# Affordable Care Act



## Freewill (Aug 17, 2015)

Due to life choices and circumstances we are losing our employer provided health care.  So I went to the healthcare.gov web site to look for plans.  What I found is this.

1.  The web site is extremely easy to use.

2.  The cost, while high, is not nearly as expensive as it was when I looked into it when ACA became the law of the land.

3.  Big penalty for making money and not having employer provided coverage.

Here is an example of what I found for 1 person first making 50,000 the second making 25000.  Which seems to me to be affordable considering that car insurance might cost as much.

What  I don't like is that the cost should be the same for everyone since it is required by the government to purchase.  In other words make it a tax deduction, if it is not already.

What I am going to call about is if I can sign up the wife for one plan, using her income. And one plan for me using mine.  I don't think this is the case.

Not cheap, but not as expensive as I thought and anyone should be able to navigate the site.  

Still, employer sponsored health care is far cheaper and better.


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## Taz (Aug 17, 2015)

Reduce your military spending to say the average of the next 5 top spenders, and everyone could probably get free health care.


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## Freewill (Aug 17, 2015)

Taz said:


> Reduce your military spending to say the average of the next 5 top spenders, and everyone could probably get free health care.



Nothing is free.  Try and do that and the expense will just go up. Look at it like a pie, cut one piece a little smaller and the other pieces will just get bigger.


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## Taz (Aug 17, 2015)

Freewill said:


> Taz said:
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Ex: Canada has practically no military and can afford free health care for everyone.


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## Freewill (Aug 17, 2015)

Taz said:


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Define free.  Who actually pays for it and how?


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## hortysir (Aug 17, 2015)

I have employer provided healthcare.
Problem is that it's the Bronze plan.

$4000 deductible, no doctor visit copay and, since I've only met about $1500, I had to cancel a back doctor and MRI appointment for today because I don't have $500 up front.

So that whole, "People won't be using ER for care" bullshit is just that.
I'll wind up going to ER, complaining of pain and numbness in my left arm. They'll think heart attack and admit me and I'll get my MRI


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## Freewill (Aug 17, 2015)

hortysir said:


> I have employer provided healthcare.
> Problem is that it's the Bronze plan.
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> $4000 deductible, no doctor visit copay and, since I've only met about $1500, I had to cancel a back doctor and MRI appointment for today because I don't have $500 up front.
> ...



Hopefully your Emergency Room visit co-pay isn't out of sight.  Which it might be with a bronze plan.


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## strollingbones (Aug 17, 2015)

last year i met the deduct out of the gate.....and got in debt over it...this year i have paid about 6 k....and will pay a few k more before the deduct is met...that is the big draw back....other than that ....its blue cross and blue shield...doctors take it without any problems....my son has insure thru his job and many doctors in this area do not take that kind.....


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## strollingbones (Aug 17, 2015)

o the co pay is outta sight...its the total bill till the deduct is reached


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## hortysir (Aug 17, 2015)

Freewill said:


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No copay for anything.
Everything goes to deductible


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## hortysir (Aug 17, 2015)

strollingbones said:


> o the co pay is outta sight...its the total bill till the deduct is reached


Mine is UHC so I don't have a hard time getting providers either. But....


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## LoneLaugher (Aug 17, 2015)

Freewill said:


> Due to life choices and circumstances we are losing our employer provided health care.  So I went to the healthcare.gov web site to look for plans.  What I found is this.
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> 1.  The web site is extremely easy to use.
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Employer sponsored health care seems cheaper to you because your employer is paying for most of it with money that he might otherwise be willing to pay directly to you. 

If you are like most people with employer sponsored health care coverage, you are only paying for about 1/3 of it out of your pocket. 

Triple your current premium and see if it is still cheaper.


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## hortysir (Aug 17, 2015)

What really sucks about being covered at work is that you're stuck.
Can't change or add additional coverage


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## strollingbones (Aug 17, 2015)

i know that being a diabetic and having bladder cancer.....no one is gonna touch me under private insurance


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## Seawytch (Aug 17, 2015)

strollingbones said:


> i know that being a diabetic and having bladder cancer.....no one is gonna touch me under private insurance



Except they have to now thanks to the ACA.


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## Freewill (Aug 17, 2015)

LoneLaugher said:


> Freewill said:
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Of course the cost is the same a person is just picking up the employer share.  Which isn't really true either because being able to buy insurance in a group is still cheaper then by person.  

Now, I say cheaper because if you don't take the insurance they don't give you anything in return, usually.  And if they do it is only a small portion of what they pay per person.  In other words the money that the company spends is transparent to the employee.  The company is actually negotiating a price for the employee.  Medicare is the same way, the price has already been negotiated.


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## Claudette (Aug 17, 2015)

Yup and everyone will be paying more for their benefits.  

My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?


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## strollingbones (Aug 17, 2015)

i am always amazed at how conservatives never got that private insurance companies are 'death panels'


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## Seawytch (Aug 17, 2015)

Claudette said:


> Yup and everyone will be paying more for their benefits.
> 
> My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?



And you can show how it was as a direct result of the ACA? Had your benefit costs ever gone up before?


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## Freewill (Aug 17, 2015)

LoneLaugher said:


> Freewill said:
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to answer your question, tripling our current premium is more expensive.  But then again it might be apples and oranges as to what is deductible and what is not.


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## Freewill (Aug 17, 2015)

strollingbones said:


> i am always amazed at how conservatives never got that private insurance companies are 'death panels'



There is no PUBLIC health care other then medicaid and medicare.  I am sure that there are limits on what they cover also.


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## Mac1958 (Aug 17, 2015)

Employers shouldn't have anything to do with health care.

Expanding the current Medicare/Medicare Supplement/Medicare Advantage program to all would take a massive monkey off the back of American business.
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## Freewill (Aug 17, 2015)

hortysir said:


> What really sucks about being covered at work is that you're stuck.
> Can't change or add additional coverage



i was wondering about that, can't you buy supplemental insurance?  I am thinking you can just like with medicare.


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## hortysir (Aug 17, 2015)

strollingbones said:


> i am always amazed at how conservatives never got that private insurance companies are 'death panels'


Amazing how liberals don't see that the ACA only benefit those same evil insurance companies.
Millions of new, forced customers


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## Mac1958 (Aug 17, 2015)

hortysir said:


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They are ideologically obligated to support it.


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## hortysir (Aug 17, 2015)

Freewill said:


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Maybe buy some little pay per day crap like aflac but no  real "plan"


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## Seawytch (Aug 17, 2015)

Mac1958 said:


> Employers shouldn't have anything to do with health care.
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> Expanding the current Medicare/Medicare Supplement/Medicare Advantage program to all would take a massive monkey off the back of American business.
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Make the age of eligibility zero. 

And it's not like Private insurance companies wouldn't still thrive. People with money always want more...so supplemental insurance can ride to the "rescue" and get them their private rooms and upgraded meals or whatever.


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## Freewill (Aug 17, 2015)

Mac1958 said:


> Employers shouldn't have anything to do with health care.
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> Expanding the current Medicare/Medicare Supplement/Medicare Advantage program to all would take a massive monkey off the back of American business.
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How big of monkey?  I am thinking you are saying, cost.  Say tomorrow all employer based insurance went away and everyone had to buy insurance on the marketplace, what do you think companies would do other then jump for joy?  They wouldn't give the employees a dime, they would keep the savings for themselves.

Don't believe me?  Companies are dropping employees from promised health care everyday due to retirement.  Unions are even agreeing.  When they do this does the company give one cent to help defray the cost they had previously promised to pay?  Hell not they keep the savings all for themselves.

That all said, I still think it would be better if everyone went on the marketplace and cost was evened out.


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## Taz (Aug 17, 2015)

Freewill said:


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General tax revenue. Like I said, Canada has almost no military, so it can afford it. It's a choice you make in society. The US is paying massive amounts of money to attack other countries (for no real reason), instead of paying for health care.


