So let me get this straight. You are suggesting that the countries with lower infant mortality rates are somehow fudging their numbers?
This seems to go against the logic you are using. If a country were spending enormous amounts of money to save every live birth and/or keep elderly people alive would that not push the % of GDP costs for health care up?
That’s the point.
Many have different standards for reporting. The US uses the most rigorous standard. Supposedly all countries should use the standard but several don’t (it appears that most don’t actually - although I’m sure someone will be along to dispute that). The reasons vary from lack of technical resources throughout the country, different ‘origins’ of when to start counting age, and, apparently, just because.
Then a country with high HC/GDP ratio should also have very favorable outcomes. What am I missing?
Because you’re spending enormous amounts of money on something that won’t end well.
For example, let’s say it costs $10,000 for Bob to end his life in hospice but John’s family just won’t let go and John uses $100,000 in hospital and doctor care. They both die and John doesn’t live appreciably longer than Bob. John’s return on investment, if you will, is much worse than Bob’s. We spent much more on healthcare on John but didn’t get a better outcome.
It is an INEVITABLE consequence of what you did say. Remember “I’m interested in a true insurance product that allows me to decide what level of risk I’m willing to accept and living with the consequences of those decisions.”?
Suppose, for example, I’m a healthy 30-year-old with no particular risk factors, so I decide I’m willing to live with the risk of a heart attack. I purchase insurance that either doesn’t cover heart attacks or provides too little coverage for such an expensive event. Oops, I misjudged, and now I show up at the ER with an acute myocardial infarction. Should they treat me?
If they (you) expect me to live (or die) with the consequences of my decisions, then I get no treatment.
If on the other hand I receive treatment, then I don’t have to deal with the consequences. I got treatment, you got the bill. For someone with little/no insurance, the chances that you will ever be able to collect more than a few pennies on the dollar are essentially nil. There are no significant consequences for me for my assumption of excessive risk.
If you haven’t realized this “free rider” problem, then you haven’t thought very deeply about this plan.
As the uninsured person receiving care, I don’t face higher costs. You may try to bill me more, but I can’t/won’t pay it and you can’t/won’t be able to collect it. A bill I will never pay is not a consequence.
If I’m middle class, I file for bankruptcy and the bills go poof! If I’m below middle class, I just don’t pay, and you can’t make me. (And your proposed solutions are pointless. If I have no money, telling me I can’t extinguish public provider debt in bankruptcy does nothing. If I do have money, letting me pay said public provider bills and then go bankrupt on my credit cards and payday loans and other bills I took on to pay the medical expense merely shifts the burden around without making a dime’s worth of difference in the end.)
This isn’t just some small segment of society, either. By some estimates, 50+ million Americans have trouble paying medical bills each year, and two million will go bankrupt on medical bills.
Sure, it’s a significant driver. Look at the example earlier: the cardiac rehab after my heart attack isn’t counted as “emergency” spending since the emergency is over, but it’s still an expense the hospital/provider is stuck with until my treatment is completed.
Moreover, that’s just one example of how lack of insurance drives up costs. Consider prescription medications. A NerdWallet report, e.g., suggests that 25 million American adults will not take their prescriptions as directed solely because of the cost. Sometimes you can get away with skipping a dose here and there, and sometimes you can’t.
For example, I used to know a lady who stopped taking most of her medications, including her anti-dementia pills, every year along about September, when she hit the donut hole and couldn’t afford them, and then she’d start back up in January when the new plan year started. I say I “used to know” her; technically, I still know her, but she doesn’t know me anymore, and she is in a nursing home with late-stage dementia. (That would be a nursing home for which you and I as taxpayers are paying almost the entire bill.) Could she have stayed at home longer if she could have taken all of her pills as prescribed? What if?
Either we’re not reading the same reports, or I’m not finding what you are seeing. I am reading Neonatal and perinatal mortality: country, regional and global estimates (2006) [PDF] and Long-term trends in fetal mortality: implications for developing countries (2008); in neither of these do I find the assertion that the major developed nations were using different definitions of live birth or reporting differently as of 2006. Do you have page numbers or specific references?
zoo’s point is that if a country is spending enormous amounts of money to save every live birth, yes, that would increase health care spending, but it would also save more births. You’d expect to see better numbers, not worse ones, and that’s not what we see.
So since I didn’t say it you’ll just assume it and move on. Gotcha’.
Yes, they should treat you. You seem to just ignore what I actually say and then assert that I said what you wish I’d said.
Once again, you seem to just ignore what I actually say and then assert that I said what you wish I’d said. If you’re middle class, you just became poor. It’s a hell of a consequence. You don’t see too many middle class folks ridin’ around without auto insurance and opting not to take title insurance when they buy a house. There’s a reason for that.
