Health Care Debate

[GGT]

Er.... no, that's not fact... and it's incorrect. He even almost admitted that it's not efficient. Why should the old and young pay the same price, when they are buying different goods? Economically, it's like forcing everyone to pay the same for a car, but young people can only choose to buy a small car and old people can only choose to buy a luxury car. That doesn't make any sense. (I left out "sick" and "healthy" here because those are very subjective terms in this case.)

That's forcing the young to subsidize the old, and that's not even factoring in any government subsidies.

The ideological part comes in when you put everyone in the same pool regardless of cost.

To clarify my post, the cost reductions I referred to were insurance premiums.

Yes, it's a fact that the bigger the pool, the lower the premiums will average (spreads risk). Of course anything is higher than zero for those who pay no premium now, like the Invincible Young who have no coverage (it's too expensive).

I didn't watch the entire summit, but there was a part about "medical value". They make have discussed efficiency of the system or insurance industry that I missed. The ideological part comes in how to get everyone in the pool (tax? mandate?) but also if health care is a right or responsibility....

Your car buying analogy doesn't work very well--not everyone needs or wants a car, there are alternatives to transportation. It might work for insurance premiums and yes, the model used is all about hypothetical risk. I think the better analogy might be public education. If we've decided our society NEEDS educated citizens (and future workers) then we have to have schools open to everyone. Paid for by everyone, whether they have their own children or not. The value-added comes in future services everyone will need and use.

[EyeKhan]

why is it worse to force the young to subsidise the old than it is to force the young to subsidise the young?

Because the proportion of young to old will fluctuate (currently decreasing) where as the proportion of young to young stays constant.

what about just making the healthy subsidise the unhealthy?

The young will some day be old. Then the generation behind will subsidize their higher health costs. And it progresses. Nobody's getting a free ride.

And we subisidize each other because we're a fucking nation. We pool our resources to get shit done. We do that with a huge array of things, why not health care? Who won't need health care at some point in their lives ffs? It's crazy to say "oh, that government ain't got nor right to make me help pay for some sick dude's medicince. fuck them." Huh????

[GGT]

Besides, for those who focus on fiscal policy only....the cost of doing nothing now is too high, tipping point's been reached.

We are ALL paying for this mish-mash piece-meal system currently in place. Insured folks are 'subsidizing' the uninsured as well as Medicare/Medicaid. Providers just move the billing and fees around to maximize recouping their costs. Prices of services go up about 10% per year, add in pharma and durable medical goods spiraling higher, Insurance adds administrative costs but not better service--- it's unsustainable.

The bigger cost of doing nothing falls to our society and nation as a whole. Talk about Death Panels....

[ar81]

People suffer higher premiums when people are more ill.
A mild illness may get serious if you wait.
It is cheaper to prevent than to react before a problem.
Economic accesibility of medical attention becomes a barrier not to wait.
Lifestyle and genetics have an influence. Genetics can't be changed.
Ironically those who are more ill are those who pay more. It is just like making the poor to pay more taxes.

It says that:
1.Hospitalls are not healing people properly
2.Ill people wait because they can't afford healthcare
3.Insurance companies are making money with genetical problems of people.
4.US system transfers the costs to those who are in need, not those who can pay.
5.The business of health is to have more ill people. Profit driven market is good when high demand is desirable. But in healthcare, hig hdemand means more ill people, which is undesirable.

This is why public systems like in UK, Canada and even a third world like Costa Rica work better than US. Childern mortality in US is at thrid world levels, and life expectancy is higher in Canada.

[GGT]

Ironically those who are more ill are those who pay more. It is just like making the poor to pay more taxes.

No, those who are 'more ill' with chronic disease or catastrophic injuries end up moving into Medicaid or disability. If their coverage is employer-based and they lose their job, after (expensive) COBRA runs out they qualify for assistance. They may keep their job but hit lifetime caps, facing recission. Small businesses are especially vulnerable to this mess and often can't offer the benefit.

[Hazir]

In this whole health care debate I am starting to get the feeling that Republicans have moved or are slowly moving towards a position where they reject any sense of community. That of course is a valid position, if you're a libertarian, but it's kind of irreconcilable with the GOP's social conservatism and law and order identity.

[EyeKhan]

In this whole health care debate I am starting to get the feeling that Republicans have moved or are slowly moving towards a position where they reject any sense of community. That of course is a valid position, if you're a libertarian, but it's kind of irreconcilable with the GOP's social conservatism and law and order identity.

