It isn’t complicated at all. It is just that it is completely regulated, quality controlled, tracked and constantly audited by the FDA. That is why you get $500 screws that look almost identical to the 5 cent ones at Home Depot down the street. There is also the constant threat of massive lawsuits that can and do happen. Everyone is doing the best that they can but some sick people die and some families want payout because 89 year old Aunt Edna didn’t make it to 90.
If Medicare was expanded so that it covered all ages, how much would the payroll deduction need to be? Currently the payroll deduction is 2.9% (employee and employer together) and covers people 65 and older. If anyone could get Medicare, what would the percentage need to be?
Alternatively, what if the government allowed people to buy “Medicare policies” at any age? So instead of getting a policy from Blue Cross, they could get it from Medicare. What would their premiums be?
Medicare isn’t the best coverage, so traditional insurance would still be used by many people. But Medicare might be a good safety net for many people if they couldn’t get a traditional policy.
Oh, hey, my plan wasn’t affected by the gol-danged gummint; I liked my plan just fine, and I got to keep it just like I was assured.
But all sorts of other folks got assured likewise, and some of them reported that they liked their plans but didn’t get to keep them, which on general principle I find to be roughly as objectionable as slander or false advertising or perjury even when I’m not the one being slandered or false-advertised-to or perjured-about.
I, uh, don’t always put things elegantly.
That’s fair.
But the question about who didn’t let them keep the plan still stands.
I’m sure you see the difference I illustrated.
:dubious: And you were promised that its costs would always remain the same? Really?
Mind you, I’m not saying that all the impacts of Obamacare were adequately understood, predicted or presented. I think there are a lot of legitimate reasons why some people are dissatisfied with some of the consequences. I’m just pointing out that there was never anything “covert” about the fact that it was going to cost money and the money would have to come from somewhere.
Well, yeah; as I understand it, some of them lost their plans because the government stopped allowing such plans. All apologies if I didn’t make that clear.
And, as numerous studies have consistently shown, it is complicated, and expensive, largely because of “the enormous administrative overhead costs that come from lodging health-care reimbursement in the hands of insurance companies that have no incentive to perform their role efficiently as payment intermediaries”.
In other words, Shagnasty, health insurance industry bureaucrats like you are a massive part of the problem. Not blaming you personally for just doing your job, but it’s the nature and existence of your job, and the inefficient way it interacts with all the other jobs like yours as well as the jobs of the people who actually provide and receive the healthcare, that makes healthcare in the US so costly.
Even factoring out the laughable hyperbole, you are dead wrong. But I won’t belabor the point.
Horseshit. 25 years ago, in Mass, everyone paid cash for prescriptions; today hardly anyone can afford them out of pocket. If they could, we wouldn’t need the ACA in the first place.
Humpy appears to be outraged that insurance companies can no longer deny coverage for existing conditions, for starters. That *has *to go.
If healthcare was provided as an entitlement rather than a forced purchase, yes I would consider that a much more desirable scenario. As it stands, the logic of the ACA has no limiting principle and the people could be forced to buy broccoli, or Ford F150s, or goods and services from only Trump owned business, else they be subjected to a tax penalty. That’s bad and should not be possible.
You’re “forced” to pay taxes to “purchase” government services. So what?
That’s a difference over which you’re willing to take health care coverage away from tens of millions of people who have no reasonable alternative. As stated, you’re making zero sense.
So that’s consistent with the constitution as it should be understood. Hopefully the new administration will make good on its promise and kill the ACA. Would you be okay if congress passed and Trump signed into law an act that forced you to only purchase services through Trump owned businesses and if you didn’t you’d be penalized with a tax?
Yes. If the people want it, they can do it as an entitlement.
No.
It’s analogous to the law that says you have to buy PRIVATE car insurance.
Some people erroneously think the ACA/Obamacare (two different names for the same thing, in case anyone here doesn’t know that :rolleyes: ) is a government health insurance program. IMHO it definitely would be better if health insurance were an entitlement paid for by taxes (like Medicare), but it is a law that makes people buy private insurance or pay a monetary penalty.
This was a compromise because the Republicans would not ever agree to a tax-supported health insurance program (e.g., Medicare for everyone) on principle. They do not believe it is the gummint’s job to give a shit about the welfare of its citizens. It’s every person/family for him/herself and if you don’t have the money or a job, fuck you.
The difference being … what? :dubious:
Providing it through private firms rather than the government matters more to you than getting real help to real people. Wow.
C’mon, man. :rolleyes:
I know *you *think you’re making sense. But you haven’t even paid enough attention to the Obamacare Is Evil party line to even quote it coherently.
