas are we talking about?
Besides, nobody says "Yes, being unhealthy is totally fine because I have insurance." This is ridiculous. Being unhealthy is already its own consequence. People don't want to live in hospital or undergo whatever treatments.
Can't we just forget about this weird system of blaming the victim for illnesses and just take care of people? I mean seriously, I've never understood this point of view where "we can't pay for smokers getting lung cancer!" What a bizarre idea. They're sick and dying, and you're answer is "Well fuck, I'm not paying for that!" <-- THIS IS STRANGE! THIS IS NOT NORMAL! I don't think smokers deserve to get cancer. But at the same time, I don't feel bad for a smoker with lung cancer. On the other hand, I would feel bad for someone who got, say, breast cancer. A smoker made a decision which is known to create a HUGE increase in medical risk. I think they should live with it.
Are you assuming the person hasn't already purchased health insurance (free rider) or is that irrelevant to your position?
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On June 30 2012 12:23 JonnyBNoHo wrote:Show nested quote +On June 30 2012 12:17 BluePanther wrote:On June 30 2012 11:26 DoubleReed wrote:
I really think the smoker situation is a bizarre turn of events. You don't deserve to get cancer if you smoke. What kind of weird system of ideas are we talking about?
Besides, nobody says "Yes, being unhealthy is totally fine because I have insurance." This is ridiculous. Being unhealthy is already its own consequence. People don't want to live in hospital or undergo whatever treatments.
Can't we just forget about this weird system of blaming the victim for illnesses and just take care of people? I mean seriously, I've never understood this point of view where "we can't pay for smokers getting lung cancer!" What a bizarre idea. They're sick and dying, and you're answer is "Well fuck, I'm not paying for that!" <-- THIS IS STRANGE! THIS IS NOT NORMAL! I don't think smokers deserve to get cancer. But at the same time, I don't feel bad for a smoker with lung cancer. On the other hand, I would feel bad for someone who got, say, breast cancer. A smoker made a decision which is known to create a HUGE increase in medical risk. I think they should live with it. Are you assuming the person hasn't already purchased health insurance (free rider) or is that irrelevant to your position?
For such an obviously unhealthy choice, they should have to pay corresponding insurance rates. I mean, if they had insurance and the company knew it, they should be allowed to charge a higher rate for that person. If they didn't have insurance already, nobody should be forced to provide it for them except at a rate equivalent to expected care. This isn't something that people just get unlucky with. It's well known that smoking causes lung cancer.
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On June 29 2012 20:51 mcc wrote:Show nested quote +On June 29 2012 15:35 Pillage wrote:On June 29 2012 14:43 FabledIntegral wrote:On June 29 2012 14:35 rogzardo wrote:On June 29 2012 14:08 JonnyBNoHo wrote:On June 29 2012 13:15 rogzardo wrote:On June 29 2012 13:09 JonnyBNoHo wrote:On June 29 2012 13:02 rogzardo wrote:On June 29 2012 13:00 JonnyBNoHo wrote:On June 29 2012 12:43 rogzardo wrote:
[quote]
I'm uninsured, and this is an honest question. How can I have my health care paid for?
