Indeed.
There is too much money being made to change it.
Profit from human suffering is an American tradition. Part of our exceptionalism, I guess.
My disagreement is your focus on “insurance” as the proxy to health care and your subsequent statement that you can’t segregate the two. I think that they are separable and I think that leaving the issue and it’s funding combined is a poor path to policy in any vein.
And this is emblemic of my disagreement, sir. It’s not that our system is wasteful because of the way it’s funded. It’s wasteful because no transparency and no accountability. Let’s go to imaginationland and say that every single person in the US is on an ACA plan at any level:
You pay something different than your neighbor based on nebulous rules about income. The companies that are competing with each other have to basically offer the same service with two to five areas of competition, most of which is simple price scaling and not based on insurance, but on care given.
So you, at any economic level above medicaid/medicare have to basically chip in 5000-10,000 dollars towards medical care, plus pay a premium, plus you have to know when things are covered (and thus you don’t pay directly) and when things aren’t so you can manage the upto $10,000 you have to spend.
This inefficiency is what drives that costs into batshit crazy territory. As I said, before, this doesn’t make it cheaper, it basically just enshrines the old system everyone thought was crap into law and gives a few additional perks (long term child insurance, pre-existing conditions, etc)
See, if health insurance was like car insurance: accident/catastrophe only, it would actually work. Embedding care portfolios into the insurance is where it veered into ridiculousness. If everyone paid their own way it would actually work as a free market. But no one does. Most large white-collar companies simply self-pay the medical costs of their employees. Unions get a bunch of money to manage health care funds, and all of this is abstracted from the end consumer of the health care.
An actual market-based approach might work. If we actually built it around that principle instead of building it around corporate cronyism. I, personally, think it should be a variation on the Canadian form of care where guidelines are given and each state can implement their own version that meet those guidelines.
But all of this is divorced of how we pay for it. We all know how we should pay for it: A simple percentage tax, most likely going to the individual states to manage whatever form of care that states works out as “best.”
An expert congressional committee? I’m sorry, but I simply don’t have enough imagination to think that Congress would hire some experts instead of taking a bunch of “Fact finding” junkets themselves. YOUR WHOLE PREMISE IS FLAWED 
Seriously, though, we don’t even need an expert committee (or junkets!). We have the internet. Most details of most other health care systems can be found online and something can be drafted by the law makers (which, I know, is a fairly foreign concept these days) based on what they find working best.
A $10,000 DEDUCTIBLE would make sense. But a 10K maximum payout? What’s the point of even having insurance in the first place?
It provides the illusion of insurance. Which is cheaper to provide than the real thing.
Sounds like a crappy plan to me. Of course when these people get an ACA-compliant policy and pay more for real insurance, they get to go on political ads and whine about how they got burned by Obamacare.
I’m single and unlikely to ever have kids, but the town I live in requires me to pay the same taxes as those people with half a dozen kids in the town’s school system. I somehow manage to cope with the injustice of this, albeit with the occasional grumble.
Your later statement that health insurance “might work” if it was like car insurance – i.e.- only for catastrophic circumstances – seems to highlight the huge disconnect we have in our discussion and our points of view. I have to more to say about that below, but here I’ll just point out that aside from the fact that I profoundly disagree with such a concept, this is the kind of idea that is inextricably tied to the traditional concept of what “insurance” is. So it’s you, not me, who is focused on “insurance” as a proxy for health care. My concept is that medically necessary health care should be regarded as a universal public service, and that has everything to do with how it’s funded.
No, you’re only hinting at what drives costs into batshit crazy territory and not really addressing it. The reasons are really fairly simple and are a direct learning from how other countries manage their health care systems. The reasons are twofold: (1) there is no systematic, uniform way to control provider costs, and (2) the fragmented system of private insurance, plus bits of public insurance and conditional assistance, leads to a costly system of enormous complexity and bureaucracy and paperwork. It’s been estimated that upwards of $350 billion a year is wasted on this bureaucracy. Not one penny of this actually contributes anything to health care, which underscores the idea that health insurers contribute exactly zero value to the health care system.
No matter how much you streamline the system, unless you have some form of de facto single-payer authority you will always have item (1), and because of that, you will also have item (2), because no matter how administratively efficient the system is, the insurance companies can only control costs at the point of service delivery and individual claim adjudication. Another way of saying this, which is a simplified by basically correct characterization of how this screwed-up overpriced system works, is that you’re paying a great deal extra for the “privilege” of having the insurance company come between you and your doctor and meddle with each and every health care decision in order to minimize their payouts. Any and all efforts to control abuses at this level and/or help the elderly via Medicare or those who can’t afford insurance just make the system even more staggeringly complex. Single-payer, by contrast, simply covers everyone and pays for everything unconditionally while contractually controlling provider costs, which not only makes it administratively simple but, ironically, cheaper. And that’s why the funding system matters.
