Wal-Mart, through it’s market share, could certainly negotiate a better deal for its employees that could you or I individually. I don’t think anyone could reasonably dispute that.
I’m not speaking as a representative of the Republican party or the tea party. If my statements are in conflict with their statements, then I disagree with either or both of them on my points. However, I don’t think that your arguments are accurate. IIRC, the GOP in anticipation of the Supreme Court striking down the entirety of the ACA (which as we know didn’t happen) were planning on enacting popular individual parts of the law, such as the one allowing 26 year old “children” to stay on their parents’ insurance.
There are some very good parts to the law. The bad parts, at least IMHO, outweigh the good ones.
The talk of the Republicans is cheap on this, their actions IMHO demonstrate that they would not be willing to even vote in the end for the good parts, (And many of those good parts depend on funding mechanisms that are condemned right now by them) what I think it was going to happen was to see proposals with the good parts go down in defeat; and people like you in the end looking like Bob Dole, that expected that good will was going to come from the current Republicans on this and other humanitarian issues.
For the current Republican party that is expecting too much.
This is the usual conservative nonsense. Insurance is about shared risk pools. That’s essentially what the whole concept of “insurance” is. The same way your auto insurance rates are determined by the records of the WORST drivers in your pool, men AND women, ACA simply puts men and women in the same pool. That’s all. If you want to childishly frame it as men paying for maternity care, fine.
I don’t know about any Scrooge Mcduck vault but I do know that healthcare premiums had been rising consistently (often in double digits) in the previous 11 years prior to ACA going into effect. Didn’t hear a word from our conservative friends then. They seem to be perfectly pleased as punch to pay increased cost so long as the govt is not involved but as soon as govt gets involved, you cry like babies. You’ll find no sympathy here for such lack of consistency.
Same point. Eleven years prior to ACA, premiums went up with no additional benefit. Nary a word from conservatives.
As I said before, auto insurance uses the traditional underwriting standards. If have have 8 DUIs, I will certainly pay more than a person who has a clean driving record. Sex is used as a discriminating factor. Young males will typically pay TWICE the amount of a young female.
Also, unlike health insurance, pre-existing conditions are not covered. Say you have a liability only policy and total your car. Good luck trying to sign up for insurance before going to the body shop. The boys at State Farm will have a hearty laugh over that one.
Yes, premiums have been going up for the last 11 years. Do you realize the huge technological developments in medicine since then? The new treatments are humbling. Things that would have been a death sentence 11 years ago now have treatment. But those treatments cost money. Where does that money come from? Increased premiums.
But those increased premiums actually pay for something: not dying. That’s a far cry from a man having to pay for the risk of him giving birth to a child.
Again, I have a list of about 300 genetic conditions that I will never, ever get. Where is my discount? And where are the limits? Can an amputee be excepted from limb condition coverage? Can all us adults drop coverage for childhood diseases? I’m not ever likely to be obese, can I not pay for other people’s bariatric surgery?
In the end, the insurance model is a pretty crappy fit for health care. In auto insurance, there is a pretty limited range of risk factors and a predictable set of things that can go wrong and associated costs. With healthcare, there are literally thousands of risk factors, some of them are genetic which opens up a crazy can of worms, the potential costs are nearly limitless and the range of things that may need to be paid for is huge.
But the health insurance industry, which adds billions in extra costs, has somehow convinced people to perpetuates a model that doesn’t work rather than the model that does work in other, similar countries.
But what about traditional underwriting practices? You’re very concerned about men having the same rates as women who get contraceptive coverage, but totally OK with healthy people having the same rates as (and subsidizing) someone who is terribly ill and will certainly require hundreds of thousands of dollars of care every year.