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## Freewill (Aug 17, 2015)

hortysir said:


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Well then what you need do is figure out how much you would be willing to spend on supplemental insurance, if available.  Then figure out your co-pays for the year and see if it is not the same.


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## Mac1958 (Aug 17, 2015)

Seawytch said:


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Exactly right.  It would open up millions of new customers to the insurance companies, plus the foundational plan would mean the insurance companies wouldn't have to deal with the basic, high-administrative stuff like doctor visits and simpler diagnostics.
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## Mac1958 (Aug 17, 2015)

Freewill said:


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Yes, taking the monkey off the back of American business would be a savings of both premiums and administrative dollars.  That's a positive in an increasingly competitive global business environment.
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## Freewill (Aug 17, 2015)

Taz said:


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So people do pay for their healthcare they just have almost no say in what that health care is.  I can go on the marketplace and select several different plans by several different companies.  Can they do that in Canada?  Are there co-pays in Canada?  Deductibles in Canada?  Maybe they are all Zero or is just the premium free?


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## Andylusion (Aug 17, 2015)

Taz said:


> Reduce your military spending to say the average of the next 5 top spenders, and everyone could probably get free health care.



Fail at math?   Medicare as it is, has trillions in unfunded liabilities.  It is actually worse off than social security.


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## Freewill (Aug 17, 2015)

Mac1958 said:


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So you are saying that Human Resource departments would be closed?

Premiums are based on the group.  If a company had a work force made up of nothing but under 30 employees their premium would be very low compared to a company whose work force is over 50.  Go to the healthcare.gov site, there are three questions they ask, Age, tobacco use, and location, that is it.  Of course then you need to sort through bronze/silver/gold and platinum plans.  A few more questions would be nice to determine the lowest cost plan.

I am all for throwing everyone in the same basket if it lowers primium for everyone.  But I am not going to do it just to give a company a windfall and screw their employees.  Health care is a benefit that attracts workers.


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## Taz (Aug 17, 2015)

Freewill said:


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You can also get private health care, and/or supplemental coverage (for a single room or other things like that). You pick your hospital, doctor, clinic... And doctors aren't as motivated by profit as they are in the US. No co-pays, no deductibles... And like I said, lots of private clinics as well for rich people... Unions...


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## Mac1958 (Aug 17, 2015)

Freewill said:


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I'm not anti-business, so we'll just have to disagree.

Profits, increased competitiveness and the growth they create are fine with me.
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## Penelope (Aug 17, 2015)

Andylusion said:


> Taz said:
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Too bad they stole from Peter to pay Paul. they an refund it.


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## Seawytch (Aug 17, 2015)

Mac1958 said:


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Personally, I think it will be the business community that drives us to a single payer healthcare system. We know we only get things in this country if Big Corp wants them and single payer is great for businesses.


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## Mac1958 (Aug 17, 2015)

Seawytch said:


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No doubt they're afraid that it would be true single-payer, and that's understandable.  

Plus, all the above would really mess with their infrastructure, and that's understandable too.  When Medicare Advantage came out, the participating insurers were given help with that, so that might be an option.

The freaking system is up, running, and works.  This whole issue is pretty frustrating.
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## Seawytch (Aug 17, 2015)

Mac1958 said:


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You're speaking of insurance companies being opposed to single payer, but the REST of the business community will be the driver of the US towards a single payer-like system. 

They will point to Canada, Mexico, Japan, etc and say "why should I do business in the US where I have to pay more for employee health care"?


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## Mac1958 (Aug 17, 2015)

Seawytch said:


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Yeah, I have no doubt about that.  The monkey off their backs in this system would be the size of an ape.

The insurance company lobbyists have been working overtime for a few years now.  But they might feel differently if a true Medicare/Supplement/Advantage system were dangled in front of them.
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## Billy_Kinetta (Aug 17, 2015)

Taz said:


> Reduce your military spending to say the average of the next 5 top spenders, and everyone could probably get free health care.



Non sequitur.  There is no "free".


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## Claudette (Aug 17, 2015)

Seawytch said:


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My benefits have gone up but not by 30% and the HR department is who advised all of us why costs were going up.

The only winners in the ACA are those the rest of us will be subsidizing.


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## jon_berzerk (Aug 17, 2015)

Freewill said:


> Due to life choices and circumstances we are losing our employer provided health care.  So I went to the healthcare.gov web site to look for plans.  What I found is this.
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> 1.  The web site is extremely easy to use.
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those are  not a very good plans


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## Taz (Aug 17, 2015)

Billy_Kinetta said:


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Free to the user, just go to Canada. Other countries as well.


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## Freewill (Aug 17, 2015)

jon_berzerk said:


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I picked middle of the road, want better, pay more.


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## Seawytch (Aug 17, 2015)

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So your HR department TOLD you that it was because of the ACA...but you don't know if that's actually true. A lot gets blamed on the ACA that is the fault of the same bad actors every time...the insurance companies.


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## Stephanie (Aug 17, 2015)

so can anyone Explain what's so AFFORDABLE about it and how about being FORCED by this Obama administration into having to PURCHASE it or be FINDED?

when was that ever the JOB of your Federal Government? Are we now Subjects of this Federal Government? a Free people to CHOOSE our lives was nice while it lasted?


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## jon_berzerk (Aug 17, 2015)

Freewill said:


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indeed 

just doesnt appear very affordable


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## Andylusion (Aug 17, 2015)

Taz said:


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No, its not free to the user either.   They pay more than double the taxes we do.   Funny how you think not having a few hundred dollar a month bill, in exchange for 40% of your income in taxes, is "free".


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## Andylusion (Aug 17, 2015)

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Back in the mid 2000s, I got a $2,000 deductible policy for only $67 per month.    That was an affordable policy.    Thanks to Obama care, those policies are illegal, and gone.


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## Freewill (Aug 17, 2015)

Andylusion said:


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Considering inflation I bet the price for YOU alone is not that much higher.


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## 2aguy (Aug 17, 2015)

Freewill said:


> Due to life choices and circumstances we are losing our employer provided health care.  So I went to the healthcare.gov web site to look for plans.  What I found is this.
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> 1.  The web site is extremely easy to use.
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Don't forget....it hasn't been fully implemented yet, and we still have Doctors......wait till it kicks in and it becomes cheaper for businesses to drop their health coverage, and Doctors start leaving the field, retiring or people just don't become Doctors.........


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## irosie91 (Aug 17, 2015)

*a copy and paste used by islamonaziette penny >>>>
“Jewish villages were built in the place of Arab villages. You do not even know the names of these Arab villages, and I do not blame you because geography books no longer exist, not only do the books not exist, the Arab villages are not there either…There is not one single place built in this country that did not have a former Arab Population.”– Moshe Dayan, from Ha’aretz, April 4, 1969

the above is a true quotation----it does fail to address the fact 
that there is not a single  shariah shit hole in the world that did 
not have a jewish population prior to the invasion and genocide 
thereof by muslims   (arab muslims of course---AND non-arab 
muslims-----the jewish villages and synagogues  are gone---
in many cases buildings including houses---simply confiscated---
cemetaries over built   etc-----*


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## Andylusion (Aug 17, 2015)

Freewill said:


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It is much higher now.  Massively higher.  I'm considering going without insurance.


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## Stephanie (Aug 17, 2015)

what's so great about a $5000 deductible? I remember when I was married our insurance was $2500 deductible. So basically you're now paying for everything OUT of pocket if you plan on reaching $5000 deductible.

and you could have done that without BEING FORCE to purchase insurance by your Federal Government


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## Freewill (Aug 17, 2015)

Andylusion said:


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67 dollars in 2000 is about 98 in 2015.

Single 20,000



Single 27 making 50,000


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## Freewill (Aug 17, 2015)

Stephanie said:


> what's so great about a $5000 deductible? I remember when I was married our insurance was $2500 deductible. So basically you're now paying for everything OUT of pocket if you plan on reaching $5000 deductible.



If I read the information right, you pay the co-pays until you reach the deductible then there are no co-pay.  Is that correct?