Cash. Some doctors / hospitals will even give cash discounts if you ask. Many will provide free or discounted care if you cannot afford it. If it is something simple, look for a free clinic nearby. Lol. If I had the fucking cash, I wouldn't need somebody else to pay for it, no? If johnny factory worker gets maimed by the bandsaw, and the surgery is 10 grand, I don't think a discount for paying cash is going to cut it. EDIT: And if I just don't pay, or the services are free, then the hospital is the one eating the bill. I'd much rather tax rich corporations slightly. Getting hurt in the factory would be covered by workers' compensation. Taxing 'rich corporations' largely gets passed on to consumers (to what degree depends on the industry). If you want that, fine, but you should know what you are asking for. Rich corporations being insurance companies, pharmaceutical companies, medical device sales, etc. They are corporations, and they're certainly rich. I agree some costs will inevitably trickle down, but it may not be as bad as you think. From whitehouse.gov.... [i]Value for Your Premium Dollar: Thanks to the Affordable Care Act’s 80/20 rule, if insurance companies don’t spend at least 80 percent of your premium dollar on medical care and quality improvements rather than advertising, overhead and bonuses for executives, they will have to provide you a rebate. The first rebates will be made in the summer of 2012. Pointless rule as it is easy to game. Just pile on more services (and higher premiums) so that your admin costs shrink as a percentage and health insurance co.'s walk away with fatter profits. Normally competition would keep profits low but the 80/20 rule will impact small co.'s more than large co.'s. Over time we'll be left with an oligopoly with expensive plans and fat profit margins. Damn again dude. If you had quoted the very next paragraph of my post it said.... Stopping Unreasonable Rate Increases: In every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. It's almost like I saw into the future and answered your question before you asked, but then you just didn't read it. They still had to justify it before hand. They just didn't have to do it publicly. And by justify I mean if they got audited by the state government, they had to have ALREADY documented it beforehand the reason for increases (or even decrease). Not to mention that the vast majority of states require all insurance companies submit to the state gov't whenever they want to change it, unless the changes are within a certain % of their existing rate. And increases are far more heavily scrutinized than decreases. On June 29 2012 14:41 Pillage wrote:On June 29 2012 14:27 FabledIntegral wrote:On June 29 2012 14:21 Pillage wrote:On June 29 2012 14:16 FabledIntegral wrote:On June 29 2012 13:50 Pillage wrote:On June 29 2012 13:38 Probe1 wrote:
Yeah, despite the crass ending white_horse is pretty damn spot on. A disproportionate amount of health care recipients are there for preventable, life style disorder/diseases. There's a fair few diabetics that, had they not swilled sugary colas and lived off M&Ms, would not need medical treatment. Same could be said for smoking and drinking related health issues.
It should not represent the majority of an argument but it is an important point. My issue with it is the fact that we are only squeezing out like 75 - 80 % efficiency from medicare and medicaid, and now we choose to spend even more money when all of the tools for pretty much fixing the situation are already in the toolbox. We have so many other options than simply throwing more money at the problem. Medical costs will rise sharply as a result of even more shitty subsidization by a government that has absolutely no idea how to get every penny out of the dollars it spends. What do you mean by squeezing out 75-80% efficiency? Do you realize that is the same average amount for insurance companies? For every premium dollar insurance companies take in, they pay about $0.75 to $0.80 back in claims on average. Then they have to pay a premium tax to the government (regardless if they make a profit or take a loss), pay the salaries of all the staff, pay overhead costs, etc. And if it's a mutual type of insurance company, a large portion of profits, if there are any that year, go directly back to the policyholders, as the policyholders are the ones that own the company in the first place. I should have elaborated more. By efficiency I meant that all of the money that goes toward fixing the problem actually plays a role in the treatment of whatever ailment is present. I understand that the overhead causes some money to be taken out but I'm strictly looking at money being used for treatment / doctor salary. So sorry, I'm not following exactly, probably my fault as I haven't kept up with this thread too much but mostly glanced over it for the past few days. You're trying to say that after all overhead costs, if you have $10,000 allocated for a treatment, only $8,000 gets paid towards it and the other $2,000 disappears somehow through inefficiency? If you're not accounting for overhead, where's the lack of efficiency? Alot of it is tied up in preventative things. Tests that need to be ordered despite all evidence collected by the MD pointing against condition X. It doesn't disappear, it just doesn't get put to practical use that will treat the patient. Medicine is full of this stuff and it's more often than not a result of bad policy from Administration and Government. The rabbit hole actually goes quite deep :/ More problems arise due to misinformation resulting from poor medical records that prevent care from being administered in the optimal manner. This is a common problem at many of the older hospitals / clinics that are usually frequented by not the richest of folks. For example, a MD may order a test to be done, not knowing that