FreedomWorks is right about Obamacare *sigh*

[Voyager]

@Grim_Render

ALL other models are cheaper than yours. And its not by any small amount. Just US government healthcare, covering 27 % of the population, costs more per citizen than the total healthcare expenses, including 100% coverage UHC, of all but two other countries.

http://www.oecd.org/unitedstates/Briefing-Note-USA-2013.pdf

I was understating this. My wife, who is a medical writer, is doing a few encyclopedia articles on Canadian and British health care. She was impressed. If we were rational we’d definitely have a single payer system, but as it stands we are lucky to get something slightly less crappy than we had before.

Amusingly, one loser in ACA is the unions. Really good insurance, which unions negotiate for their members, gets a kind of luxury tax. Makes sense terms of equalizing coverage a bit more.

[Grumman]

@Twoflower

The entire insurance industry has always been based on the fact that some people get less back than they pay in, to balance those who get more.

Wrong. Insurance is based on the fact that everyone, on average, gets less back than they pay in and gets improved stability in exchange. It’s a way to smooth out your costs, not a deliberate transfer of property from the marks to the subsidised.

Young people have already been fucked over by the current economic climate. Ripping them off to subsidise the only demographic who came out of the recession richer is obscene.

[Snowboarder_Bo]

@yorick73

Well, feel free to provide some context. I didn’t take your question out of context…I damn near quoted the entire post. Here, I’ll quote the whole post so you can point out that part that I missed (you know, the context and all)

The part you missed is what this thread is about: health care. Specifically the PPACA. That’s the context of the discussion and, naturally, also the context of my remarks to Bricker. How is it that you don’t know what the subject of this discussion is?

@yorick73

Now, maybe I’m dense but I don’t see any reference there to health care. Oh, maybe the context was in your mind but I’m unable to read that. What I can clearly see is you trying to backpedal.

I’ll say it again, in simple, short words: this thread is for people to talk about health care. The context of my post is the same as the context of the thread.

I don’t need to backpedal on anything in that post, since there aren’t any assertions made.

@yorick73

What? Did I say I wan’t interested? Where? What I’m not interested in is a poster who either can’t read or understand his own post (in context)

No, you didn’t say you weren’t interested; I posited it as a possible reason for your engaging me in this thread.

[Wesley_Clark]

@brickbacon

Lastly, there is only a very small slice of the public for whom not buying insurance makes economic sense. Between the subsidized plans for the working poor-ish, and the penalties for not being covered, it hard to make the math work. The people we are talking about are probably over 25 and under 40. If they have a decent job, and their employer doesn’t provide insurance, they will likely be liable for any and all healthcare costs they incur. The problem is compounded by the fact that they will pay MUCH higher rates for most of that care. Even if foregoing insurance is a negative proposition relative to health care costs shouldered by the insurance company, it likely isn’t for someone paying out of pocket. It is a win-win for many relatively healthy people given the insurance company can leverage their power in pursuit of lower prices.

The ACA is also a bad bargain for people who earn more than 400% of the poverty line, but not enough to be upper middle class (so individuals in the 45-80k income group) who are not insured through work. An individual earning 40k a year has their premiums capped at about 9.5% of income, so it doesn’t go above about $330 a month. A premium for an elderly person on the silver plan (2nd lowest) can push $800/month. If you earn 50k a year you get zero assistance, and have to pay the entire $800/month yourself. Add in another $6350 in deductibles and copays and a person can easily be asked to spend 30% of their gross income on health insurance premiums, deductibles and copays.

Then again, you would assume most people who earn 45k+ a year at a job would probably be insured through work.

[Chief_Pedant]

@SlackerInc

Well, not about the law in general, or in wanting to repeal it; but they have a powerful message that highlights a serious vulnerability in the law’s structure.

I am a strong Obama supporter, keep in mind, and it pains me to say this. But I am tired of cringing when I hear NPR stories like this:

What young person with an IQ higher than room temperature is going to hear things like that and think Obamacare sounds like a good deal they should sign up for? It’s not a huge extrapolation to go from there to “this system will only work if young people pay in more than they get back out, so older people can get back more than they pay in”. Why on earth was it set up that way, rather than simply putting the wealthy on the hook to subsidise everyone else to varying degrees?

Unlike some, I don’t insist that the only way to do healthcare is single payer (my Canadian sister has had some sobering problems on that front) or a “public option”. But it’s insane that they set up a system that would require the president’s most loyal age demographic to semi-voluntarily take on a bad deal for themselves to keep his signature program afloat. And when they try to sell it as a good deal for young people to “get coverage” despite the realities described above, it just provides an opening for conservatives to whisper sweet libertarian nothings in their ears and get them to distrust government.