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## Freewill (Aug 17, 2015)

2aguy said:


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I am not sure why, with the way it is set up, that doctors will be leaving.  One thing might be the medicaid expansion.  But for those who are just buying insurance it seems to me to a be a windfall for the insurance companies and doctors.  More people with insurance the more business for the doctors.


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## Stephanie (Aug 17, 2015)

Freewill said:


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I have no idea,  as I'm healthy and I refuse to purchase something FORCED on me by this man, Obama. He's a President not my Nanny or my dicktator


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## Freewill (Aug 17, 2015)

Stephanie said:


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I go to the doctor once a year to hear that I am obese, which I don't think I am but the scale says otherwise.  Any way, do you have NO health care today?  If you do it works the same way.


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## Stephanie (Aug 17, 2015)

Freewill said:


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I pay out of pocket when I need a doctor. that's how I have always done it.


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## Freewill (Aug 17, 2015)

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So you have no health care plan?

If you pay for everything out of pocket then the deductible does mean anything to you.


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## Stephanie (Aug 17, 2015)

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no it doesn't. I did when I was Married. been single for 11 years and pay out of pocket.  but I was asking the question for all of you who is buying this Scam Insurance from Obama.


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## Freewill (Aug 17, 2015)

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Obama isn't selling insurance.

Are you going to pay the penalty?  I am sorry, are you going to pay the tax?


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## Claudette (Aug 17, 2015)

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Yup and they should know as they are the ones who have to navigate that POS system that the Dems have forced on we taxpayers.

If you want to believe they are lying, be my guest. Anyone with benefits from their employer is in the same boat I am. Higher costs because of the ACA.


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## Freewill (Aug 17, 2015)

Claudette said:


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How does the ACA increase costs for the employer?


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## bedowin62 (Aug 17, 2015)

*Health care premiums: Health experts see big price hikes for ...*
www.politico.com/.../how-affordable-is-the-affordable-*care*-act-1...

Cached
Politico
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May 30, 2015 - The *cost* of *Obamacare* could *rise* for millions of Americans next year, ... *Health* Advisors as she purchases *insurance under* the Affordable *Care*


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## g5000 (Aug 17, 2015)

Freewill said:


> Still, employer sponsored health care is far cheaper and better.



Employer sponsored health insurance is cheaper for *you *because your employer is paying the bulk of it.  But it is not cheaper.


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## Claudette (Aug 17, 2015)

They are passing the cost on to the employee's so my costs have gone up as have anyone with employer provided benefits.

The most common ways employers plan to deal with increased costs due to ACA are shifting costs to employees (53%) and encouraging participant health by increasing wellness and value-based health care initiatives (36%).


ACA s Cost Impact Employer-Sponsored Health Plans


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## bedowin62 (Aug 17, 2015)

*Health Insurance Costs Under Obamacare: Premiums To ...*
International Business Times - International Business News Financial News Market News Politics Forex Commodities*health*-*insurance*-*costs*-*un*...

Cached
International Business Times
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May 15, 2015 - *Health Insurance Costs Under Obamacare*: *Premiums* To *Rise* In 2016, Low *Costs* 'Unrealistic,' Blue Cross Executive Says. By Elizabeth ...


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## g5000 (Aug 17, 2015)

bedowin62 said:


> *Health care premiums: Health experts see big price hikes for ...*
> www.politico.com/.../how-affordable-is-the-affordable-*care*-act-1...
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The cost of health insurance has been rising faster than the rate of inflation for *decades*.  And during all that time, the Democrats have made it very clear what they would do if they ever got the chance.  From Ted Kennedy all the way to Obama, for the past 40 years they have made it very clear they intended to socialize medicine.

Despite the Democrats telegraphing their intentions, the Republicans never put a comprehensive health care reform plan on the table.  And when they owned the Congress, the White House, and the Supreme Court, what did the Republicans do?  They created a new massive trillion dollar government medical entitlement program, without paying for it.

And to this day, they STILL have not put a comprehensive reform plan on the table.

So whenever I hear the Republicans whining about ObamaCare, I laugh.  It's all theater for the rubes.   It should be blazingly obvious to everyone by now the Republican party sold us all down the river to socialized medicine.  I am positively gobsmacked there are still a multitude of rubes who have not yet caught on.


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## Freewill (Aug 17, 2015)

g5000 said:


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Yes it is.  It is negotiated with the insurance companies.  How much cheaper is dependent on how much those negotiating get a kick back, in my opinion.

Where I worked there was company based health care.  The union went out on their own and negotiated that they would handle the healthcare for their members.  They did get it cheaper and better.  So if they could then the company could have also.  But it seemed they didn't really care, except to cut people off.

As time went on though the insurance carriers realized that the union members were have health problems above average and they either wouldn't pick it up or the rates increased.

Groups have always been cheaper, if the groups didn't use healthcare.  Can you imagine what Medicare would cost if it wasn't for the government?


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## Freewill (Aug 17, 2015)

bedowin62 said:


> *Health Insurance Costs Under Obamacare: Premiums To ...*
> International Business Times - International Business News Financial News Market News Politics Forex Commodities*health*-*insurance*-*costs*-*un*...
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Do you think it a bit unfair to blame ACA on the rise in costs?  In my opinion the ACA was never designed to reign in health care costs.  Only to make health care insurance easily available and affordable to lower paid Americans.  

There is nothing I see in ACA to hold down prices.   When prices go up, someone always pays.  In this case it is those who can afford to buy health care insurance.


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## Andylusion (Aug 17, 2015)

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I'll look it up, but  I did not say 2000.   I said mid 2000s.   Meaning 2005 or 2006.

Moreover I got a policy for a friend, that was only $52 a month.

Additionally, it does not say $85.  It says $149 per month.


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## Freewill (Aug 17, 2015)

Andylusion said:


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The 85 dollars was if a person was 27, non smoker, and making 25000 dollars per year.  The 149 is if they were making 50000.


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## Andylusion (Aug 17, 2015)

Freewill said:


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That is not what it says.    Can you not read the fine print?


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## g5000 (Aug 17, 2015)

Freewill said:


> g5000 said:
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The insurance company has all the leverage.  A small employer has none, especially since the government geographically limits the insurance companies available to buy from.


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## Freewill (Aug 17, 2015)

g5000 said:


> Freewill said:
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That is true of small companies, I will agree.


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## Freewill (Aug 17, 2015)

Andylusion said:


> Freewill said:
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Are you talking about the fine print of "before tax credit?"  If so what is your point?


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## Andylusion (Aug 17, 2015)

Freewill said:


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Tax credit does not help me.   What is the dollar amount on my bill going to be?    That's the only thing that matters.


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## Billy_Kinetta (Aug 17, 2015)

Taz said:


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"Free to the user" is someone else's burden..

And frankly, I don't give a rat's ass what other countries do.  Why should I?


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## Taz (Aug 17, 2015)

Billy_Kinetta said:


> Taz said:
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Because you could learn from others how to do it right. But I'm guessing that you're not too good at sharing.


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## Andylusion (Aug 17, 2015)

Taz said:


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Yeah.   And who has done it "right"?


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## Taz (Aug 17, 2015)

Andylusion said:


> Taz said:
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Lots of countries, England, Canada, the Scandinavian ones...


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## Andylusion (Aug 17, 2015)

Taz said:


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Brit health care is terrible.   Canadians sued their government to get pay for service care, and routinely come to America to pay for better care.    Scandinavia varies, is often no better. 

All are models to not follow.


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## Taz (Aug 17, 2015)

Andylusion said:


> Taz said:
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All are models that are better than the US.


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## Andylusion (Aug 17, 2015)

Taz said:


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By what measure?

Wait times are years in those countries.   You'd rather wait years, instead of a few days? 

Survival rates are lower in those countries.   You'd rather have a higher chance of dying?

Care is simply denied in those countries.   You'd rather be told 'sucks to be you, good luck'?

Taxes are almost double in those countries.   You'd rather save a few hundred in insurance premiums, and lose thousands in income, capital gains, and sales tax?

