Republicans: Please Define Health Care Reform

[Euphonious_Polemic]

@magellan01

I had an accident and tore my ACL. With therapy and exercises I was able to get to the point where I could do pretty much everything except certain sports. I had the operation in order for me to do those things. It had nothing to do with work. Why should you pay the $40,000 it cost (there were complications) for me to be able to ski?

You post an extreme example to try to counter my point.

I would think it would be worthwhile to pay $40,000 up front to enable you to WALK and STAND so that you could hold down a job. This would be better than paying you welfare for the rest of your life.

ETA: This is often where you hear bitching about waiting lists under a UHC. If you need an operation in order to walk, you will get it much quicker than the same person who needs the operation in order to ski. In fact, if your case is extreme (ie you really only need the operation in order to ski race, and you’re pretty much OK otherwise), you may find yourself being told to pay for it yourself, and not use the public dime.

[Marley23]

@Shodan

It gets tiresome spoon-feeding you people, especially since you don’t pay any attention when I do.

You can lead a horse to water, but you can’t make him drink. Much the same is true about a jackass, especially for a party who chose one as their symbol.

You’re coming close to calling ElvisL1ves a jackass here. Please avoid personal insults when you’re not in the Pit.

[yorick73]

@ElvisL1ves

Reducing competition by eliminating competitors and competitive advantages is quintessentially oligopolistic.

You are assuming that this will be the case. So, yes, reducing competition will result in an oligopoly but that’s circular.

@ElvisL1ves

Huh? The competition would be between states, to offer the insurance companies the most profitable environment possible for them. There would be no incentive for them to reduce prices at all, just as there isn’t much now. Remember that their profits depend on minimizing services to patients, and that an individual rarely has an option anyway other than the single provider their employer contracts with. And, if they’re unemployed, effectively no option at all.

Certain states do not require insurance policies to cover many of the benefits of more expensive plans, such as dental and vision, free checkups, and, yes, sex reassignment surgery. The baseline will be the minimum coverage that can be provided, no question, but many people want to pay extra to have more covered. This is how insurance works.

I agree with you about a need to untether insurance coverage from employment. That alone would have a large effect on competition.

[CannyDan]

@John_Mace

No, it doesn’t because no, we don’t.

I think you are now stretching an arguing point that is purely semantic and serves no purpose beyond registering your objection.

We as a society require emergency care be provided to anyone who presents themselves at an emergency facility, regardless of ability to pay. So yes, in any realistically observable universe, this can be stated as a societal guarantee. Forcing the word “rights” into this debate just drags along a wealth of explicit and implicit baggage that does nothing to change the simple fact.

Providing only emergency care does not limit a patient to one single instance of care, even for the same injury. An emergency broken arm may have further complicating emergencies in the days and weeks after first treatment, so the same injury can cause a literally unlimited number of emergency visits. Even that ACL injury referenced upthread would receive emergency treatment. If that treatment was paliative and not reconstructive (“No expensive arthroscopic surgery for you! You get a wrap and some pain meds!”) then I can guarantee the patient will return, and frequently, with further emergencies from the same original injury. Same for the kid with sniffles that gets cough medicine and a brushoff, who goes home only to return in a week with pneumonia. Note that these people are also of high risk to become disabled because of their injuries and the less-than-optimum treatment they received. They can easily be turned from poor but productive citizens to homeless wretches, at further cost to society.

We as a society pick up the tab for this provision of emergency services, and for all of its consequences. It costs us a whopping insane amount. Look again at per capita costs in the USA versus any other first world country. We pay at least twice as much, for no better overall outcome.

So it is disingenuous to state that we have not societally agreed to provide for our less fortunate. What can be stated, and what can be debated, is the level of financial need at which public help is triggered, the kinds and amounts of care that will be publicly provided, and the means by which public help will be gathered and distributed.

A reasonable debate can be made about taxes, fees (including insurance premiums), single payer option, and much more. There have been a huge number of such possibilities, with permutations and combinations, proposed in the past several months of wrangling. Since it appears to the OP that the Republicans have denounced and rejected each and every single one of them, the OP asks if the Republicans have anything fresh to offer.