As I’ve asserted in other threads, I still think Democrats have a bright future and will retain the loyalty of the millennial generation (as well as the one following it at least). But there’s no sense taking this for granted or shooting ourselves in the foot.

Your post made stuff come out my nose from laughing.
Especially the part where you appear to be shocked…SHOCKED…that anyone but “the wealthy” should have to be put on the tax hook of “subsidizing” someone else.

See, it’s this sort of hilariously naive approach to taxation and responsibility that makes me just want to buy gold and wait for the country to finish fiscally crapping out.

If young people in this country really do think collectively that only “the wealthy” should subsidize benefits for everyone else, we’re doomed. Fortunately, I’m old enough not to care that much, and I think I have time to hunker down and wait for kids like you to figure it out the hard way.

Now give me a minute so I can go back to fighting for your free education along with your free healthcare.

[brickbacon]

@Wesley_Clark

The ACA is also a bad bargain for people who earn more than 400% of the poverty line, but not enough to be upper middle class (so individuals in the 45-80k income group) who are not insured through work. An individual earning 40k a year has their premiums capped at about 9.5% of income, so it doesn’t go above about $330 a month. A premium for an elderly person on the silver plan (2nd lowest) can push $800/month. If you earn 50k a year you get zero assistance, and have to pay the entire $800/month yourself. Add in another $6350 in deductibles and copays and a person can easily be asked to spend 30% of their gross income on health insurance premiums, deductibles and copays.

Then again, you would assume most people who earn 45k+ a year at a job would probably be insured through work.

I agree (especially with the bolded portion). There are just not that many people for whom it makes strict economic sense to not buy insurance. Either way, your scenario is a worst case situation in which it still likely better to be insured as if you spend $6350 in deductibles and copays, the bills you would receive as an uninsured person will likely be much higher than the cost of the insurance.

That said, I am sure that someone might get screwed by the whole thing, but the same can be said about nearly any legislation.

[SlackerInc]

@Chief_Pedant

See, it’s this sort of hilariously naive approach to taxation and responsibility that makes me just want to buy gold and wait for the country to finish fiscally crapping out.

Aww…it’s a right wing goldbug. I didn’t know they had those anymore. How’s that been working out for you the last year or so?

About a year and a half ago I was telling all my friends that if they had money to invest they should short gold. I sure didn’t have any money to spare, but several of them did and actually thought about it but did not pull the trigger, sadly for them.

@Chief_Pedant

Fortunately, I’m old enough not to care that much, and I think I have time to hunker down and wait for kids like you to figure it out the hard way.

Now give me a minute so I can go back to fighting for your free education along with your free healthcare.

Huh? I am 44: is that a “kid”? Also, I have not gotten any education free since I was 20, and have no health coverage, free or otherwise.

[SlackerInc]

@brickbacon

That said, I am sure that someone might get screwed by the whole thing, but the same can be said about nearly any legislation.

I am really getting screwed by it, as I detailed awhile back. Sucks.

[Werekoala]

I have no kids, and am getting to the point I likely won’t, so this might not be such a bad thing for me. Suck it, Gen Y+ - give me my money and quit yer bitchin’!

[yorick73]

@SlackerInc

So what you are really saying is that even though they can take the free money for three years and then quit, they will be unlikely to do so because they would find it too uncomfortable to cut off that service. Thing is, though: that is already what is going to happen to them. Under the old system (if we can call it that), the federal government provided hospitals money to care for the uninsured. Now, in states that don’t have the Medicaid expansion, that money will be gone. Hospitals in those states will have to reduce their staff, and some may even close.

And comparing this expansion to the regular program is ridiculous as the federal government’s leaves a much larger share (up to 50%) for states to pay.

The fact that states can drop the program probably has less effect than the fact that, should states continue with the program, they will be on the hook for 10% in a few years. Two points:

1.It is politically difficult or impossible to drop an entitlement once it has been enacted. Free money for a few years will soon turn into a liability for states even though the feds are picking up 90%

2. There is no guarantee that the feds will continue to pay 90% of the expanded medicaid program moving forward. Combine that with point #1 and you should be able to see why some states are concerned about costs over time.

Also, I’m not comparing the old and new program…I’m adding them together. States will have to add that 10% of the new program onto the 25-50% of the old program that is currently busting their budgets.

[SlackerInc]

@yorick73

I’m not comparing the old and new program…I’m adding them together. States will have to add that 10% of the new program onto the 25-50% of the old program that is currently busting their budgets.

Sounds a bit like the sunk cost fallacy. If they will keep “classic Medicaid” regardless, there is no more reason to add them together than there is to throw in the highway fund or the prison system.

[yorick73]

@Snowboarder_Bo

The part you missed is what this thread is about: health care. Specifically the PPACA. That’s the context of the discussion and, naturally, also the context of my remarks to Bricker. How is it that you don’t know what the subject of this discussion is?