The difference being it would be consistent with the constitution as it should be understood. If you don’t find that important that’s not surprising.
You’ve misunderstood. If healthcare for all were to be provided like Medicare that would not be treading new ground. And yes, principles matter to me.
C’mon yourself? I don’t think the ACA is evil in the slightest. I think it’s well intentioned but ultimately poor public policy. But you didn’t answer the question. Would you be okay to be forced to purchase Trump provided goods and services, and if you declined you’d be penalized with a tax? My guess is you’d be opposed, but you seem to avoid answering direct questions for some reason.
I’m a healthcare analyst. I live in Massachusetts; I’m originally from Florida. And I agree with you that the ACA didn’t work when it was rolled out nationally.
Because:
1.) Politics. The Republicans’ message was so negative and pervasive about this. The end result was many red states going with the party line and declaring, “We ain’t gonna expand no Medicare!” (Never mind the 50% uninsured population, half of whom are asthmatic, have cancer, or are pre-diabetics that make up the state. BTW, uncontrolled chronic health problems are bad for hospitals’ bottom line)
2.) Industry creativity – the pseudo-coverage known as “high deductible plans” do nothing to help anyone’s health, nor does it provide much in the way of coverage or security. And the creative tricks used to reduce coverage of medications used for standard care need to stop, too.Declaring every medication used to treat a condition “non-preferred” is fucking wrong.
And 3.), no one took on the drug companies. The drug companies have been coddled and allowed to run amok, and will never, ever have a conversation about how to combine reasonable pricing and making reasonable profits until America starts to import drugs from India.
To my mind, we need single-payer, universal coverage. Some form of universal coverage has worked in every westernized country, and serves to keep citiziens healthier by treating problems as they come up rather than when they are at the ER.
The infrastructure for single payer already exists with Medicare, which has been successful for fifty years. (Medicare also needs some updating; but that’s another post.)
Negotiations with drug companies so that epi-pens aren’t $600 a pop, and sixty-year-old drugs don’t cost $1200 per month. Import drugs if the pharmaceutical companies won’t negotiate.
Existing insurance companies can process claims (as they do for Medicare) and sell add-on plans to employers, to be employee perqs.
There are dozens of countries we can look at to analyze how to implement this, but I’d suggest one that was analyzed in this Commonwealth Fund report.
Nope. We’ve been over this only about 1,000 times but let’s do it again, just for you:
- States have plenary power. The Feds do not.
- You only have to buy insurance if you own a car and drive on public roads.
But most importantly:
- You only have to buy liability insurance-- that is, insurance in case you cause harm to someone else.
So no, it’s not analogous to states mandating car insurance.
I haven’t been following all of this conversation but I would like to interject here. No, I would not be OK with being forced to purchase Trump goods and services, and I would object strenuously to such a proposition. Yet OTOH, I live in a country in which all citizens participate in a universal single-payer health plan, and I have no problem with that whatsoever. In fact as you probably know, I’ve been arguing in favor of the Canadian health care model here (and elsewhere) for years. I’ll try to explain the difference.
And I now have a new perspective on the issue, too. I’ve argued for years about my personal observations on how my various relatives and friends, including very elderly ones, have been very well served by the single-payer system in Canada. I was fortunate in being healthy myself despite getting older and now being retired. That all changed two weeks ago. Two weeks ago I became a first-hand player in the health care system that I’ve praised for so long as a third-party observer. Two weeks ago the Canadian health care system saved my life. Literally. Via a costly procedure that I would never have been able to afford, nor would I have been predisposed to buy or been able to afford the kind of individual insurance that would have fully covered the cost. As hard as I’ve argued for this system before, now it’s personal.
Principles matter to me, too. My principles include a belief in a fundamental common social responsibility for health and human life and a compassionate perspective thereof. No snark intended, but I find it hard to imagine a contrary principle that has an equal moral imperative. Certainly the desire of wealthy individuals to hold on to as much of their money as possible is mere ideological persiflage compared to matters of life and death and the fundamental values of the society we live in.
Maybe in a sense, but, on a whole, I disagree.
As a citizen of the United States, if I cannot afford car insurance on top of my other expenditures (or simply don’t want to), I have no obligation to purchase it. I’m not expected to pay extra for that inability or disinterest. I just can’t have a car (which I don’t).
With the ACA, however, there is no “opt out”. It’s either buy the insurance or pay a penalty. It doesn’t matter if I refuse to go to a doctor or hospital in the first place or if I can’t afford it, I have no choice but to buy it or face a cash penalty. I’m forced, regardless of circumstances, to pay something.
There’s a big difference between “you don’t have to pay anything if you go without a car” and “you have to pay, regardless of whether you opt to go without healthcare”.