So far, except for the semantic exercises above, the answer seems to be

<crickets>

[ElvisL1ves]

@yorick73

You are assuming that this will be the case.

Based on precedent, yes. Would you really rather argue against precedent?

Certain states do not require insurance policies to cover many of the benefits of more expensive plans, such as dental and vision, free checkups, and, yes, sex reassignment surgery. The baseline will be the minimum coverage that can be provided, no question, but many people want to pay extra to have more covered. This is how insurance works.

As I already said, very few people have that option, and removing interstate barriers is not going to make it appear.

I agree with you about a need to untether insurance coverage from employment. That alone would have a large effect on competition.

That’s yet another thing the GOP has simply refused to consider.

[Desert_Nomad]

@Euphonious_Polemic

CHOOSES to get a job with no insurance?

So you are of the opinion that everyone with pre-existing conditions who is denied insurance simply has to CHOOSE to find a job with insurance? How is this going to operate country wide? I’m honestly baffled by how you think this is going to work?

Yes, how does this work? I own my own business. On the private market I have been declined by every insurer licensed in my state (more than a dozen of them) because of a pre-existing condition. I tried to apply as a group for 2 or 3 people.

2 people: $4,700 per month = $56,400 per year.
3 people: $5,400 per month = $64,800 per year.

This is very much beyond what 99% of the people can pay so I simply left the USA, employed a foreigner instead and spent $250K on an overseas property instead of one in the USA. In the end, America’s system losses… it loses employment and investment.

[Desert_Nomad]

@Sateryn76

I thought we were talking about employer insurance, not an individual policy. Did I miss something?

And, yes, I have. My family is currently covered under an HSA/catastrophic policy, which I put together completely on my own. Prior to that, I worked with both my employer and my husband’s employer re: insurance coverage.

Do you have any numbers about how many uninsured are turned down, after being hired, based on being uninsurable?

I am uninsurable (pre-existing since birth). As owner of my own company I can’t be turned down as a group, but they can charge any thing they like. I was told $4700 per month for my wife and I together. That is the same as being turned down.

Does anyone here actually pay $2350 per month for insurance?

Note that in the last 4 decades I have spent less than $10K on medical care related to my condition.

[Desert_Nomad]

@Bricker

I think you and your daughter are responsible for her heatlh care, not me. I’ll handle mine and my wife’s and my son’s.

Then you can pay for your own military defense too. I don’t even live in the USA yet I have to pay for your roads, and military (and emergency rooms!)

[The_Tooth]

@Bricker

I think you and your daughter are responsible for her heatlh care, not me. I’ll handle mine and my wife’s and my son’s.

If that’s your attitude, why should anyone else care what you want or do not want? Does anyone owe you consideration? Have you done anything to merit consideration from anyone but your wife and son?

I try to take your point of view and I arrive at the conclusion that cheaper health care would be good for me and mine, so it’s a good thing. This may be contrary to your ideology, but it’s your ideology, not mine, so it doesn’t matter.

[pinkyvee]

@LavenderBlue

Because as nearly as this American Dem can tell the Republican response is that of George W. Bush’s let them go to the emergency room when they’re sick variety.

Thank you.

I’m not a republican. I am a registered democrat.
I consider myself independent of either party.
I’m an American.

I started a thread about health care, way back.
It got zero responses.
I think it got zero responses because I did not attempt to place blame on any particular politician’s back.
Threads that start with an intention to bludgeon any particular politician or party are simply more fun, I guess.
http://boards.straightdope.com/sdmb/showthread.php?t=537189
As a recently retired primary health care provider, I have concerns about government control
Oversite is one thing, control & management is entirely a different matter…

“Discussion about sliding the meaning of the physician’s “hippocratic oath” sideways - toward the physician’s concern ought to be “greater good for society” rather than the good of the individual patient. This is truly debate worthy”

bon appetit

[Desert_Nomad]

@Sateryn76

She needs to find another job where she can get insurance. That’s all.