the previous doctor for a patient ordered the same test but the results are now gone. This happens often individually with patients who either - Travel / Move Frequently for Work - Have pre-existing conditions - Require extensive tests for certain conditions. There is a ton of money to be made in optimizing hospital patient databases, I have several acquaintances that actually travel and do this for a living, and make damn good money in the process. There are other things I'm sure you could think of, I'm too tried to come up with more off the top of my head. Many people will look at these things and think that these are little things that don't matter. I will disagree and make the case that throughout every optimization process, every system that is curtailed to approach perfection, its the little things that matter the most more often than not because of the frequency of which they occur. The bottom line is that we don't need more money, we just need to spend it smarter and give people the abilities to maximize their utility. So it's not really medicare specific then? Is this typically related to how U.S. hospitals operate? I was always under the impression the United States system was significantly more efficient in terms of providing service, record keeping, etc. than other countries, but just charged a shitton for it. Alot of it just centers around our current policies toward medicine. I can say that the US is very good with it's care quality as well as the expedience of many of the procedures. There are three great things about having a private Medical Industry, everyone knows what they're doing, they're experienced, and they'll fix you up fast as hell. I'm not sure about how well it handles the "paperwork" relative to Single Payer countries but I'd bet is a little bit better because the government lets it do its own thing. The main issue is the fact that when you introduce government into the equation it's "one more phone call you need to make" if you know what I mean. The introduction of bureaucrats slows the process down, as they don't really know what's going on, they're just a check-step for all of the procedures. Hospital administrators are just as guilty too for slowing things down, but they often can see all of the pieces on the board when a patient is being treated, and serve their purpose for 'conducting the orchestra" on a day to day basis. That is the inevitable result of subsidization though, things become more expensive for everyone and overall quality drops because the government must serve the lowest common denominator that requires 80% of all of the work. If there is one thing I like about the law its the fact that it forces the insurance companies to speed the process up by paying for shit right away regardless of what's going on with the patient. That's the way it should work. The doctor gives his orders, the orders are obeyed, the proper money is given for the treatment, and the patent goes home feeling fine. The dynamic between insurance and MD is at the front lines of determining the price of the treatment. You have the insurance company trying to fulfill it's end of the contract while trying to keep costs low, and you have the doctor doing the diagnosis and trying to find the best treatment options for the patient. This is honestly where I don't think any regulation needs to exist anymore, as the IC must pay regardless of what is going on. Chopping off existing regulations here streamlines the process, and I'm disappointed that the bill did no such thing. On another note one more benefit is that it also prevents them (the IC) from blowing off patents who have easy to fix things that if left untreated will go to the ER and jack the bill up for the taxpayers. The law is structured in an ok manner is this regard, there are some other things that are concerning, but i'm too tired to nitpick right now. The converse of that, and what I don't really like, is the fact that the companies will have to pay out the ass to prevent every little thing that's possible from happening to Mr. Smith. This is inevitably what will happen with a large government presence in healthcare, due to the fact that government gives zero fucks about how much money it spends. When the government has that much power over insurance companies, no one will be able to pay for their own healthcare. Are we there yet now? I'm pretty sure we're not, but the direction its going in plus everything else I see in the media today makes it seem to be looming in a more obvious manner. I fundamentally refuse to accept a single-payer system here, as it will obliterate the quality of medicine we've worked so hard to build here and send many prospective doctors into other fields. We need smart people in medicine, as mistakes here are punished through the loss of life on a daily basis, not many other professions can say the same. The bill has some good ideas in it, but my faith in the the effectiveness of their implementation is small, government here has never been known to execute their plans in an effective degree, and I don't see why new legislation is needed when the pieces are already there (Medicaid). The bill also fails to cut regulations in other areas that I deem important now that the bill is law. This is why I don't like new legislation in the first place really, because government can't clean up after itself when it gets a new toy. You argue based on your "feeling" when data seem to disagree with you. Administrative load (paperwork) of government run "insurance companies" with single payer systems is actually lesser by significant margins than private ones. This can be due to the fact that the private ones in US are also heavily regulated by US, but since you are not for complete deregulation of healthcare, it would seem that it would be better to introduce single payer if efficiency was your concern. Single