Name one area, one measurement, in which they are better?

You have no idea what you are talking about.  I've been to Europe.  Been to their hospitals.  It's not the same.  Not even close.


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## jon_berzerk (Aug 18, 2015)

Stephanie said:


> what's so great about a $5000 deductible? I remember when I was married our insurance was $2500 deductible. So basically you're now paying for everything OUT of pocket if you plan on reaching $5000 deductible.
> 
> and you could have done that without BEING FORCE to purchase insurance by your Federal Government




there is nothing so great about a 5000 deductible even less  with an additional  5000 out of pocket per person


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## jon_berzerk (Aug 18, 2015)

Freewill said:


> Stephanie said:
> 
> 
> > what's so great about a $5000 deductible? I remember when I was married our insurance was $2500 deductible. So basically you're now paying for everything OUT of pocket if you plan on reaching $5000 deductible.
> ...



after what ever max *out of pocket* has been met besides the deductible


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## Sun Devil 92 (Aug 18, 2015)

LoneLaugher said:


> Freewill said:
> 
> 
> > Due to life choices and circumstances we are losing our employer provided health care.  So I went to the healthcare.gov web site to look for plans.  What I found is this.
> ...



You think you are covering the total cost of your insurance through Obamacare ?


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## Sun Devil 92 (Aug 18, 2015)

Taz said:


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Do it right ?

I'd love for someone to explain or define what "right" is ?

Taxing the crapp out of people ?


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## Sun Devil 92 (Aug 18, 2015)




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## jon_berzerk (Aug 18, 2015)

Sun Devil 92 said:


> LoneLaugher said:
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in most cases  the tax payer is footing a sizable chunk of the premium


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## Andylusion (Aug 18, 2015)

Sun Devil 92 said:


>



I saw that too.   Absolutely hilarious.

It illustrates two aspects of failed left-wing logic.

First, all leftists assume that everyone loves their policies.  Like Hitler in Germany, and like Gaddafi in Libya, and Chavez in Venezuela, they all routinely surround themselves with sycophants, and convince themselves that everyone else in the country loves them just the same.

So here's Krugman, and he steps out of his echo chamber into the rest of the world, and assumes every Canadian loves their health care system.   Not so much.

Second, he like all leftists, assumed that taking a poll matters.   If the majority says the moon is made of cheese, then therefore it is.     Just like Greece assumed if they had a poll against austerity, they simply wouldn't have austerity.

That's fail.   Canadians health care is bad.   Everyone in the entire country could say it's good all they want.  You could have a million polls, where people voted it to be good.   It's still bad.


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## Taz (Aug 18, 2015)

Andylusion said:


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I'm not even going to argue with you, you base your arguments on falseties. Thinking that the US system is the best is just absurd.


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## Taz (Aug 18, 2015)

Sun Devil 92 said:


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The US has enough tax revenue, you just prefer to spend a huge chunk of it attacking people for no reason instead of investing in your own people's health.


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## Billy_Kinetta (Aug 18, 2015)

Taz said:


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Theft is never "right", and if they are so right, why are they in even more trouble than we?

No, I'm not very good at involuntary sharing, at gunpoint.


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## Politico (Aug 18, 2015)

Sun Devil 92 said:


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Right is not calling an unaffordable 0olicy with a 12k deductible insurance.


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## Taz (Aug 18, 2015)

Billy_Kinetta said:


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You already share in all kinds of things: roads (some of which you help pay for but don't use), the military and their useless wars, supporting illegals... sharing to help your fellow citizens have access to health care seems to me to be a fundamental component of a just society.


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## Billy_Kinetta (Aug 18, 2015)

Taz said:


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Indeed, but roads and other infrastructure are necessary to the functioning of this society.  Aiding citizens is one thing - providing them with welfare as a default lifestyle is however detrimental to this society, and there is certainly no legitimate reason to take money from citizens by force and pass it to illegal aliens who've invaded simply because they know you people will do just that in order to one day secure a guaranteed majority.


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## Sun Devil 92 (Aug 18, 2015)

Taz said:


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You didn't answer the question.

Define what it means to do it right.


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## Taz (Aug 18, 2015)

Sun Devil 92 said:


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Covering everyone as a free public service.


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## doctordog (Aug 18, 2015)

Freewill said:


> Due to life choices and circumstances we are losing our employer provided health care.  So I went to the healthcare.gov web site to look for plans.  What I found is this.
> 
> 1.  The web site is extremely easy to use.
> 
> ...



the deductible and out of pocket are cheaper than my employer plan, however I checked my state and my premium was $1200/month but we are in the $150k bracket


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## Sun Devil 92 (Aug 18, 2015)

Taz said:


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Sorry, but that isn't what happens in other countries.

That is why private health insurance is still offered in places like Canada and Britain.

Covering everyone for everything is simply not possible.

But thank you for the definition.

I expected this to be the case...just wanted to make sure.


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## Freewill (Aug 18, 2015)

doctordog said:


> Freewill said:
> 
> 
> > Due to life choices and circumstances we are losing our employer provided health care.  So I went to the healthcare.gov web site to look for plans.  What I found is this.
> ...



that must be a gold or platinum plan.


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## doctordog (Aug 18, 2015)

Freewill said:


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No it was a silver


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## Andylusion (Aug 19, 2015)

Taz said:


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Everyone in the country, from the poorest impoverished beggar, to the richest corporate CEO, benefits from roads, and the military.

Health care harms one group, for the benefit of another group.

Moreover, the cost of the military and roads, is a tiny tiny fraction of the cost of blowing trillions on trillions on health care.


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## Andylusion (Aug 19, 2015)

Taz said:


> Sun Devil 92 said:
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And we can end up like Greece.  Not a good plan.


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## Andylusion (Aug 19, 2015)

Taz said:


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I made specific claims.  Can you disprove them... or not?

Sorry, but I base my opinion on fact.  You only say "that's absurd" as if that is evidence.

Can I use your 'debate tactic' too?    Ok, You are absurd, so I am not going to argue with you.     There, now you are absurd too.  Now what?


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## LoneLaugher (Aug 19, 2015)

Andylusion said:


> Taz said:
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"Health care harms one group, for the benefit of another group."

Take some time to think ebola about that typhoid statement, and AIDS I am sure that you will polio have a change of heart. Unless, that is, you think people who have the means to support for profit health care are immune to such silly diseases.


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## Andylusion (Aug 19, 2015)

LoneLaugher said:


> Andylusion said:
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The elimination of Polio was done on a capitalist free-market system.  It wasn't paid for by government.

One of the reasons that we constantly have vaccine shortages, is because it's not legal to make a profit on vaccines, and it takes millions of dollars to get approval for a vaccines.   It used to take 10 years of testing to even get a vaccine sent for approval.  I've heard that has been reduced a bit, but it is still millions of dollars.

Point being, government intervention has been more of a hindrance, than a benefit to health care.

I love how in 1990s, we increased taxes on health care research, and now everyone is pushing for more government research grants for health care.    How dumb does the left have to be, to think this makes sense.   Let's jack up taxes on the companies doing health care research, and then when research budgets shrink, give out government grants to make up for the money government taxed away.

Brilliant.....


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## LoneLaugher (Aug 19, 2015)

Andylusion said:


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Fool. You want your kids to play with a kid with some undiagnosed disease at the local Chuck e Cheese? 

The only way for you to be sure to avoid that is to provide preventive care to people regardless of ability to pay. 

In the end....this approach saves money and strengthens our nation. 

Get used to it......the good guys are winning.


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## Freewill (Aug 19, 2015)

doctordog said:


> Freewill said:
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Then you are a big family?


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## Taz (Aug 19, 2015)

Sun Devil 92 said:


> Taz said:
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Everyone is covered, private insurance is for rich people, politicians, unions... But EVERYONE is covered. And NO ONE has to pay a co-pay.


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## Taz (Aug 19, 2015)

Andylusion said:


> Taz said:
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"Health care harms one group, for the benefit of another group." WWHHAAAATTTT!!!!!!!!!! Health care heals everyone. Doctors take an oath not to harm anyone. On the other hand, wars kill people, destroy countries, homes, families... Geez, get your brain in gear.