Only about half the jobs in my former (I moved out of the USA) state offer insurance. Easier said than done.

20% of children in Nevada have no insurance (that’s 100,000 kids)

37.2% of Nevadans under 65 have no insurance.

Where are all these people supposed to get insurance?

[pinkyvee]

@Desert_Nomad

Only about half the jobs in my former (I moved out of the USA) state offer insurance. Easier said than done.

20% of children in Nevada have no insurance (that’s 100,000 kids)

37.2% of Nevadans under 65 have no insurance.

Where are all these people supposed to get insurance?

http://www.insurenv.com/

[tacoloco]

@Sateryn76

I would assume, since a medical condition cannot be disclosed during hiring, it would be discriminatory for someone to be hired with insurance as a benefit, then denied that benefit after a medical condition is disclosed.

Are there any facts in evidence that indicate that someone who is considered to be uninsurable would, in fact, not be eligible for insurance through an employer?

The burden is on you to support your assertion that all someone who is considered uninsurable can just “get a job with insurance” and poof they’re magically covered.

[Desert_Nomad]

@pinkyvee

http://www.insurenv.com/

Shall I forward to you copies of all my “declined” letters? :rolleyes:

[yorick73]

@ElvisL1ves

Based on precedent, yes. Would you really rather argue against precedent?

What precedent? Did we try allowing insurance companies to sell across state lines and I missed it?

@ElvisL1ves

That’s yet another thing the GOP has simply refused to consider.

Is this a partisan issue? I haven’t heard either side suggest untethering insurance from employment. It is possible I missed this but do you have a cite?

[Kearsen]

@ElvisL1ves

…

And so may those things. So which set should we try first, hmm?

Because, essentially, your proposal is imaginary. Your party has refused to advance it or even consider it. Maybe you should try convincing the other party to include it and promise to support the package as a result?

The least intrusive of course. Now which set is that?

[ElvisL1ves]

@yorick73

What precedent? Did we try allowing insurance companies to sell across state lines and I missed it?

You did miss the part about the effects of deregulating the credit card industry, yes.

Is this a partisan issue? I haven’t heard either side suggest untethering insurance from employment. It is possible I missed this but do you have a cite?

It hasn’t been part of either bill discussed by this Congress, since it doesn’t fit well in anything but a single-payer approach, and that was never seriously a possibility.

@Kearsen

The least intrusive of course. Now which set is that?

The one we have now, which has failed us so badly.

[Kent_Clark]

@Sateryn76

So she’s completely able to work, but chooses to get a job that provides no insurance, knowing she’s uninsurable otherwise?

She needs to find another job where she can get insurance. That’s all.

@Bricker

I think you and your daughter are responsible for her heatlh care, not me. I’ll handle mine and my wife’s and my son’s.

Sateryn – forgive me for putting words in your mouth, but you seem to suggest that the solution to health care is that employers should make insurance available to their employees, and that a rational person concerned about health care should accept employment only from those organizations.

Does that mean you expect employers to provide health insurance? Since, under your solution, employers are the gateway to health care, should all employers be required to provide insurance? If so, how would you answer **Desert Nomad’s **concerns?

Bricker, since you believe my adult daughter should be responsible for her health care just like you are responsible for yours, does that mean you also are without insurance? If you do have insurance, do you feel that’s the best way to be responsible for your health care? If so, then would you agree that my daughter should also have insurance? If so, where should she get it from, since insurance companies refuse to sell it to her?

[Kearsen]

@ElvisL1ves

You did miss the part about the effects of deregulating the credit card industry, yes.

It hasn’t been part of either bill discussed by this Congress, since it doesn’t fit well in anything but a single-payer approach, and that was never seriously a possibility.

The one we have now, which has failed us so badly.

If you insist on being obtuse, the conversation ends here and now.
We are talking reform (which is evidently the same to you as leaving things status quo)

[yorick73]

@ElvisL1ves

You did miss the part about the effects of deregulating the credit card industry, yes.

Oh, so there is no competition among credit card companies? That doesn’t explain all those damn offers in my mailbox.