No, it’s not men who don’t need maternity or contraceptive benefits. It’s men who do not have a wife or daughter covered under the same policy who don’t need maternity benefits and contraceptive benefits- a smaller group than “men”. And even before the ACA , group policies did not underwrite to the extent that you’re talking about- I didn’t pay a different rate for having a son and a daughter rather than two sons or two daughters, there aren’t different rates for different numbers of children (sometimes there’s a “single plus one rate” lower than the family rate, but family rate is the same whether it’s three people or ten ) nor were there different prices depending whether my daughter was pre-or post pubescent, or a different price if I had already had a hysterectomy and therefore wouldn’t need maternity or contraceptive coverage and so on…
It’s possible non-group policies underwrote to that extent, but there come a point where detailed underwriting makes insurance worthless- if the only people I’m sharing the risk with are the small number of other people who carry the genes for an incredibly rare genetic disease, I might as well not have insurance at all.
You don’t understand! When certain folks complain because they will never, personally, need to pay for contraception or for an obstetrician, they ought to get off scot free. (I’m wondering if any of them are heterosexual, sexually active men–but that would be a rude question.)
But if the evil Obamacare has made them pay more for insurance & have fewer job options, we must feel empathy. (Some folks would berate them for making poor career choices–but I won’t.)
I’ll admit that I’m not familiar with how far underwriting was performed in the health care industry prior to the ACA. Perhaps it is not worth going to the extreme of scanning for genetic diseases or singling out amputees. It is certainly obvious to all people with a brain that men don’t need maternity care.
Yes, it will. But there was a widespread problem that was the product of existing law that prevented people with prior health conditions from getting insurance. Many of those people already had insurance with an employer, but couldn’t leave to start their own business because they would go without health insurance. Those people weren’t cheating the system; they bought insurance prior to their condition and were just wanting to switch coverage. They couldn’t do that; under my proposal they can. Remember I did say that there should be safeguards so that you can’t wait until the first illness crops up and then sign up for insurance.
Disagree. Yes, married men who share household expenses with their wives would not see a difference under the plan. (His premium increase is offset by the wife’s premium decrease). My only bitch was about a man who has to pay for his own policy that assumes he might give birth.
Your other statements are like even sven’s above. We take take underwriting to an extreme level where the cost exceeds the value. However an obvious thing like men not needing emergency contraception is very clear.
Why does the fact that a man might be heterosexual and sexually active make a difference in this debate? I might be a womanizing man whore who impregnates 5 women per week. That would make me a pretty bad guy, but it doesn’t increase my personal risk of giving birth to a child.
While every man may not have a wife, every man had a mother.
If you don’t pay for contraception, you are going to have a larger number of pregnancies which require pre/post natal care and delivery which cost much more than paying for the contraception would have cost.
If you don’t pay for pre/post natal care and delivery, you are going to have complications in home child births, birth defects, and childhood diseases that will cost a lot more than paying for the pre/post natal care and delivery would have cost.
If you don’t for the cost of complications in child birth, birth defects, and childhood diseases for your citizens, then you have no right to call yourself a developed country.
Paying for these things early saves everyone money later on.
As far as there being winners and losers, under ACA, I challenge the nay-sayers to indicate any piece of legislation that did not have a negative effect on someone. I don’t have kids but I’m glad that as a society where we do our best to give everyone a basic education, if for no other reason than it makes it easier to live here if the vast majority of people can read and write. Similarly I would like to live in a society where most of the people I encounter are vaccinated, and where if someone gets TB, or Ebola, they are likely to seek out medical treatment. Where the value of my house doesn’t go down because of healthcare related bankruptcies and foreclosures. But most importantly because by and large I like the other people who populate the country in which I live and I wish them well, and I don’t want them to be one bad accident or genetic quirk away from destitution. Humans long ago realized that working together as a unified group provides a better life than being a collection of individuals only asking what’s in it for me. If you don’t like it you can feel free to ostracize yourself, but don’t come whining to us when you find you aren’t as self sufficient as you think you are.
