So you’d rather pay more and receive less service… just so you don’t have to pay for stuff you don’t want?
By the way, paying for stuff you may not need is pretty much the way insurance in general works.
Honestly, I really wish there was a way for people like you to just completely opt out of the system… as long as, when you do eventually need coverage and you can’t afford it, it’d be impossible for you to hit up the ER and make the rest of us pay to save your life.
I’m willing to bet, of course, that your response to my paragraph, above, will be “Great! Sign me up!”. Again, cutting off your nose to spite your face. There seems to be a complete inability for a lot of the GOP and Libertarians to prepare for the worst.
All politicians lie/distort. All government officials lie/distort. That’s a given. For example, Sibelius, in her testimony to Congress and in other statements keeps saying that there were “700,000 applications on healthcare.gov”. What she means, actually, is that 700,000 people applied for an ID to get into the site (maybe, she later said that she couldn’t be certain of the number). The impression she’s trying to create (as opposed to the truth) is that 700,000 people applied for a health care policy on the site. Not once have I seen it reported that she actually clarified the matter.
An insurance policy can be non-compliant simply because preventive services aren’t free. The presence of a co-pay for those services does not make an insurance plan crappy. Nor does an insurance plan that lacks contraceptive coverage, even if you use contraception. Consumers are supposed to be able to decide for themselves what insurance works best for them.
I said paying for stuff you’ll never need. So an insurance plan can be cancelled despite being a fine deal for both the consumer and the insurance company, but since it’s bad for a third party the administration wants to help, it’s non-compliant. But that’s not “crappy” insurance.
We can. There is no significant enforcement mechanism for the individual mandate. Millions will not comply. According to Pew, nearly a third of the uninsured have no intention of signing up. I’d bet many more won’t when they figure out how it affects their budget.
And that is the big stumbling block in any insurance reform. We are not willing to tell people, “Either do XYZ, pay for it yourself or die in the street.” So people will not do XYZ, can’t pay for it themselves and then count on us to pay for them when they need it. That’s why ACA is such a failure because those that don’t think they need insurance and then when they get hit by a car or stage-3 cancer people need to pay for them. The real solution is:
Control healthcare cost to the point that everyone (insurance and out-of-pocket) pays the same amount. Make true costs transparent so that the numbers aren’t pulled out of doctors/hospitals imagination.
Make health insurance true insurance. When my car gets hit, I pay a reasonable deductible and insurance covers the rest. Life insurance (no deductible), fire/flood/theft insurance is the same. So why do I pay for insurance AND sometimes partial costs of other services like $140 for an immunization and ingrown toenail removal. If there is a deductible like $500 per year, I’d have no problem paying full price than having everything covered rather than “I though that was covered.” or “Why am I being charged by the hospital and doctor?”
Individual mandate - Every American pays 2% of gross income to HHS (via IRS to make it legal according to CJ Roberts) minus documented health costs (insurance premiums + costs). For low income families this means zero actual payment. Everyone (like uninsurables) who choose can get insurance through HHS and if you do not have insurance, you still get life saving care paid by HHS but the Feds can sue you to recoup their cost plus penalties.
I generally like the President, and want to believe, but, no I think it’s clear he lied.
We want to have our cake and eat it too with Obama. He’s the smartest guy in any room . . . until it’s convenient for him not to be. And this is the case here. I find it impossible to believe that he wasn’t advised that due to the law hundreds of thousands if not millions of Americans couldn’t keep their insurance. I think he knew how this would play out. But he made the political decision that
“If you like the plan you have you can keep it”
would help him sell his plan and
“If you like the plan you have you can keep it assuming you have a policy that in fact does do what the bill is designed to do and meets will all the new requirements that we are adding to the law”
wouldn’t.
I think he made a political decision that he wanted to get the law passed and he’d deal with the political fallout in 2013 once there was nothing that could be done about it and he had zero elections in his future. In his heart of hearts he decided that the upside of the law overrode the downside of the lie.
This would be extremely complicated (even besides for the fact that Medicaid varies a lot on a state-by-state basis).
For one thing, Medicaid recipients pay no contributions, and there are restrictions on cost sharing (copays etc.). So it would be a lot more expensive than just subsidies for insurance. Unless you made different rules by income (these already exist but to a limited extent) which would complicate things significantly.