The GOP have calculated that they have nothing to gain politically by supporting health care reform. It has nothing to do with policy, ideology, or what this country needs. They want power back and they know if they give Obama a win, of any kind but especially this, it hurts their chances of regaining Congress and the Presidency. If Obama fails here, his presidency is neutered for the duration, Democrats are guaranteed to lose congress in November, and the Republicans have a much better shot of limiting Obama to 1 term. Its cynical and its bad leadership, but its our reality....

[GGT]

Someone should do a Case Study of Cheney's cardiac care history, then compare it to random same-aged men of average income with private insurance.

[ImAnOgre]

what about just making the healthy subsidise the unhealthy?

Do we really need this discussion again?

Many people are unhealthy because of lifestyle choices THEY have themselves made. Overeating, smoking, unprotected sex...

In 2007, the US has over 20M People with diabetes. What is that attributed to? Well, when I go to the doctor the little sign says don't be fat and don't smoke.

Lung disease.... i guess I should have to pay extra taxes because uncle Johnny smoked his entire life?

Hogwash.

I don't want my hard earned money going to anybody.

[Hazir]

Yeah, well, our bobsled team didn't chicken out. That must mean we have better healthcare.

You're forgetting that they're in Canada, a country with socialized health care

[EyeKhan]

Do we really need this discussion again?

Many people are unhealthy because of lifestyle choices THEY have themselves made. Overeating, smoking, unprotected sex...

In 2007, the US has over 20M People with diabetes. What is that attributed to? Well, when I go to the doctor the little sign says don't be fat and don't smoke.

Lung disease.... i guess I should have to pay extra taxes because uncle Johnny smoked his entire life?

Hogwash.

I don't want my hard earned money going to anybody.

But your lifestyle doesn't dictate whether you get coverage and largely how much your premiums are. I think if you're fat, drink too much, smoke or ride your motorcycle without a helmet, you should pay more in premium. But you shouldn't be refused and you shouldn't be priced out of the system. And everyone out there should have access to reasonably priced health coverage no matter what.

[ar81]

No, those who are 'more ill' with chronic disease or catastrophic injuries end up moving into Medicaid or disability. If their coverage is employer-based and they lose their job, after (expensive) COBRA runs out they qualify for assistance. They may keep their job but hit lifetime caps, facing recission. Small businesses are especially vulnerable to this mess and often can't offer the benefit.

This happening to Americans: Going bankrupt because of health problems.
People in need paying more than those who are not in need.

“My wife and I are both self employed, she left a state job 2 years back when we moved to Florida where I had taken a consulting position, I have been self employed for 15 years. We no longer were entitled to the great health benefits we enjoyed when my wife worked for the state. The issue is that our son has a pre-existing condition and we are unable to get insurance coverage for him. yes it is possible to get this coverage but at the cost of going bankrupt! I am not against paying toward health care but I do take issue when a child of 7 years of age can not get coverage due to insurance companies refising on grounds of pre-existing conditions that he shows no signs off? If we are supposedly the most advanced and caring nation in the world then how come a 7 year old child is refused health care or can not afford health care due to the high cost? Shame on us. Reform is needed urgently to address this shameful situation in our country. – Stephen from Florida”

“When my son turned 22, he ‘aged out’ of the family's health insurance plan. (He was no longer covered.) He applied to an insurance company for an individual health insurance policy. He assumed that, because he was young, strong, and healthy, his application for coverage would be approved. But the company did their ‘due diligence’ and discovered that my son had recently been treated for the dreaded disease, strep throat. My son received a letter from the insurance company stating that his application would be denied BECAUSE HE HAD HAD STREP THROAT! That, (strep throat, one step up from a cold) was his ‘pre-existing condition’! Talk about cherry-picking only the healthy to insure--I guess, with this company, if my son had admitted to having a hang-nail within the preceding three years, he would have been denied coverage. This is WRONG, and I fully support President Obama's plans to change the way health insurance is delivered in our country.” – Lisa from Colorado

“Health care reform is long overdue. I am a health care provider and a single mother of a chronically ill child who has reached 21 years of age. As a health care provider I have cared for the underserved populations for the greater portion of my years as a practicing nurse and nurse practitioner. I presently work for a county health system. One third of my monthly salary goes to my health insurance premium. My daughter requires health care from a major medical center that is doing research regarding her suspected diagnosis. I am required to carry a PPO which is an 80/20 plan after an annual deductible. After a few hospitalizations that 20% adds up. Further I have worked two to three jobs (at the same time) over the years and have kept her on private health insurance paying large premiums and many times finding I have to challenge the insurance company to get them to pay for her medications and treatment. Now that she is 21yrs of age and unable to attend school or work, I face her loosing her health insurance due to age restrictions.” - Elizabeth from California

Source: US government

[GGT]

Do we really need this discussion again?