It’s equally obvious that a women who had a hysterectomy doesn’t need it, or that a man ( or woman who cannot get pregnant ) whose only dependents are sons doesn’t need it, or one whose only dependents are preschoolers doesn’t need it or … The difference is not in whether it’s obvious. The difference is that when you account for all the different reasons one person or another might not need particular coverages the whole concept becomes unworkable as insurance or any other sort of risk spreading- it becomes prepayment for medical care . And therefore you want to focus only on your situation - single men obviously don’t need maternity coverage, so they shouldn’t have to pay for it, but we don’t need to think about post-menopausal women who don’t need that coverage or women who don’t need coverage for prostate issues or people whose children have already had all their shots so they don’t need immunization coverage or people who will never get sickle cell so they don’t need that coverage . Nope, we should just make sure one particular group doesn’t have to pay for coverage they don’t need.
But it does increase the chance that you will benefit from those five women having contraception/maternity coverage. It is after all possible for child support orders to include payment for prenatal and postnatal care not covered by insurance.
That’s right. And it may make sense for auto insurance. Still you could argue that it’s behavior based given that men are more prone to have accidents or DUI’s or whatever. In healthcare, it would be strictly biology based. Women shouldn’t be charged more for a policy just because they’re women. Thus, remove gender consideration in setting policy standards.
You meant… Unlike health insurance ***AFTER ACA,***pre-existing conditions are not covered
Now THAT’S more of a rationalization than an actual reason. I mean, it’s not like “huge technological developments” have stopped since ACA went into effect. If you’re going to make that jump before ACA, there’s nothing stopping that being the chief cause of premium increases after it. But I’m sure no self-respective conservative would EVER deny premium increases are all about ACA.
What’s really happening is conservatives simply knee-jerk anything govt involved. No matter how irrational it ends up making them look.
Does every man have to pay for his mother’s health insurance? Assuming, arguendo, that contraception coverage should be added, shouldn’t it be paid for by those who need it?
First paragraph, we are still nitpicking about underwriting standards regarding coverage. Yes, we could talk about prostate issues and children. We also could decide that this type of underwriting costs more than it is worth. It is pretty simple to say that men don’t give birth.
As to your second paragraph, assuming that it is good that the law requires women to have such coverage, then I am protected against that. Remember, in this debate, we are only talking about what should be charged to insure an individual’s health. Women can have babies: that is a factor that should be included in pricing their policies. Men cannot have babies: that is a factor that should be included in pricing our policies. Yes, we can have sex with women and impregnate them with our seed. We have a responsibility to pay money for that.
It doesn’t follow that a health insurance policy written on my body should take into account that I cause another person to give birth who is required to carry insurance on their body. By existing child support laws, I have to pay for that. Making me pay for insurance (which she may not have in violation of the law, er, failure to pay the tax) has no connection to her giving birth. What if she has an abortion? What if she fails to get insurance as provided by law? Do I get a rebate?
I mean, the mandate didn’t specify that only because of my actions she must carry maternity coverage.
I’m not seeing your distinction between auto and health insurance. Yes, men are priced higher because of the propensity to do stupid stuff like get a DUI. The higher price isn’t for a malicious purpose, just for a realization that men do get more DUIs than women.
Likewise, in health insurance, women give birth to 100% of babies. Pricing discrimination is simply a realization of that fact and not due to any malicious purpose.
Your last point, again, assumes that I am a spokesman for conservatives or the Republican party. I’m not. If increases in health care premiums over the last year are due to technological advances, then I am not bitching about those. What I am bitching about a real, undisputed increases in premiums for males related to maternity coverage which gives them no real benefit (which was the initial point of my comment).
Re: link 1: Three out of the 4 stories in the link above are about patients not being able to see ***THEIR ***doctors because of their insurance company’s network restrictions. Networks are a pain in the ass, and hell, I’ve have problems seeing my own doctors when I had to change networks because of a job. But that’s nothing to do with “Obamacare” beyond these being plans on the exchange.
If I have a plan, and can’t see my doctors at the Mayo Clinic, but there are four other medical centers in the same city, is it true to say that I can’t find a doctor? No. It means that I can’t go to Mayo Clinic.
Re link 2: Insurance companies dropping expensive doctors isn’t news – they’ve done this for *years * as a way to save money. The blame should go to the insurance company dropping the doctors, not to the ACA; “Obamacare” has nothing to do with insurance executive decisions.