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## Taz (Aug 19, 2015)

Andylusion said:


> Taz said:
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You already owe more money than Greece. WWAAAYYYY more!!!!


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## Taz (Aug 19, 2015)

Andylusion said:


> Taz said:
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You want one area where other countries are better? Canada hasn't instigated a war, ever. The US has been at war for nearly its WHOLE EXISTENCE! And just spent TRILLIONS attacking countries for no reason.


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## Andylusion (Aug 19, 2015)

LoneLaugher said:


> Andylusion said:
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Nothing I said, changes anything I said.

Moreover, if you look at places like Greece, diseases that we haven't had to worry about in 70 years, are coming back.   And unlike the US system, they have "free" health care.   Which would you prefer?


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## Andylusion (Aug 19, 2015)

Taz said:


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Now that was classic.   We're talking about health care, and I make specific claims that you couldn't even come up with a response to.   I point that out and here you are saying "Yeah well what about instigating war?!?".......   Are we talking about war on a thread titled "Affordable Care Act"?     If the title of the thread was "Affordable War Act", I wouldn't be mocking you right now.


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## Andylusion (Aug 19, 2015)

Taz said:


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   Yeah dude....   that's why I'm saying we need to stop before we end up with the crash that Greece has.

What exactly is your point?   Hit the gas, and crash into the ditch faster?


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## Taz (Aug 19, 2015)

Andylusion said:


> Taz said:
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Forget Greece, if that's all you have to compare yourselves to, you're in deep fucking shit! 
The point would be that you've spent your money attacking countries for no reason and other countries stay home and spend their money on keeping their citizens healthy.


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## Taz (Aug 19, 2015)

Andylusion said:


> Taz said:
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You asked "Name one area, one measurement, in which they are better?" And I gave you one. You want one specifically about health care? Canada and other countries cover all their citizens without forcing them to be at the mercy of HMOs... and pay through the nose.


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## Andylusion (Aug 19, 2015)

Taz said:


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You do understand the concept of "context" right?   Context is the idea of using preceding comments and statements, to understand the given text.

So when I ask a question, that was preceded by statements regarding health care, you should from that context, grasp that I am asking which measurement of HEALTH CARE, you would point to that the US comes up poorly compared to other nations.

The cost of health care, is not a statement of the quality of the health care.   I already asked you, would you rather have a higher chance of dying, or wait years for treatment, for the savings of a few dollars?

And equally, I already pointed out that the taxes in all those countries is double that of the US.

I don't spend $10,000 a year on health insurance.   Yet, under your "free" health care countries, I would have to pay at least that much in taxes, based on my income.

So would I rather pay several hundred for insurance, or several thousand in taxes... I'll take the much smaller insurance premiums.


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## Andylusion (Aug 19, 2015)

Taz said:


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Insanity is trying the same action over and over, and expecting a different result.

If you look at other countries doing the actions you advocate, and think we will have a different result by doing them here... you are insane.   A blithering incompetent fool. 

The amount of money we spent attacking other countries is irrelevant. It's drops in the ocean.   Most of the money, by a massive margin, that we have spent is all entitlements and social programs.

Moreover, the amount of future liabilities, the amount we owe for future benefits is all entitlements as well.


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## Taz (Aug 19, 2015)

Andylusion said:


> Taz said:
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You're defending a health system that no country in world would want to or has tried to replacate. MASSIVE EPIC FAIL!!!
Hint: The other countries cover everyone, your plan doesn't. BIG DIFFERENCE!


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## Taz (Aug 19, 2015)

Andylusion said:


> Taz said:
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Actually, the US should try NOT attacking other countries for no reason, that's what other countries do, and it works!!


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## doctordog (Aug 19, 2015)

Freewill said:


> doctordog said:
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no, two people


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## Sun Devil 92 (Aug 19, 2015)

LoneLaugher said:


> Andylusion said:
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Way to address his very valid points.

Such pie in the sky blathering is meaningless......

He just showed your statements to be bogus.

I am not against government getting involved at some level.  

I am against poor statements like yours.


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## Sun Devil 92 (Aug 19, 2015)

Taz said:


> Andylusion said:
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That argument is meaningless.

First, they can't try it in it's entirety.

Second, they do have private plans.  Now why don't you explain why ?

And tells us why that is the big fail too.


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## Freewill (Aug 19, 2015)

doctordog said:


> Freewill said:
> 
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could you give me a zip code?  I just do no think your coverage would be that much.


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## Freewill (Aug 19, 2015)

Here is something else I am not sure is fair and I think if we keep SCOTUSCARE it could be fixed.  I think if a health care insurance company offers any plan it is available to anyone.  For example, US steel negotiates a price for health care.  That price and plan would be one of the plans available to everyone.  Those without any sort of negotiating power are actually paying for those who do and those who do might also be some of the highest paid people.


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## doctordog (Aug 19, 2015)

Freewill said:


> doctordog said:
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My state is ky. That is all u need


Freewill said:


> Here is something else I am not sure is fair and I think if we keep SCOTUSCARE it could be fixed.  I think if a health care insurance company offers any plan it is available to anyone.  For example, US steel negotiates a price for health care.  That price and plan would be one of the plans available to everyone.  Those without any sort of negotiating power are actually paying for those who do and those who do might also be some of the highest paid people.



US Steel? Are you from Ecorse, Granite City, or Gary?


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## Taz (Aug 20, 2015)

Sun Devil 92 said:


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All the citizens in other countries are covered, free to the user, ALL OF THEM ARE COVERED. The U.S. system is still catching up to that humane concept.


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## Stephanie (Aug 20, 2015)

OScamCare is the LARGEST tax increase on us that also made your federal government tyrants and Fascist. look who it taxes. Now you see why MILLIONS of people want this POS repealed. lets hope it happens

65 BILLION ON those people who doesn't want to be FORCED by this government to PURCHASE something. wake up folks


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## Sun Devil 92 (Aug 20, 2015)

Taz said:


> Sun Devil 92 said:
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Covered with what ?

Not all of them are covered for everything.

Hence, you have a two tiered system.

This is not a humane concept.  It brings lots of issues that other countries fight with.  I am not saying it is bad, but I am saying it isn't all that others say it is cracked up to be.


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## Taz (Aug 20, 2015)

Sun Devil 92 said:


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K, so you don't know what you're talking about. Got it.


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## Sun Devil 92 (Aug 20, 2015)

Taz said:


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Sure.

And you explained why Canada has private health insurance.

Got it.


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## Andylusion (Aug 21, 2015)

Taz said:


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You must be joking.   Clearly you are either ignorant, or have your head shoved so far up your ideology, that you can't see anymore.

Canada, the public SUED THEIR GOVERNMENT... to allow Capitalist Free-Market health care.

Now when people are SUING to get the ability to pay for health care....     When they supposedly get it "free".... that's a bad sign for socialism.

And when you look around the world, the less 'free' and more 'capitalist' the system is, the better it is.  Germany, the vast majority of the country has pay-for-service private insurance.

In the UK, they have the highest rate of "medical tourism" in the world.  What is Medical tourism?   It's when you live a country with socialized "free health care" and yet choose to fly to a different country, and PAY for health care there.

And by the way, what hospitals do they go to in those countries?  The government funded socialized hospitals in India?  No, they go to the pay-for-service Capitalist hospitals.

Over and over.... people might "say" they like their socialized health care system, but in reality, they vote with their feet and their money, for capitalist hospitals.


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## Taz (Aug 21, 2015)

Andylusion said:


> Taz said:
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Ancient history. Plus, nobody in Canada ever lost their house because they got sick.


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## Andylusion (Aug 21, 2015)

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How is it more or less "humane"?

You act as though sinking the rest of the country in massive oppressive taxes, dooming people to work hundreds of hours just to pay the government, and live in poverty, while people wait on multi-year waiting lists... is somehow "humane".

