Hope your Cancer is in remission. Sorry to hear that. How bad is your debt situation? Is it a manageable payment, or is it something where you’re choosing which utility to shut off? Also, what type of insurance do you have? Is it through an employer or individual or something else?
Related to your Boston friend, I’m not a fan of high deductible plans, unless they’re coupled with well-funded HSA. But I realize not everyone gets that choice.
…these are questions that are unimaginable about basic healthcare anywhere else in the Western World. My mum just spent about eight days in hospital. Cost to us out of pocket? $6.00 a day for carparking when we went to visit.
“How bad is your debt situation?” Do you realize how mad that question must sound to people outside of the United States, in the context of a discussion about healthcare? We pay less than what you do for healthcare. On average other countries spend half of what the US do on healthcare. I don’t have to pay separately for health insurance. The district nurse comes to my house once a week to check on my mum. Pay nothing out of pocket. I had a pulmonary embolism a few years ago. Follow up visits every few months with the cardiologist? Nothing out of pocket.
If my little country with just under 5 million people that sits on the ass-end of the world can leverage our tiny economy in a way that we can pay half the amount of money than you do and not have to worry about our “personal debt situation” in regards to healthcare then it is most certainly possible for the most powerful and most richest nation in the history of the world to do the very same.
But it starts with people like you. You need to break out of your paradigm. You need to stop accepting that “the way that it is” is very close to “the way that it should be.” You need to decide that this is no longer acceptable. That the idea that you should go into personal debt for something like healthcare is simply madness. Is that something you are willing to accept?
No, it doesn’t start with people like me. You have no idea what you’re talking about, so spare me the condescending lecture.
I’m not part of the problem in this country. There’s a political party that has gone stark-raving mad, that has made it impossible to do almost anything to help average people when they’re in power. They are the problem, not people like me. I support what our last president, a Democrat, did to end the problem of the uninsured, which will make a big difference in the lives of millions. And if the ACA had been implemented as it was intended without Republican sabotage, we’d have almost no uninsured, and we’d be on the way to lowering health care costs. You high-minded people from other countries don’t realize how hard it was just to get the ACA implemented, and it’s helped 25 million people get insurance, which is no small thing. That’s far from accepting “the way it is”.
Single-payer will politically never happen in the US. And even if they tried to do it, our system of tradeoffs and backroom deals, and trying to please Republicans, would leave us with a kludgy mess of a “single payer” system. The last thing we need is a single-payer system that would leave us all at the mercy of Republicans, who would dismantle the first chance they get.
We should keep the basic system we have, and strengthen the ACA when Dems come back into power.
…of course it does.
Of course I do.
Was I more condescending than responding to a statement like “(my) co-pays and deductible have not been reasonable nor affordable” with “Is it a manageable payment, or is it something where you’re choosing which utility to shut off?”
Of course you are.
Did that political party just appear out of nowhere? By magic?
Millions of people didn’t vote for it?
The rest of the fucking world have to deal with the fact that your fucked up country somehow managed to allow a charlatan to become the most powerful person in the world. It didn’t happen overnight.
You can’t put the blame for this on the results of the last election.
From the outside looking in I can barely see a distinction.
Oh spare me.
Hey guess what?
I supported what Obama did the last time as well. Us “high-minded people from other countries” do realize how hard it was to get the ACA implemented. Which is why after all the hard work that Obama did to get the ACA passed you guys dropped the ball so much as to allow it all to fall apart.
In simpler words: you accept “the way that it is” is very close to “the way that it should be.”
The system of tradeoffs and backroom deals and trying to please Republicans is the problem. It is “the way it is” that you accept. If you hadn’t noticed: there is no “pleasing Republicans” (excluding never-Trump variants) anymore. The hypocrisy has never been so blatant. So why continue to "try to “please Republicans” when they are going to turn around, spit in your face and then lie to you and the people of America?
Again, this is the fucking problem. The ACA was the ultimate compromise. It actually worked. It wasn’t “socialised healthcare”. But it did the job.
And then the Republicans came into power they were determined to fuck it all up. And this leads into this:
Its a cycle.
The Dems will come back into power. Then they will loose power again. And the ACA will get weakened. Or if a bunch of smarter Republicans get into power then they will figure out a way to scrap the ACA all together.
This is fucking bigger than waiting to see what will happen at the next election.