If anything, this underscores why we need single-payer universal coverage for all, with the caveat that all hospitals and physicians must accept that coverage. No insurance company games, no shell games with networks, no doctors deciding they don’t want to deal with Medicaid…none of that crap. You practice in the US, you accept US payment. End of story.
It is just as simple to say any of those other people don’t need those specific coverages. We can decide that we will either adjust premiums for all of them or none of them and since adjusting for all of them costs more than it’s worth we will therefore adjust for none of them. I don’t understand why it is exactly that you seem to believe single men shouldn’t have to pay for maternity coverage that they don’t need but everyone else can pay for coverages that they don’t need.
The higher price might not be malicious but it is punishing. You’re charging one gender more than the other. The distinction is that in auto it’s due to behavioral factors (men are more likely to drive recklessly) than by a consequence of mere birth (a health insurer charging women more essentially just for being women).
My assumption was due to your “liberal nonsense” remark. That aside, I can’t take seriously a group of people (conservative or whoever) who rationalize higher prices as A-OK when businesses set them all on their own without explanation or obvious cause, but raise holy hell when they feel govt is involved. It’s not consistent.
The point I’m making is that all future generation benefit by having the current generations women reproductive health covered, and the cheapest way to do it is to make it mandatory, so as to reduce the larger expense that would be incurred if women went without it. I assume that you believe that those with debilitating child birth defects should be able to get medical coverage.
Or come to think of it perhaps you don’t. Since you don’t have cystic fibrosis perhaps you feel that you shouldn’t have to pay to cover it. Of course the result of this would be that the cost of covering cystic fibrosis so there is no point in insuring it. Also those who don’t have high blood pressure shouldn’t have to pay for those who do, so lets drop high blood pressure from the list of things covered by insurance. While we’re at it we can do a quick gene screening of everyone and charge extra to those who are likely to be susceptible to certain diseases. Have a bad BRACA1 gene, whoops your insurance premiums just went up $10,000 a year, have huntington’s disease? don’t ask you can’t afford it.
But you know it could be even simpler. Let’s arrange it so that pay insurance only to cover those procedures you actually use in any given month. If break an arm you buy broken arm insurance. If you need chemo you buy chemo insurance. Of course the cost of broken arm insurance is equal to the price of treating a broken arm and the price of chemo insurance is equal to the price of chemo therapy. We can call this new plan “NO insurance” I’m sure it will be popular.
But getting back to reality, there was one primary goal of the ACA, was to prevent discrimination on the basis of pre-existing conditions, allowing the possibility those that needed health care the most would be able to get it. All other previsions of the law were the logical results of a workable system without pre-existing conditions. As it happens gender is a pre-existing condition. One that no one has control over. As such it shouldn’t be discriminated against any more than any other biological trait such as whites being discriminated against because they have an increased chance of skin cancer.
It’s also pretty wrong. Thomas Beatie was legally male, and listed on his health insurance paperwork at male, through four pregnancies (three live births and one ectopic pregnancy that necessitated emergency surgery).
Sure, his case is incredibly rare. However, in this brave new world of modern medicine, it’s no longer possible to say definitively that somebody defined by the law as male does not possess female reproductive organs that may require the attentions of an OB/GYN.
How would you price male insurance policies in light of his and similar situations?
On a personal note, my wife retired 5 years ago at age 55. I’m 63 and self employed. During the last 5 years before ACA we had a Blue Cross policy with a monthly premium of $408 for the two of us. A high deductible but that was our choice.
ACA kicks in. We do not qualify for any subsidies and don’t want any. Blue Cross advised us that our old policy did not comply with ACA and they mapped us to an equivalent policy that did. Premium… $1312 per month.
So we had to dumb down our coverage and now have a “bronze” plan with a higher deductible than before and a premium of $814 per month, double our old premium.
I want all American citizens covered but there must be another way. I have no problem paying my fair share increase to level out and allow existing medical conditions to be covered for everyone. John McCain wanted to send out a $5000 voucher to every family for health insurance. That was too simple.
Anyway, thanks Mr. President for screwing up our monthly household budget with the “Affordable” Care Act.