The fact is, anyone can get any health care they want in America, provided they pay for what they get.

Is 100% "coverage", while being forced to wait years, or leave the country to get health care, a positive development?

Again, you keep talking like getting "coverage" is the same as getting "health care" it is not.   Do you really want to avoid paying a bill so bad, that you are willing to risk your life?


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## Andylusion (Aug 21, 2015)

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Yeah, they might have lost their life.      How is that a win?

The whole reason they sued to get capitalist pay for service health care, is because people were dying.

Do you really think keeping your house, while you are buried 6-feet down, is a good trade off?


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## Taz (Aug 21, 2015)

Andylusion said:


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Ok, I'm done here, you have no clue. Have fun.


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## Sun Devil 92 (Aug 21, 2015)

Taz said:


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No, you simply have no argument here.

You were done before you started.


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## Andylusion (Aug 21, 2015)

Taz said:


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Dude, you've been done for a long long time.  You just didnt' know it.   You can't argue the facts.   The facts are on our side.  The waiting lists are on our side.   The recent VA scandal, is just another example of socialized care.   Every possible method of measuring health care outcomes, is on our side.

You have NOTHING.  Never did.... and at this rate... never will.   At least you finally figured it out, and stopped talking.

Until you show us your system working......    You are done here.   Have fun.


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## Luddly Neddite (Aug 23, 2015)

_"You act as though sinking the rest of the country in massive oppressive taxes, dooming people to work hundreds of hours just to pay the government, and live in poverty, while people wait on multi-year waiting lists... is somehow "humane".

Is 100% "coverage", while being forced to wait years, or leave the country to get health care, a positive development?"
_

Andylusion describes exactly this:


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## Andylusion (Aug 23, 2015)

Freewill said:


> Here is something else I am not sure is fair and I think if we keep SCOTUSCARE it could be fixed.  I think if a health care insurance company offers any plan it is available to anyone.  For example, US steel negotiates a price for health care.  That price and plan would be one of the plans available to everyone.  Those without any sort of negotiating power are actually paying for those who do and those who do might also be some of the highest paid people.




Union: U.S. Steel wants workers to pay up to $9,600 per year in health care costs

I'm not sure what you are talking about.    US Steel has no more negotiating power, than any other business.   All businesses shop around for health care, and there is nothing special that I can find about US Steel.

Do you have some example we can look at?

I also don't know what you are talking about with 'those without negotiating power are paying for those who do'.    The only people who are paying for other people, are private patients are paying for gov-patients.

Obama care doesn't do much, but what it does do is increase the number of gov-patients, at the expense of private-patients.

*If you really want negotiating power......*

The way to get real negotiating power is to completely deregulate the entire market.   No mandates.  No regulations.  No controls.

Allow anyone to open a medical school.
Allow anyone to open a clinic or hospital anywhere.

The cost to become a doctor will drop.   The cost to open a clinic will drop.   The cost to open a hospital will drop.   The duopolies will disappear.

Eliminate the tax credit, and mandates that tie health care to businesses.    This will move people into the open market, where insurance companies will be forced to compete for customers, and the customers will be the actual patients, instead of the business.

*So I checked into the gov care.  * I filled out my information, clicked on get quotes.  Nothing came up.  New window, asking for my information.   Put in my information, clicked on get quotes.   Nothing came up.  New window asking for my information.    Next thing I know, I have a dozen phone calls by insurance agents, trying to sell me.

Turns out, I don't qualify for government health care.  See, I work for a living.  I'm not a public leach.  So the government doesn't help people like me.  They tax people like me.  I get up every morning at 3 AM, and therefore I'm the one who has to pay for everyone who doesn't.

The web site had switched me over to private insurance sites, which is why I had to enter all my information over and over.   Those sites forwarded my information to insurance brokers, which started spamming text messages and phone calls to my cell phone.

If this is your idea of a good system, I think you are nutz.


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## Greenbeard (Aug 23, 2015)

Andylusion said:
			
		

> Eliminate the tax credit, and mandates that tie health care to businesses.    This will move people into the open market, where insurance companies will be forced to compete for customers, and the customers will be the actual patients, instead of the business.



The sentiment is right, but the execution won't work as you suggest.

We've seen pretty clearly over the last few years that a well-functioning market will indeed put intense pressure on insurers to attack underlying cost drivers to compete for customers. The result has been a surprising (and heretofore largely absent) emphasis on cost containment, including more individual responsibility to be price sensitive at the point if service. That's good.

But that's only been the case because these insurers are competing head to head in a transparent, structured marketplace. If we were to totally deregulate, as you suggest, that goes away. The incentive is no longer to attack the underlying cost drivers in the system, it's to be most creative in keeping people who actually need health services out of your risk pool. Restore the opacity and the Byzantine structure of the old "market" and the game goes back to finding ways to hide or shift the costs, not address them. Innovation is aimed not at getting a handle on ever rising health costs (as is the case in the new marketplaces now), but on making them someone else's problem, usually the public at large. The insurers once again become advantaged over the would-be consumer.

Moving more people out of group insurance and into the competitive marketplaces that exist now would likely be a good thing. But dumping 150 million more people into the old individual insurance markets that _used_ to exist would be a catastrophe.


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## Andylusion (Aug 23, 2015)

Greenbeard said:


> Andylusion said:
> 
> 
> 
> ...



No, I would disagree with you.

*First, having a "structured marketplace" is a great way to drive up costs. *   The only way that small companies can ever compete with large companies, is by designing products that work outside the box.   By forcing everyone into a "structured" box, you eliminate the ability for companies to make competitive products.

This is why many of the big insurance companies are now generally supportive of Obama Care.  It eliminates competition, which allows them to raise prices.

You don't see a government controlled "structured marketplace" for office supplies.   And shockingly, office supplies are extremely cheap.

*Second, the entire problem we've had in health care, has been directly because of this enforced 'structured marketplace'.*    The whole reason we are where we are, is because we've been doing your line of thinking.

There are only about a half dozen Emergency rooms in Columbus Ohio.  Of those, there are actually only four total providers.  Riverside Methodist, Mount Carmel, Grant, and OSU University Hospital (which is terrible gov-care).

In an area of 2 Million people, why are there only a whooping four Emergency Health care providers?

Because government controls that market.  If you and I got together, pooled our money, got some investors, and tried to open an Emergency Room service.... we couldn't do it.  The government prevents outsiders from competing.  It's called 'certificate of need'.   Its a method to have a "structured market".  You can't just let anyone into the market!  That would be chaos!

Then you complain about health care costs being too high.

We saw the same thing with SouthWest Airlines.   The government prevented SouthWest from expanding their service for decades.   Why?  Because we can't have an unstructured marketplace.   Of course every place that Southwest was able to expand to, ticket prices dropped.
*
Additionally, the insurance companies make special contracts with health care providers.*  Because they only need to make a contract with three health care companies, and they have a lock on the market.  They have a monopoly.

That couldn't happen if there were dozens of health care providers.  But when there are only three main providers, it's easy to get a lock on the market.   And when government prevents new providers from getting into the market, it's easy to have only a few main providers.
*
Lastly, you mention correctly that when business competes for customers, there is a pressure to lower price.*  While that is true, you don't seem to get that our system removes customers from the equation right at the start.

Again, this 'structured marketplace' by it's nature removes the patient from the feedback loop.   When you get insurance through your work, which is required by the government regulations and mandates, who is the customer?    Are you the customer?   No.  You are actually not the customer.   You didn't determine what plan you had.   Your company did.

Your company is the only customer that the insurance company cares about.   Once the insurance company signs a contract with the business, you have no choice in the matter, and they know that.    Again, they have a monopoly over you, thanks to this "structured market".

In a completely free market, where insurance is not tied to your employment, the insurance companies, and the hospitals, clinics, and doctors, would all have to compete for YOUR business.   Not your employers business.

And we haven't even gotten to how Medicare and Medicaid drive up the cost of health care directly.