payer systems are significantly more efficient than the hybrid one you have in US. There was some paper that analyzed that aspect of Canadian system compared to US system, I can find it if you want, but google should do. Another point is that from the point of view of customer you actually need to make "less phone calls". I come to a doctor, get what I need and leave. Never did I have to call anyone or whatever. Your only contact here is with a doctor, no bureaucrats ever come into the picture from consumer's point of view. From what I know about US system, you have to actually go through much more hassle as you actually have to deal with the insurance company more often. Of course in some cases you might run into some bureaucratic nonsense, but my point is that it is statistically less. Also it is not true that things become more expensive for everyone. With similar or better results all single-payer countries have cheaper health-care. And it is cheaper not only for the poor, middle-class also benefits as the government through economies of scale and better negotiating position can drive prices down. The only people who have it more expensive are people who did not want to have insurance at all and roll the dice, but have to under single-payer system. Also some richer people might have it slightly more expensive. Depends if the system has upper limit on the amount that a person has to pay into the system and how high it is. Your view about how doctors treat and ICs pay is kind of naive, as ICs will delay and even withold the payment as long as possible if they can find a way. That is where the regulation comes in to prevent them from doing the most nasty shit. Of course here the people handling the money also try to pay as little as possible, but they have it much harder as there is very little loopholes for them to use, but in this our system is fucked up compared to some other single-payer countries as we have private insurance companies handling the public money and paying the doctors. As for the quality of medicine (ignoring the whole insurance issue), single-payer systems do not decrease it. Wealthy countries running single-payer systems have similar quality of healthcare as US. There are individual differences, but they are caused by things other than single-payer system.
How am I arguing based on feelings? Everything I've mentioned in there is true to some degree and I threw my opinion in to say what my problems are with the law. I feel as though I've hit the nail on the head regarding alot of what I wrote about.
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On June 30 2012 12:17 BluePanther wrote:Show nested quote +On June 30 2012 11:26 DoubleReed wrote:
I really think the smoker situation is a bizarre turn of events. You don't deserve to get cancer if you smoke. What kind of weird system of ideas are we talking about?
Besides, nobody says "Yes, being unhealthy is totally fine because I have insurance." This is ridiculous. Being unhealthy is already its own consequence. People don't want to live in hospital or undergo whatever treatments.
Can't we just forget about this weird system of blaming the victim for illnesses and just take care of people? I mean seriously, I've never understood this point of view where "we can't pay for smokers getting lung cancer!" What a bizarre idea. They're sick and dying, and you're answer is "Well fuck, I'm not paying for that!" <-- THIS IS STRANGE! THIS IS NOT NORMAL! I don't think smokers deserve to get cancer. But at the same time, I don't feel bad for a smoker with lung cancer. On the other hand, I would feel bad for someone who got, say, breast cancer. A smoker made a decision which is known to create a HUGE increase in medical risk. I think they should live with it.
Following this brilliant line of reasoning, any driver injured in a car accident should be held responsible and should have to pay alone for his needed care.
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On June 30 2012 14:12 kwizach wrote:Show nested quote +On June 30 2012 12:17 BluePanther wrote:On June 30 2012 11:26 DoubleReed wrote:
I really think the smoker situation is a bizarre turn of events. You don't deserve to get cancer if you smoke. What kind of weird system of ideas are we talking about?
Besides, nobody says "Yes, being unhealthy is totally fine because I have insurance." This is ridiculous. Being unhealthy is already its own consequence. People don't want to live in hospital or undergo whatever treatments.
Can't we just forget about this weird system of blaming the victim for illnesses and just take care of people? I mean seriously, I've never understood this point of view where "we can't pay for smokers getting lung cancer!" What a bizarre idea. They're sick and dying, and you're answer is "Well fuck, I'm not paying for that!" <-- THIS IS STRANGE! THIS IS NOT NORMAL! I don't think smokers deserve to get cancer. But at the same time, I don't feel bad for a smoker with lung cancer. On the other hand, I would feel bad for someone who got, say, breast cancer. A smoker made a decision which is known to create a HUGE increase in medical risk. I think they should live with it. Following this brilliant line of reasoning, any driver injured in a car accident should be held responsible and should have to pay alone for his needed care.
Apples and Oranges. There's a far cry between making a mistake on the road during one day of your life and poisoning yourself daily for years on end.
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On June 30 2012 14:17 Pillage wrote:Show nested quote +On June 30 2012 14:12 kwizach wrote:On June 30 2012 12:17 BluePanther wrote:On June 30 2012 11:26 DoubleReed wrote:
I really think the smoker situation is a bizarre turn of events. You don't deserve to get cancer if you smoke. What kind of weird system of ideas are we talking about?