I was at the recent Ministry of Justice Summit, where under discussion was the best way forward for the justice system in our country. Many things were talked about, including a complete reimagination of how justice is administrated, what it means for both victim and perpetrators, what it means for the future of prisons.
One person stood up and said to the Justice Minister “If you do this, then we will have your back. We will fight for you. We will be activists for you. We will support you. And we will keep you in power until its done.”
Do you know what you guys didn’t do for Obama?
You didn’t have his back. He fought for the ACA. He fought for a better America. And you let him down. Yes there was interference. Yes they played fucking dirty. But there was a clear and present danger to your nation at the last election and those that opposed that clear and present danger didn’t do enough.
So we come back to the cycle.
“Strengthening the ACA when Dems come back into power” is continuing the cycle. Because when the Republicans get back into power the very first thing they will do is to weaken the ACA. This cycle, this paradigm, is what you choose to accept. Thats my point.
You don’t have to accept this anymore. Literally seconds ago on my twitter feed somebody posted this:
What kind of fucked up existence is this? Half of all gofundme campaigns are for medical bills. Will that number change significantly if the “ACA is merely strengthened?”
You need to be thinking much bigger than you are at the moment. And you need to start acting. You don’t have to accept that “the best you can do” is to strengthen the ACA. You simply don’t. Maybe if you had Obama’s back then that could have worked. But you didn’t. The Trump regime and what comes after it aren’t playing games. They are playing to win. You need to push them out of power and then keep them out of power.
And if you are able to break the cycle and push them out of power and are able to keep them out of power: then why are you limiting yourself to bringing things back to where they were a couple of years ago? Why be at the mercy of Republicans?
just pretend your taxes went up and put the money in an HSA. or use the money from the recent tax reduction.
…would the money from a “recent tax reduction” pay for the $175/week for medicines to keep the wife of the person I cited in my previous post alive? Because apparently it didn’t. Would putting money into a HSA make nelliebly’s co-pays and deductible more reasonable and affordable?
One argument against UHC might pertain to quality control. Right now, we have a physician QC system in place based on a capitalist market dynamic, in the form of malpractice insurance. Poorly performing doctors see their insurance rates go up, eventually pricing them out of practice if their performance fails to improve. With Socialist UHC, the QC mechanism devolves upon federal bureaucracy which, as we all know, always performs worse than private industry in every endeavor.
Another concern might be peripheral cost-cutting measures. A government-based healthcare system has access to tools that are effectively unavailable to the private system. The Medicare central office might determine that a popular thing (e.g., bacon) causes health problems “disproportionate to its benefits” and should be restricted (with higher taxes or lower subsidies). Under UHC, the government might start to take away the things that make us happy in order to balance the books on health care, something private insurance companies simply cannot accomplish. The detriment or merit of such draconian actions is not entirely clear, but if it reduces freedom or interferes with the free market, we must assume that it is bad.
Yes. You can pay the HSA in the form of taxes or out of your pocket.
One has choices, one does not. You appear to need someone to act on your behalf.
Hey, um, hold on here a sec: can you detail the “hard work” that Obama did to get the ACA passed? Because my memory of that is lacking. I remember him saying “make it revenue-neutral – now, have at it”, cheering a bit from the sidelines and signing it proudly. He did almost nothing toward getting it passed, mostly just spectated.
Although, my memory could be faulty.
…that would be paying more money than you are at the moment correct? You are already paying more money than I do on healthcare, and your solution is to pay more money?
Can you explain how paying more money than you do at the moment into a HSA somehow makes co-pays and deductible more reasonable and affordable?
…yeah, that’s probably it.
Right, then, tell me what I missed. What hard work did he put into it?
I pay more and get more. so, thanks for playing.
…you could always try paying less and getting more like the rest of the world has decided to do.
Fortunately I don’t have to “play your game.” But for many that do, they can’t afford to pay more. Like the person who is currently on twitter begging people for $175 a week for medication to keep his wife alive. How does “playing your game” suddenly make that medicine affordable?
…if you hold the belief that all Obama did to get Obamacare passed was “cheering a bit from the sidelines and signing it proudly” then I don’t have a hope in hell convincing you otherwise. You believe whatever the fuck you want to believe: I have no interest in trying to convince you otherwise, the point is not material to the debate.