Many people are unhealthy because of lifestyle choices THEY have themselves made. Overeating, smoking, unprotected sex...

In 2007, the US has over 20M People with diabetes. What is that attributed to? Well, when I go to the doctor the little sign says don't be fat and don't smoke.

Lung disease.... i guess I should have to pay extra taxes because uncle Johnny smoked his entire life?

Hogwash.

I don't want my hard earned money going to anybody.

You do know there are different types of diabetes, and not all lung disease is caused by smoking, right?

About your hard earned money "going to anybody".....do you say the same for public education? Ya know, especially those who had unprotected sex!

[ar81]

Do we really need this discussion again?

Many people are unhealthy because of lifestyle choices THEY have themselves made. Overeating, smoking, unprotected sex...
I don't want my hard earned money going to anybody.

Yes, we need. Lack of proper information makes people not to make good choices.
Smoking: Cigar companies should pay the premiums.
Overeating: Makers of unhealthy food should pay.

[Hazir]

ImanOgre is typical for this 'I belong to no community' attitude you see so often in the US these days.

[ImAnOgre]

You do know there are different types of diabetes, and not all lung disease is caused by smoking, right?

About your hard earned money "going to anybody".....do you say the same for public education? Ya know, especially those who had unprotected sex!

I do know there are different types of diabetes (I am a diabetic, adult onset). Probably a little factoid you didn't know about me.

Do I say the same for public education.... no, because most children cannot make choices that affect their upbringing.

But your lifestyle doesn't dictate whether you get coverage and largely how much your premiums are. I think if you're fat, drink too much, smoke or ride your motorcycle without a helmet, you should pay more in premium. But you shouldn't be refused and you shouldn't be priced out of the system. And everyone out there should have access to reasonably priced health coverage no matter what.

Why should I subsidize some dumbasses behavior? You ride your bike without a helmet, you are on your own pal.

ImanOgre is typical for this 'I belong to no community' attitude you see so often in the US these days.

I don't want to belong of a community of dumbasses.... that's why I'm here!!! With the smart folks.

[Aimless]

Do we really need this discussion again?

Many people are unhealthy because of lifestyle choices THEY have themselves made. Overeating, smoking, unprotected sex...

oh right you're one of those PUNISHMENT FIRST folks aren't you

how come you don't want to punish children who make mistakes wrt lifestyle??

[ImAnOgre]

Why should I be punished (by paying more) for someone else's fuckup? Why should anyone be forced to pay? If you want to, be my guest. I always like it how people can be so charitable with other people's money.

As far as children are concerned, they are at the mercy of their parents until they leave the home (which happens usually about the time they are considered adults)

[Spawnie]

Why should I be punished (by paying more) for someone else's fuckup? Why should anyone be forced to pay? If you want to, be my guest. I always like it how people can be so charitable with other people's money.

As far as children are concerned, they are at the mercy of their parents until they leave the home (which happens usually about the time they are considered adults)

Instead of the old "why should i? Why should i?" rhetoric - try thinking "how does it benefit me?"

Just for fun, because i do hate to see someones mind run down the same tracks on every topic.

[Being]

ImanOgre is typical for this 'I belong to no community' attitude you see so often in the US these days.

Yeah, he'll keep it up until he finds himself in a mess that was no fault of his own.

[Cracky]

Wait wait... back it up a bit.

You people are honestly saying that some lardass who eats 20lbs of KFC then smokes 2 packs of cigarettes a day should get the same health coverage as someone who behaves in a way to preserve their own health?

Because I think that's what you are saying...

[Aimless]

Why should I be punished (by paying more) for someone else's fuckup? Why should anyone be forced to pay? If you want to, be my guest. I always like it how people can be so charitable with other people's money.

As far as children are concerned, they are at the mercy of their parents until they leave the home (which happens usually about the time they are considered adults)

a lot of these harmful behaviours and trends are established at a young age and are extremely difficult to fix, esp. in a retarded society where regular people don't get any breaks.











cracky, i am saying that, more or less (barring eg. organ transplants and the like). it'll be fine once you as a society get somewhere in the fight against smoking and against eating at kfc.

[Cracky]

What is "it"?

[Spawnie]

Wait wait... back it up a bit.

You people are honestly saying that some lardass who eats 20lbs of KFC then smokes 2 packs of cigarettes a day should get the same health coverage as someone who behaves in a way to preserve their own health?

Because I think that's what you are saying...

Yeah pretty much. In fact, you should have just quoted us. That would have saved you the effort of typing it out.