The point though is, a transparent market happens naturally, if the market is free of regulations.   It's only in the highly regulated and controlled market (structured market), that you end up with system we currently have.


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## Billo_Really (Aug 23, 2015)

Here's the reality of the ACA...

It has made more people accessible to healthcare.  There is a marked increase in ER patients. In-care patients.  This is causing "all" hospitals to increase their bed capacity, ER capacity through modernization projects.  And for people like me, that's a good thing!

Modernization projects need engineers and architects to design the tenant improvements.  There is no better patriotism one can show to this country, than contributing an increase in the construction industry.

God bless you, ACA.


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## Greenbeard (Aug 23, 2015)

Andylusion said:


> *First, having a "structured marketplace" is a great way to drive up costs. *   The only way that small companies can ever compete with large companies, is by designing products that work outside the box.   By forcing everyone into a "structured" box, you eliminate the ability for companies to make competitive products.



You're latching on to an adjective, not the actual content of my post. Without transparency, the ability of consumers to make apples-to-apples comparisons of competing products and send clear signals, and basic consumer protections there isn't a market. It becomes the same risk-shifting shell game it used to be, with no incentive to tackle underlying drivers of cost in the system. I already mentioned what constituted "innovation" under the old incentive structure.



> Because government controls that market.  If you and I got together, pooled our money, got some investors, and tried to open an Emergency Room service.... we couldn't do it.  The government prevents outsiders from competing.  It's called 'certificate of need'.



As near as I can tell, Ohio only has a CON requirement for long-term care beds. So you're going to need another explanation.

*



			Additionally, the insurance companies make special contracts with health care providers.
		
Click to expand...

*


> Because they only need to make a contract with three health care companies, and they have a lock on the market.  They have a monopoly.
> 
> That couldn't happen if there were dozens of health care providers.  But when there are only three main providers, it's easy to get a lock on the market.   And when government prevents new providers from getting into the market, it's easy to have only a few main providers.



You're conflating insurance markets (which is what I've been talking about) with provider markets, which are a different beast. You want more hospitals so that there's more competition, that's great. But hospitals have high fixed costs and their inpatient occupancy rate has been declining for years. So simply building a new hospital doesn't necessarily mean costs drop in an area--in fact, given their high fixed costs and the need to generate revenue by filling beds, costs in that area may well go up. That's why CON laws, misguided or not, came about in the first place. These aren't issues that can be fixed with a pithy slogan.



> Again, this 'structured marketplace' by it's nature removes the patient from the feedback loop.   When you get insurance through your work, which is required by the government regulations and mandates, who is the customer?    Are you the customer?   No.  You are actually not the customer.   You didn't determine what plan you had.   Your company did.



The employer-based system is not the marketplace I described. I said in my last post that transitioning people out of ESI and into a real market (the recently created marketplaces for individual, not group, coverage) would likely be a good thing. But what you describe is not transitioning them into a real marketplace, but rather into the broken market that used to exist in the individual market.


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## Andylusion (Aug 23, 2015)

Billo_Really said:


> Here's the reality of the ACA...
> 
> It has made more people accessible to healthcare.  There is a marked increase in ER patients. In-care patients.  This is causing "all" hospitals to increase their bed capacity, ER capacity through modernization projects.  And for people like me, that's a good thing!
> 
> ...



That hasn't been proven.   But let's even say it is true.

If the way in which the ACA has increased access to health care, is by increasing government borrowing and spending on health care programs..... then you basically are saying doing what Greece did, is a good thing.

Greece spent endless money to give the Greek public more and more services.   How are they doing now?   Not so good.

Is sacrificing the future, for the sake of more health care now, really worth it?   Greece may never recover from what they are going through.   If we do the same thing, because left wingers sacrificed the entire country for health care, that's not a win.


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## Billo_Really (Aug 23, 2015)

Andylusion said:


> That hasn't been proven.   But let's even say it is true.
> 
> If the way in which the ACA has increased access to health care, is by increasing government borrowing and spending on health care programs..... then you basically are saying doing what Greece did, is a good thing.
> 
> ...


How does it increase government borrowing and spending?

And if you want to go there, nothing increases government borrowing and spending more than our obscene defense budget.


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## Andylusion (Aug 23, 2015)

Greenbeard said:


> Andylusion said:
> 
> 
> > *First, having a "structured marketplace" is a great way to drive up costs. *   The only way that small companies can ever compete with large companies, is by designing products that work outside the box.   By forcing everyone into a "structured" box, you eliminate the ability for companies to make competitive products.
> ...



Well, that was my point.   The government regulations and controls, are exactly what has prevented the existence of a transparent market.

In any other market, without government intervention, a transparent market organically evolves into being.

With Health care, which is one of the most heavily regulated and 'structured' markets in this economy, a transparent market hasn't existed for around 70 years.

That's not an accident.   Government involvement, by it's very nature, distorts markets.

*Certificate of Need in Ohio*
Certificate of Need


The development of a new long-term care facility.
The replacement of an existing long-term care facility.
The renovation of or an addition to a long-term care facility that involves a capital expenditure of $2 million or more, not including expenditures for equipment.
An increase in long-term care bed capacity.
A relocation of long-term care beds from one site to another.
Any other failure to conduct a reviewable activity in substantial accordance with the approved application for which a Certificate of Need was granted, if the change is made within five years after implementation, including a site or capacity change.
The expenditure of more than 110 percent of the maximum expenditure specified in an approved Certificate of Need application.
You can not make a new facility, replace a facility, upgrade a facility, increase the number of beds, move the beds from one location to another, or spend more than 110% of the stated amount you are allowed by the Certificate of Need.

What is a Long-Term Care facility or Long-Term Care bed?

Lawriter - ORC -     3702.51     Hospital care assurance program - certificate of need definitions.

Ohio revised code, any bed covered by skilled nursing care.  Any bed covered by Medicare or Medicaid.   Any facility that is registered under the Social Security Act.  Any Nursing home, county home, County Nursing Home, Hospice home.

That pretty much covers every single bed in the entire hospital, that a patient spends a night in.

The only exception would maternity wards, which ironically are covered by a different licensing system.

Maternity Units
Good luck getting that license.

What is a hospital, without a beds to take care of patients, and skilled nurses covering them?     It's a doctors office. 

Again, Certificate of Need, and other government regulations and controls on the market, are exactly what is causing the problems.

*And yes, I get that hospitals love the CON laws*, so that they won't go out of business.  But that's why we have Nursing Homes that cost $100,000 a year.    Regardless of the rationalization for it, that's why we have the problem we do.

If a new upstart company, can open a Hospital for a fraction of the cost, and is able to provide Hospital services much cheaper than the health care establishment....  yeah... they are going to go out of business.

That's how free-markets work.    The bad results we currently have, is exactly because we don't have a free-market, and no one is going out of business.

*Hospitals have high fixed costs, because of government regulations and controls on the market.*

For example, why does it cost so much to get aspirin in the hospital?  One reason is, according to Federal law, they can't buy a bulk container of aspirin, but rather individually wrapped aspirin.   And they can't just have an nurse in training, or intern, give you the aspirin.   No it must be a Registered Nurse or LPN, which of course costs a ton of money, to pay someone $70,000 to hand out Aspirin.

You should take a look at the endless codes and regulations on how a hospital must operate.
Code of Federal Regulations Hospital Conditions of Participation

You say "hospitals have high fixed costs" as if that's a given.   No, it's not.  They have high fixed costs, because government requires them to.    It's a "given" because we've made laws making it a "given".   But it doesn't have to be that way.   Those hospitals in India, that have medical tourists coming to them from all over the world... they are almost completely unregulated.   They don't even follow the regulations of the government hospitals that Indians go to.

Then you wonder why it's so much cheaper to have surgery there?

*And I get that you were primarily talking about Insurance Markets,* but if all you do is try and fix the insurance market, you will fail to lower costs.   All of these things are interconnected.

All of the competition in the world in the insurance market, won't lower costs by very much.   The poison of spiraling costs of health care, goes all the way down to the roots of the constraints of medical schools training limited numbers of doctors, all the way up to the top of individuals buying insurance.