I’ll say it again, in simple, short words: this thread is for people to talk about health care. The context of my post is the same as the context of the thread.

I don’t need to backpedal on anything in that post, since there aren’t any assertions made.
No, you didn’t say you weren’t interested; I posited it as a possible reason for your engaging me in this thread.

Let’s see…Bricker quotes Marx and you ask if we are, indeed, in this together…this country, our laws and the society we have. Yes, the thread is about health care but that doesn’t mean your response must be about health care. Clearly it was not. You are asking a larger question… are we in this society together or not? I shouldn’t have to explain this to you.

[yorick73]

@SlackerInc

Sounds a bit like the sunk cost fallacy. If they will keep “classic Medicaid” regardless, there is no more reason to add them together than there is to throw in the highway fund or the prison system.

I’m saying that if states participate they will end up spending more money in the long haul. My understanding is that the feds are picking up 90% of the tab of the expansion…not 90% of medicaid in its entirety. Is that incorrect?

[Fear_Itself]

@Wesley_Clark

A premium for an elderly person on the silver plan (2nd lowest) can push $800/month.

The elderly will be covered by Medicare, not Obamacare.

[Voyager]

@yorick73

I’m saying that if states participate they will end up spending more money in the long haul. My understanding is that the feds are picking up 90% of the tab of the expansion…not 90% of medicaid in its entirety. Is that incorrect?

Depends on the state. If today they are letting lots of their citizens go without health insurance, they will pay more. If they cover lots of their citizens, they will pay less.
None of this considers the impact of pressure on the health industry to be more efficient, which might reduce costs for everyone. We’ve got lots of room to cut costs, after all.

[Shodan]

@Fear_Itself

The elderly will be covered by Medicare, not Obamacare.

Yes, but a lot less, since Obama has said he will cut Medicareby some $700 billion to pay for Obamacare. So, if Obama were telling the truth*, that is an instance of Obamacare shifting the burden onto the elderly and off the younger uninsured.

Regards,
Shodan

*Pull the other one - it has bells on it.

[Fear_Itself]

@Shodan

Yes, but a lot less, since Obama has said he will cut Medicareby some $700 billion to pay for Obamacare.

Wrong. Another falsehood perpetrated by rightwing media.

http://thinkprogress.org/health/2013/06/11/2136371/gop-talking-point-medicare/

Conservatives regularly claim that Obamacare “cuts” Medicare, and will cause less seniors to enroll in private Medicare Advantage (MA) plans while forcing insurers to cut benefits. Now, the exact opposite of those dire predictions is occurring, as record numbers of seniors have enrolled in Medicare Advantage, according to a new analysis by the Kaiser Family Foundation.

Obamacare extends Medicare’s solvency by eliminating some $700 billion in excess payments that are made to providers that contract with private MA plans and reducing hospital payments in an effort to incentivize efficiency. By scaling back the MA payments, the law tries to bring MA spending more in line with the traditional, public Medicare program, which consistently comes in under budget even as private plans drive up costs. As the new enrollment data proves, those cuts — which began being implemented last year — haven’t had any adverse effects on enrollment or benefits while significantly strengthening the Medicare entitlement.

[YogSothoth]

I’m relatively young and I am 100% for Obamacare. Just being young and healthy doesn’t mean I can’t be struck with a sudden illness, and given that I already have to pay medical insurance, I might as well get some karma points out of it. Even if I didn’t have health insurance, I would buy it because you don’t know if you’re going to get hit by a bus tomorrow and need medical care

[ElvisL1ves]

Besides, if you don’t need much health care today, you will someday, and who will you ask to pay for it then?

The social compact is intergenerational, among its many aspects. We don’t have a society without it.

[SlackerInc]

@yorick73

My understanding is that the feds are picking up 90% of the tab of the expansion…not 90% of medicaid in its entirety. Is that incorrect?

No, that’s correct. My point was that it is disingenuous to oppose the expansion based on the combined cost of the expansion and the original program that they are going to pay for either way. It’s like if I say to my wife “hey, let’s get Netflix: it’s only eight bucks a month” and my wife says “but you have to have high speed Internet to use it, and we pay sixty bucks a month for that; so the total cost is really $68” (and, to my chagrin, she does in fact sometimes say things like this). Well, no: there is no chance we are going to cancel our internet service, so the actual *decision *is whether to spend eight bucks a month and get Netflix or not to spend eight bucks a month and not get Netflix.

@Shodan

Obama has said he will cut Medicare by some $700 billion to pay for Obamacare.

:mad: AFAIK, every Republican who has made this charge has voted for (or stated their support for) the Ryan budget, which contains the same exact $700 billion cut. Which makes this accusation about the most breathtakingly disingenuous, steaming pile of bullshit imaginable.