Any market-based approach to health care fails before it’s even started, if one accepts (as one inevitably has to) that medically necessary health care is a basic human right in any civilized country.
I agree that some variation on the Canadian form of care would work, but I’m not sure if you understand the implications. It is indeed a system where there are federal guidelines and each state (province) can implement the system in its own way, but those guidelines are fundamental: the system must be universal, covering all citizens and legal residents, and it must not have any sort of co-pay or deductible or extra-billing for any medically necessary procedures. IOW, if your doctor says it’s medically necessary, there is no money involved from your point of view. The sorts of things that provinces have discretion over are things like whether premiums are broken out separately from general taxes, whether they are indexed to income, and some minor gray areas about what is covered and what isn’t.
I solved this problem by changing my thinking.
I now consider that I am paying school taxes to pay for the education I received instead of what my neighbor’s kids are getting.
They’re all your kids. The ones with a direct genetic connection, just more so.
“Lost insurance” in this article doesn’t mean that they’re uninsured. It means that that was the estimated number of people with non-qualifying plans.
I’m one of the poor, poor people constantly referred to by the right who lost my insurance plan, because my old plan didn’t meet ACA standards. I even had a premium increase (gasp). What isn’t noted is that my employer did the research and found us a new insurer – through a new line of insurance products created in response to the ACA and the exchanges – who gave us less of a premium increase than we’ve historically had in prior years. Also, we now have new insurance options, so I was able to select a platinum plan.
So yeah, I “lost” my insurance. And my out of pocket is now $24 higher a month. However, I’ll be saving thousands of dollars this year from the change in my deductible, co-insurance and the like.
Ok, I see three, including one from someone who supports health care reform. For the sake of intellectul honesty, I want to affimatiely state my main question was answered, and I got what I was looking for, and there are horror stories – though that still leaves the question of why Obamacare opponents aren’t promoting them much, and why they ones they are promoting so often crumble under examination.
Well, Obama shouldn’t have said it in the first place. That’s not my characterization of BigT’s position, I’m saying that myself; I wouldn’t call Obama’s bumper-sticker a lie, but there were some assumptions built into the statement that I suspect were handwaved for the sake of pithiness: that insurance companies would bring their plans into compliance rather than eliminating them, and that someone who likes their plan likes it because it provides the coverage they need at a price they’re happy with rather than because it isn’t evil Muslim socialst O666amacare.
Enrolled in what? In the Maryland exchange or in any insurance at all? Is it necessarily the case that all 13,000 people are now uninsured?
Also, are these numbers from the same source? Can one be sure that it’s an apples-to-apples comparison?
I solved this problem by thinking about what those kids would be doing if they weren’t required to be in school all day by state law. Fucking, doing drugs and throwing eggs at my house, essentially.
I solved this by thinking about how Society should work, and how I would want it to work, given my ideas about Justice, and Fairness and Opportunity.
Happy to pay for other people’s kids to go to school. This creates an educated society and keeps the little monsters busy.
Am not bothered if my taxes pay for people who can’t work, for whatever reason.
Want my taxes to pay to fix things, and to help people, and to maintain a World where I don’t have to worry about all sort of little shit that gets taken care of and people get opportunities they wouldn’t have if people like me weren’t paying for it.
“I like paying taxes. With them I buy Civilization.”
- Oliver Wendell Holmes
And yeah, I pay for insurance I’m not using, health and homeowner and car. It isn’t “I paid x amount, I demand x out of it, dammit!”, it’s “I pay against the chances that I’m going to need more out of it than I could ever have hoped to have paid in, because GOD HELP ME if that emergency comes up and I don’t have this to save me.”
That would depend on whether the 73,000 figure includes people who switched to new plans. That article isn’t exactly investigative journalism; it’s just verbatim reporting of one Republican’s complaints.
+1
Yes, but with two houses, damn it is expensive.
:rolleyes:
Five reasons Americans already love ObamaCare — plus one reason why they’re gonna love it even more, soon
"There’s a reason Republicans have been rushing to try and defund the Affordable Care Act before October 1, when major sections of the law take effect.
Republicans know what polls show — that most Americans don’t know what’s in ObamaCare, but when told what the law actually includes, a strong majority support the law."