Plus, the amount that Medicaid reimburses medical providers is significantly below what private insurance pays - don’t hold me to this but IIRC it’s less than 50% on average (it varies by state). This amounts to a sort of hidden tax on private insurance holders - they are effectively subsidizing the doctors who accept Medicaid and the hospitals. The more you expand this, the less of a subsidy base you have and the more pressure you have to increase reimbursements, which would amount to speculatively reorganizing the market.
Beyond this, the current rules on Medicaid, in addition to varying a lot by state, are also unbelievably complex even within each state, with multiple categories of eligiblity and different rules for each one.
In sum, the only way to put all uninsured people on Medicaid would be to wholesale rewrite the Medicaid program, which would hardly be “the simple way”.
One of the core problems of the health care sector is that the key decision-makers don’t have enough skin in the game. If you have insurance which covers services, then you will ignore the cost aspect of your decision as to whether to use services. This makes sense on an individual level, but since someone ultimately pays, and since the economy as a whole doesn’t have enough resources for unlimited medical services, it is damaging in aggregate.
One reason for the move to High Deductible plans in recent years is the notion that if people had more skin in the game they would make more responsible decisions.
[In a single payer government system, bueaucrats make these decisions. In a free market system, people make the decisions. But at some point cost needs to be a factor, either way.]
It’s not comparable to auto insurance where an assessor determines the damage and that’s it. You wouldn’t want that type of situation WRT your medical care.
That’s because Medicaid is currently a state/federal program and states can’t be forced to do expand it, or even have it in the first place.
However, if it was re-federalized, the federal government could do whatever they wanted with the program, plus it would provide a nice short term stimulus to the states, since their budgets would no longer be burdened by it.
The feds would also have to cough up the 43% of Medicaid which is currently paid by the states. That’s quite a lot of long and short term stimulus to the states, but also quite a lot of short and long term cost to the feds.
Government cannot control cost in this manner, only price. The cost of something is unchanged by the mandated pricing. The only way to control costs would be to limit or ration services, or make those services actually cost less through innovation or efficiency. ACA was not sold to do those things primarily.
Maybe Obama did lie. Maybe he also lied about not wanting to include an individual mandate in health care insurance reform. It wouldn’t surprise me so much if that were the truth.
This is just another example of the ineptitude of Democrats. With the republican shutdown of government leading to their gigantic disapproval among the public, the Democrats should have a relative cakewalk in 2014 in holding onto the Senate and making gains in the House, and winning the presidency in 2016. But it’s shit like this that makes even a liberal like me look at republicans doing well and say to the dems “you brought this on yourselves and you deserve it.”
You have no idea how much it pains me to agree with adaher and the other conservatives here, but they are right on this issue. This is not a non-controversy like benghazi or umbrellagate. This is real and it will stick and if it costs the democrats elections, they will fully deserve it.
Let me throw this out there and bearing in mind I’m not simply talking majority but congressional districts, demographics, etc.
All those who think they benefited from ACA or have a low enough cost increase that it is worth it for the greater good vote Dem. All who think they are in a worse position under Obamacare vote Pub. Who wins the House in 2014?
Well, one thing I keep saying is, “govern well and you will do well in elections”. An opposition party can only do so much damage to itself, and by the same token, it can only do so much to help itself. In the end, Americans usually re-elect parties that govern well, and punish parties that don’t.
GWB was an unmitigated disaster. If he’d governed well, we’d be talking about John McCain’s Presidency right now. Heck, Obama probably wouldn’t have even bothered if GWB had left office with 60% approval ratings and bestowed his blessing on his successor.
And speaking of governing well, now we find out that security was one of the things that was not tested, and the administration was warned that this presented a significant risk:
For people putting their private information on the site to not be told this is unconscionable. Republicans could make a good case that people should not give any info to the site and it wouldn’t be sabotage. It would just be good sense.
The Democrats might take a bit of a hit over the ACA, but they got an important part of their agenda enacted. The purpose of politics is to get your agenda enacted, not to win elections. Sometimes you have to accept a bit of a tradeoff.
By contrast, the Republicans shut down the government, took a hit over it, and did not advance their agenda at all.
To the extent that “ineptitude” applies, it applies to the Republicans.