Unless, of course, thats not what we were saying. *gasp*

[Aimless]

What is "it"?

the GIANT problem of the lardass who eats 20lbs of fried chicken and smokes two packs of cigarettes per day.

i have a brilliant idea how about we sponsor 1. gastric bypass surgeries 2. programmes to help people quit smoking ???






btw what the hell was ogre talking about with his snide remark about generosity with other people's money??? is he suggesting that i don't pay taxes, or that i won't be paying more taxes the more i earn?? that sounds crazy

[GGT]

Wait wait... back it up a bit.

You people are honestly saying that some lardass who eats 20lbs of KFC then smokes 2 packs of cigarettes a day should get the same health coverage as someone who behaves in a way to preserve their own health?

Because I think that's what you are saying...

Not sure what Ogre's saying. He doesn't seem to realize we ALL pay for everyone, insured or not, thru higher prices for services.

-Group insurance doesn't usually review each person's health history (they can, some employers do that, and make employees' contribution higher for obesity/high lipids/smoking, or lower if they lose weight/stop smoking.)

-Individual insurance scrutinizes your entire history, for everything, and the application forms ask lots of lifestyle questions. They charge premiums based on that data, and can deny coverage of any body part or system. (ie If you have osteoporosis can they exclude coverage for any broken bones or PT or rehab related to broken bones....)


This is one move that wouldn't cost tax payers or providers anything in subsidy, but could bring down cost of premiums:

Feb. 26 (Bloomberg) -- Christine Varney, the U.S. Justice Department’s chief antitrust enforcer, said the dominance of major health insurers might be hurting competition.

“We’re very concerned whenever we see the kinds of concentration we see in the health-insurance market,” she said in an interview today in the Washington bureau of Bloomberg News.

Varney endorsed a measure approved by the U.S. this week that would revoke insurers’ 65-year-old federal antitrust exemption. Insurers now share data to help set premiums without fear they will be charged with federal price-fixing violations. Revoking the exemption had been part of a health-care overhaul that has stalled in Congress.

......

Too Much Concentration

The health-insurance industry is regulated under state laws that ban price-fixing, market allocation and other anti- competitive practices.

Congress enacted the McCarran-Ferguson Act in 1945, granting insurers an antitrust exemption after the Supreme Court ruled the companies could be regulated by the federal government. The act was intended to preserve the states’ roles in overseeing the industry without federal intervention.

“Whenever you have anybody with an enormous amount of market share, whether it’s 70 percent, 80 percent, 90 percent of the product sales in a particular market, that tells us that market is probably not competitive,” she said.

Revoking the federal antitrust exemption “could alter behavior,” she said. “Hopefully it will introduce more competition. Anytime an industry or a sector of the economy enjoys immunity from a law, they behave differently than if they have to compete.”

http://www.bloomberg.com/apps/news?p...e9wsxvcU&pos=6

[Being]

Wait wait... back it up a bit.

You people are honestly saying that some lardass who eats 20lbs of KFC then smokes 2 packs of cigarettes a day should get the same health coverage as someone who behaves in a way to preserve their own health?

Because I think that's what you are saying...

So what you are saying is, it'd be fine if we purposefully take profits away from KFC instead of paying for the heart surgery for the bastard that eats too much of it.

Either way it's lost revenue.

[Cracky]

the GIANT problem of the lardass who eats 20lbs of fried chicken and smokes two packs of cigarettes per day.

i have a brilliant idea how about we sponsor 1. gastric bypass surgeries 2. programmes to help people quit smoking ???

Err.. this has nothing to do with the original topic then...

Not sure what Ogre's saying. He doesn't seem to realize we ALL pay for everyone, insured or not, thru higher prices for services.

-Group insurance doesn't usually review each person's health history (they can, some employers do that, and make employees' contribution higher for obesity/high lipids/smoking, or lower if they lose weight/stop smoking.)

-Individual insurance scrutinizes your entire history, for everything, and the application forms ask lots of lifestyle questions. They charge premiums based on that data, and can deny coverage of any body part or system. (ie If you have osteoporosis can they exclude coverage for any broken bones or PT or rehab related to broken bones....)


This is one move that wouldn't cost tax payers or providers anything in subsidy, but could bring down cost of premiums:



http://www.bloomberg.com/apps/news?p...e9wsxvcU&pos=6

I'm not sure how market monopolization really relates to this...

So what you are saying is, it'd be fine if we purposefully take profits away from KFC instead of paying for the heart surgery for the bastard that eats too much of it.

Either way it's lost revenue.

What? No, I don't see how you can extract that from my quote.