I believe medical debt owed to public institutions shouldn’t be dischargeable - almost like a student loan. I think debt to practitioners requires some thought.
That truly is an amazing figure considering there were only 1 million consumer backruptcies in 2013 (cite). Generous estimates put the number of filings due to medical bills at around 50%. It’s unusual for a bankruptcy not to include other consumer debt, so for some (many?) of these filings, that new Lexus has something to do with it. I don’t think you should be able to erase debts to the public or debts guarenteed by the public via bankruptcy.
See above. And I do believe something should be done about prescription costs (ACA doesn’t address this in any meaningful manner anyhow). Unless your example is an unusual case, this is a Medicare issue.
Page 8 - the money line is “A number of studies in developed countries show that incomplete reporting of vital events varied between 10% and 30%.”
No. I now have a live birth with a much greater chance of not surviving compared to a normal live birth. It drives your mortality rate up.
Here we go again:
Round 3: SCOTUS to rule on HealthCare.Gov subsidies
I really, REALLY think that John Roberts doesn’t want to wade into this issue, but perhaps he is assuaging his other conservative underlings at the Court.
Hey, for reference, does anybody know how many times the Court had to rule on the constitutionality of Medicare? I’m honestly curious whether the ACA has had to endure more Court scrutiny than the latter program.
The Court is not re-considering “the constitutionality of” the ACA.
Now would be an appropriate time to use your legal expertise to explain the nuances.
That’s not what I said, though I admit I could have phrased it more clearly. Given that this entire case hinges on semantics anyway, that’s actually kind of funny.
This would be the third time that the Court has confronted the ACA. The first time was answered the philosophical constitutionality questions; the second time granted religious rights to corporations; and this time would be an interpretation issue.
My question is how many times did the Court have to examine Medicare? I’m assuming at least once to determine its constitutionality, but after that, how many - if any - additional Medicare cases did the SCOTUS have to hear?
Not on any employer plan I have ever seen. 20 years ago working at a local factory with the best insurance in town, it wasn’t as good as the current gold plans. My current plan is equivalent to a low end silver plan, and it beats every other plan I have heard about locally. If you really have an employer plan that is equivalent to a gold plan, then just thank the lord and hope they don’t figure out they can save money.
And this is an incredibly stupid and/or ignorant remark. I have a close friend that has 3 children. The second one was planned, the first and the third both happened while on chemical birth control. Even the best birth control methods are not 100% effective. It is possible to get pregnant while using an IUD or an implant. Even vasectomies and tubal ligation are not 100%.
Bricker will correct me if I’m wrong, but I don’t think Medicare was ever challenged because it’s structured like SS, and that was litigated already in favor of SS. Since ACA is nothing like SS and Medicare in its means, there were new issues that had to be considered.
Now the other part of your question, I’m sure Medicare cases go to the courts all the time. There are disputes over statutes and regulations all the time. This is no different. The ACA law was written in sloppy fashion so this stuff has to be litigated.
I only had one employer after I left the military and before I went out on my own (company had less then 500 employees). The platinum plan looks closest to what I remember of it, although the average deductible I’m finding on the internet seems a little higher (but that’s probably because it’s an average).
Quite a few large employers and unions have health plans that put “gold” plans to shame. Most of them are not happy campers about this.
And why is that my problem? What’s next - you had another close friend who decided that collision for her car was a little too high and dropped it just two months before a tree jumped out in front her?
I think this is worth posting. This is Jonathan Gruber talking about the Bill and the financing of it.
https://www.youtube.com/watch?v=G790p0LcgbI&feature=youtu.be
Gruber has been described as the architect of Obamacare. He certainly seems to have been influential in its construction.
http://en.wikipedia.org/wiki/Jonathan_Gruber_%28economist%29#Involvement_with_Obamacare
He’s describing politics.
It’s your problem because you live in a society. Sort of like how you pay for roads you’ll never use, or airwaves you’ll never listen to, or to educate children you’ll never have.
You’re not an island and you yourself mooch off others in countless ways. The interlocking web of mooching is what a society is.
No, he’s describing the Affordable Care Act. He’s also admitting transparency is bad for the financing and implementation of some bills. So, next time we try to find out the true cost of certain Government policies or programmes we need to remind ourselves that they are often designed so voters are unable not to find out the true costs. If its hard to find out the true costs its fair to assume its equally as difficult to find out the true benefits let alone the true cost/benefit ratio.
It’s also worth posting this the next time someone asks for a “cite” on the true financial cost of certain Government policies.
Isn’t it strange that what they have in common is taxes.