Besides, nobody says "Yes, being unhealthy is totally fine because I have insurance." This is ridiculous. Being unhealthy is already its own consequence. People don't want to live in hospital or undergo whatever treatments.
Can't we just forget about this weird system of blaming the victim for illnesses and just take care of people? I mean seriously, I've never understood this point of view where "we can't pay for smokers getting lung cancer!" What a bizarre idea. They're sick and dying, and you're answer is "Well fuck, I'm not paying for that!" <-- THIS IS STRANGE! THIS IS NOT NORMAL! I don't think smokers deserve to get cancer. But at the same time, I don't feel bad for a smoker with lung cancer. On the other hand, I would feel bad for someone who got, say, breast cancer. A smoker made a decision which is known to create a HUGE increase in medical risk. I think they should live with it. Following this brilliant line of reasoning, any driver injured in a car accident should be held responsible and should have to pay alone for his needed care. Apples and Oranges. There's a far cry between making a mistake on the road during one day of your life and poisoning yourself daily for years on end.
In both cases you are deliberately exposing yourself to the risk of your health being damaged (not every smoker gets lung cancer). It doesn't even have to be your mistake on the road - your car can get hit by someone else making a mistake.
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On June 29 2012 21:53 Manit0u wrote:Show nested quote +On June 29 2012 21:36 LaughingTulkas wrote:
Disclaimer: I haven't read the thread, this is just my reaction.
The main issue for me here is that unprecedented expansion of the governments power.
Basically, the government now has the right to demand money from me (tax) when I don't do what they want me to do. Sure, right now it's healthcare, which is a good thing. I'm not mad about it being healthcare. But the precedent is now set that they can do this for whatever they see fit. There's nothing to stop them from demanding I pay them money if I don't by HoTS, or any other private product sold by a private company.
I'm not saying they will do this, but the power is now theirs to control, and with human nature being what it is, its more than likely it's only a matter of time before such power gets abused. These are the liberties we are giving up, and who knows when the price will need to be paid.
(I am all for having everyone have healthcare, especially those who want it but can't afford it, but there has to be a better solution than forcing under penalty of law those who don't want to buy it, especially at the cost of giving the government such control over our lives.) Is everyone in the US so paranoid about government having some actual power? As I see it, one of the biggest problems the US are facing now is that they got blinded by capitalism too much which led to overgrowth of private sector and now they need to fix it by taking some of it back into public sector. I know that words like "socialism" scare the hell out of Americans but you need to understand that socialism=/=communism and some of it is actually good. Even if I were to take my own country as an example, where we have free healthcare and government-controlled pension system (if you work a % of your income is automatically added to your pension, the same with healthcare), which aren't perfect as there's constantly some problems with it, but they work. After all, if you make more money you can use it to get better healthcare by purchasing insurances from private companies, better pension by investing your money wisely etc. But the best example would be the schools. Most of the schools and universities in Poland are public, completely free and much better than private ones, which cost a lot. This is beneficial for the country as you get qualified workers who aren't in horrible debt at the start of their career. Really guys, if you don't trust your own government, then why would it trust you? Put some faith in it and maybe things will start moving towards a better future. Democracy at its finest...
Sorry for jumping pages, but I had to respond to this.
As an American, we are born of a nation founded bythose who sought refuge from Governments. We have rebelled against Kings in the past, have fought amongst ourselves over the power of government, and often times to thi day send in soldiers to fight and die for people who are pushing against their governments.
Governments exist to augment the power of the people, not the other way around. No, we do not trust our government, and clearly they do NOT have our best interests at heart. For the love of god, these people haven't even bothered to pass a budget in the last 3 years, while at the same time our nation is spiraling into debt. They need to get the boot, and a better crop of leaders put in.
Simple asnwer is this: No patriotic american should trust the government. It is our civic duty to question our leaders, to keep them honest, and to control THEM, not let them control US.
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The only good government is a subservient puppet government we establish on the far side of the world! Who's with me!!!
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EPT