[agamemnus]

Your car buying analogy doesn't work very well--not everyone needs or wants a car, there are alternatives to transportation. It might work for insurance premiums and yes, the model used is all about hypothetical risk. I think the better analogy might be public education. If we've decided our society NEEDS educated citizens (and future workers) then we have to have schools open to everyone. Paid for by everyone, whether they have their own children or not. The value-added comes in future services everyone will need and use.

It was purely an analogy of cost distribution.

Your analogy lacks a few elements of health care which the car analogy does not. =)

1. Spreading health care to everyone with disregard for the health needs of people not only puts an unfair burden on young people (or I daresay healthier people), but it also makes people go to the doctor more often than they need and do more expensive procedures than they need. It's free, after all. This is proven in many contexts, including Soviet Russia (in terms of jobs that pay a flat rate regardless of peoples' efforts) -- when people CAN get something for free, they WILL -- except the taxpayer is paying for the waste. The alternative to this is a government bureaucracy set up to judge when you can get health care, which is what liberlulz have always claimed will never happen. A huge and inefficient government bureaucracy is the ONLY way to keep costs from spiraling insanely out of control. Completely free public health care is simply economically untenable.

*Insurance*, instead of "free healthcare lulz!" for everyone? That's a different matter.

For "free" insurance, use a scale AND DON'T INCLUDE ILLEGALS. For most cases (unemployed or **SEVERELY** disabled people (not just the current whimsical legal definition of "disabled") , only give a set number of free doctor's visits a year, plus various required medications and equipment (that required for the patient), and still add a co-pay requirement to some visits or pills.

Also, DON'T INCLUDE THINGS THAT ARE NOT ABOUT HEALTH CARE, like baby food!

I think Republicans would go along with this, if Democrats just agreed to (1) Tort reform, (2) free and unrestricted insurance company competition across state lines, and (I forgot the third thing that Republicans [and not just myself] wanted, so I'll add the one I would want) (3) much higher fines and penalties for insurance companies that try to skip out on their customers' claims by using obscure boilerplate contract terms.

[GGT]

I do know there are different types of diabetes (I am a diabetic, adult onset). Probably a little factoid you didn't know about me.

Hope it works out for you. Means you won't be drinking beer anymore...?

Do I say the same for public education.... no, because most children cannot make choices that affect their upbringing.

So you're in favor of SCHIPs, WIC and foodstamps? And allowing children on parents' insurance policies until age 21? Maybe public-funded college too?

Why should I subsidize some dumbasses behavior? You ride your bike without a helmet, you are on your own pal.

They're in your insurance pool, they're your neighbors, they share the road and the health system, the dumbasses. Your utopian society can't separate individuals from the group, no matter how hard you try.

Why should I be punished (by paying more) for someone else's fuckup? Why should anyone be forced to pay? If you want to, be my guest. I always like it how people can be so charitable with other people's money.

Based on that, your employer should kick you out of their group insurance, since your diabetes "punishes" everyone in the pool. To be consistent about it, you should be buying your own individual policy, paying a much higher premium, full fee cash OOP for every office visit, market price for every medication.

Maybe your employer should do away with their insurance benefit altogether, so that cost won't trickle down to the consumer in higher airline tickets? Why should we have to pay higher prices to fly, when it's padded with your benefits and not simply work performance/value? I like how you can be 'charitable' with my money, when it goes into your pocket.

It was purely an analogy of cost distribution.

Sure, but there are different COSTS and prices. Insurance premiums, medical services (consumer and provider), entitlement programs, subsidies----whole fruit basket! The Summit tried to address this, can't be done in 6-7 hours.


The biggest COST I referred to was a societal one; if millions are unhealthy they can't be productive. If they can't get care it drags us all down. Hard to niche or measure what kind of nation we want to be, but I know we shouldn't let people suffer or die (or go bankrupt) just because they can't pay for treatment or buy insurance.

<snip>

I think Republicans would go along with this, if Democrats just agreed to (1) Tort reform, (2) free and unrestricted insurance company competition across state lines, and (I forgot the third thing that Republicans [and not just myself] wanted, so I'll add the one I would want) (3) much higher fines and penalties for insurance companies that try to skip out on their customers' claims by using obscure boilerplate contract terms.

I listed the top 5 ideas that came from the Summit (from my POV)

If they're all hell bent on seeing Care = Insurance, then we need to reform that industry. (Cracky, that's why the anti-trust laws matter.)

If Republicans want to have any credibility, they'll stop saying how great Medicaid and Medicare are, but anything else is SSSocialism or wealth re-distribution. They can't be alarmists clanging the liberty bell about guv'ment intervention, while keeping our whole system under Insurance Industry's (or Big Pharma's) big fat thumbs.