Thank you. My prognosis is pretty good but is complicated by the lupus. I am making payments to the hospital. My utilities are not about to be shut off, but if I get hit with any other major expenses, I’m in trouble. I have insurance through the marketplace. I’m very nervous about what may happen to those of us with pre-existing conditions, as high-risk pools would leave me high and dry. Actually, I’m pretty nervous about premiums going up. And I’ve been frugal. I scrimped to put money into an HSA. I’ve never traveled. I don’t own nice furniture. I’m well-educated. I’ve worked hard my whole life and until now, stayed out of debt. I’m proud and don’t want charity.
The problem with HSA’s is that the maximum contribution (about $3400 for individuals) is a lot lower than the deductible for high-deductible plans.( Like many people, my unlucky Boston friend couldn’t afford a lower-deductible plan. And a year after her cancer treatment, she fell and broke an arm and a leg–Chemo weakens bones–and had to spend three months in rehab.She was self-employed and couldn’t work.) In fact, the maximum HSA contribution is lower than max out-of-pocket expenses for many insurance plans. I felt good about having an HSA until I saw how quickly it was depleted and how much I owed in co-pays. And oh, this is rich: the hospital offered a discount if I could pay the co-pay in full before the surgery.
My situation is not as screwed up as the system is, and I’d know this even if I were wealthy and healthy. We keep trying to make a system work that really doesn’t, and we do so by scaring people into believing their taxes will skyrocket (Shh! Don’t mention the spiraling costs of insurance and healthcare!), the quality of their health care will suffer, and they’ll somehow find themselves living in the gulag archipelago.
[quote=“eschereal, post:327, topic:816997”]
With Socialist UHC, the QC mechanism devolves upon federal bureaucracy
[QUOTE]
Not in the UK. Quality control of individual doctors rests with the medical professional bodies. Quality control of organisations and their clinical management likewise rests with a national body of professional inspectors. Everything they do is publicly transparent. Neither inserts a pricing mechanism, run by unknown and unaccountable bean counters, as an extra and somewhat oblique/opaque signalling system. Would you replace driving tests with higher insurance premiums?
How so? As in your country, governments in the UK might well bring in measures to discourage things that are bad for health, and while it’s true that a handy measure is the extra costs to the NHS of the ill-health that is caused (and it is often compelling in public debate - transparency again), how is that “taking away” pleasurable things? We certainly don’t have people physically prevented from buying bacon, or sugary doughnuts or cigarettes, even if they face price signals through taxation or a lot of nagging from their doctors.
The free market is always and everywhere subject to interference, whether it be by manipulation from one or another party or by government regulation of things like safety standards, provision of information, anti-monopolisation measures, and so on.
OK, I’m sorry for your situation. I just wanted to get more understanding, and it sounds like your conditions were more expensive than your coverage was able to fund. Is your exchange policy a silver, bronze, gold? What’s the level you bought on the exchange?
I support more changes to the system to make it better. I think step one was the ACA. Step two is finishing implementing it as it was intended (all states expanding Medicaid, more states running their own exchanges, more subsidies so that middle class aren’t screwed on this, etc). I think at that point, more people would choose to go on the exchanges voluntarily, and over time, the system would shift away from employer-based to individual-based. There were parts of the ACA that were implemented specifically to control costs (ACO’s, IPAC, etc). I think over time, we could monitor that and adjust as needed.
HSA’s should be beefed up to make them larger if people wanted them. Singapore has them, and the government provides it if the person can’t fund it themselves.
The reason I asked nelllie about her debt situation was that I was trying to get an understanding of how bad the bills were hitting her. She brought up her situation, so I wanted to engage with her on that. It’s not condescending to ask for more information when people volunteer on this forum wrt their own lives, so stop pretending otherwise. You’re the one being condescending with your political lectures, as if people can snap their fingers and get Trump un-elected.
I tried to keep Trump out of office with my vote, and will do so again in 2020. Momentum is building in the country to throw him out, and potentially to flip the congress against his party in 2018. Stay tuned.
Finally, in that incredibly long, and rambling pile of nonsense, I don’t know how many times you used the F-word. But you might consider dialing back on that word. It makes you sound like a 12-year old who has discovered curse words, and is trying to impress his buddies.
People are fucking dying. I think some goddamned cursing is appropriate.