They are all connected.

*Lastly, your statement about deregulating, and ESI, seems odd.*

You *seemed* to imply that Obama Care leads to a structured market, and that we would want to move people off of Employer Sponsored Insurance, into this structured market.

But that is not what Obama Care has done.   Not by a long long margin.






Obama Care as moved more people onto ESI, and Medicare and Medicaid.

The individual market, has actually gone down, not up.   And Medicare and Medicaid, is not a market system.   In fact, both of those drive *UP* the cost of care.   The more people insured through the government, the worse our health care costs are going to be.

So I'm not sure what you think I support, but this isn't it.


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## Harry Dresden (Aug 23, 2015)

Taz said:


> Freewill said:
> 
> 
> > Taz said:
> ...


my state has more people than Canada.....its somewhat easier doing that with 30 million people as compared to 300+million....


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## Andylusion (Aug 23, 2015)

Taz said:


> Freewill said:
> 
> 
> > Taz said:
> ...



Which explains why Canadians routinely travel to America to PAY for health care.   Obviously it's just so incredibly free..... they felt bad and came here to pay for care.


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## Greenbeard (Aug 23, 2015)

Andylusion said:


> In any other market, without government intervention, a transparent market organically evolves into being.



Neither health insurance nor health care are office supplies. I thought that comparison above was in jest but now I'm beginning to think you're serious. The market structure and the incentives in question are unique and rather complex. That's why health economics exists as a sub-discipline. Health care is not and will never be "any other market," which is why we're even talking about it.



> That pretty much covers every single bed in the entire hospital, that a patient spends a night in.



We'll no, it doesn't. "Skilled nursing" is not simply another name for "nursing," it pertains to a specific type of custodial care offered in a long term care facility (namely a SNF or other LTC setting). It doesn't apply to standard acute care settings. Ohio appears to have no CON requirements for acute care settings or emergency care.

Like I said, you need to find a different explanation.

*



			And yes, I get that hospitals love the CON laws
		
Click to expand...

*


> , so that they won't go out of business.



Hospitals _are_ going out of business, even (perhaps especially) in areas where they have no competitors. As I already mentioned, inpatient occupancy, and thus revenue, has been in a state of decline.



> For example, why does it cost so much to get aspirin in the hospital?  One reason is, according to Federal law, they can't buy a bulk container of aspirin, but rather individually wrapped aspirin.   And they can't just have an nurse in training, or intern, give you the aspirin.   No it must be a Registered Nurse or LPN, which of course costs a ton of money, to pay someone $70,000 to hand out Aspirin.



Hospital charges have very little to do with what anything actually _costs_. They mark up virtually everything because (1) they can, and (2) they're cross-subsidizing other services or expenses on which they would otherwise lose money.



> You say "hospitals have high fixed costs" as if that's a given.   No, it's not.  They have high fixed costs, because government requires them to.



Hospitals are expensive organizations. They're generally prepared for a huge variety of eventualities and they tend to be the largest nongovernmental employer in a region.What cost is it you propose to eliminate through the magic of regulation? Staff salaries?



> All of the competition in the world in the insurance market, won't lower costs by very much.   The poison of spiraling costs of health care, goes all the way down to the roots of the constraints of medical schools training limited numbers of doctors, all the way up to the top of individuals buying insurance.



The exchanges have already shown very clearly that insurers competing in a real market on premium (which, granted, is a pretty new phenomenon for them) will either negotiate down prices with providers or exclude high priced providers from certain networks entirely. They'll support alternative payment models meant to support cost-saving, efficiency-promoting reorganizations of care delivery. And they'll devise insurance products meant to both encourage health on the part of consumers and make them more price sensitive when they actually look to access health care services. And that's why their premiums have been surprisingly low.



> You *seemed* to imply that Obama Care leads to a structured market, and that we would want to move people off of Employer Sponsored Insurance, into this structured market.



The ACA has created a structured _individual_ market, and price competition had been extremely robust (lower-than-projected premiums are one of the reasons the law is coming in hundreds of billions under budget.)

The group markets still exist and indeed the law has an employer mandate to preserve the status quo. But small (and ultimately large) employers can make use of the exchange infrastructure. And I have little doubt that exchanges will be the way forward for any market based approach to health insurance.


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## Andylusion (Aug 24, 2015)

Billo_Really said:


> Andylusion said:
> 
> 
> > That hasn't been proven.   But let's even say it is true.
> ...



I am all for slimming down our defense budget where it is wise to do so.   In general, the left cuts money where it is most harmful, and then we have to spend twice as much money replacing what we shouldn't have cut.

That said... you people make it out like 90% of the budget is all defense, and we want to advocate cutting tiny 5¢ programs.

The reality is the exact opposite.     Military spending is only about 16% of the budget.   The vast majority, more than half, is entitlements and social programs.

The truth is, the leftists are the ones trying to cut the 5¢ off the budget, while ignoring the multi-Trillion dollar elephant.

And that's just the direct budget expenses.   You are missing the liabilities.  






This right here, is what sinks entire nations.

According to most estimates, and you can look up Medicare / Medicaid Unfunded liabilities on google, there are dozens of sources about it....   The health care reform has INCREASED future unfunded liabilities.

That's a problem.     The military, if we really get into a pinch, we can cut the military.

This problem here....   people change how they live, when they think the government is going to cover their health care.   We are going to owe TRILLIONS.   And that's going to play havoc, just like it has in Greece.


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## Andylusion (Aug 24, 2015)

Greenbeard said:


> Andylusion said:
> 
> 
> > In any other market, without government intervention, a transparent market organically evolves into being.
> ...



I am absolutely serious.     You can say "Health care isn't like office supplies" and yet what we have seen here in America, and around the world, is the fundamentals of economics work exactly the same.    You can say it's not the same, but it works the same.   You limit entry into the market... price goes up.  You regulate the market.... price goes up.   You limit competition in the market... price goes up.   You attempt to control the price... shortages show up.

This is why you have places like India, where medical tourist hospitals, that are free from the regulations of the government, and are only controlled by the chaos and wild-cat fundamentals of economics based on supply and demand.... and you can have a surgery that cost $100,000 in the US, cost only $18,000 in India.

The fundamentals of economics don't magically change, because "this is health care!".

And every time you do, the result is disaster.   Energy isn't like office supplies.... right?   And then you end up with rolling black outs across California.

*CON laws*

But I posted the specific law, which said "Skilled Nursing, or Nursing.".     Nursing or skilled nursing.    That pretty much covers all nursing of any kind.   Name a bed in a hospital in which there is no nurse in attendance?

You can't, and I can tell you why.    I posted the list of laws governing hospitals, and one of the requirements is that there is a nurse assigned to every single bed which has a patient.    By law, every single bed, has a nurse.

Now maybe there is some other part of the law, that I don't know about.....   but....  based on what I read, CON laws cover every single bed in any hospital in the state of Ohio.   

*Hospitals are going out of business, and hospitals mark up everything they can, because they can and to subsidize other services they would lose money on.*

Most of what you said is true, with the exception of "because they can".   Clearly if hospitals are closing.....  then they are marking up prices because they are trying not to close.

But what all of what you said, ignores the cause.     Here is the cause....
Analysis: Why Rural Hospitals Are Closing | Daily Yonder | Keep It Rural

I have to admit I love these small time media outlets, who are not driven by a political bent, and have no problem just saying the truth.

In 1984 Congress changed the way Medicare paid hospitals. Instead of paying whatever hospitals claimed for taking care of Medicare patients, the agency began paying what it judged was reasonable for a particular illness.
That change was hard on a lot of hospitals, but the larger ones were able to live with it. For bigger hospitals, the length of patient stays averaged out. And, to the extent that Medicare was systematically underpaying, hospitals raised their charges to private insurance companies to make up the difference.​So Congress decided to determine how much is reasonable to pay, instead of hospitals telling government how much it cost them to provide care.   Why?   Because Medicare expenses were growing at an unsustainable rate.

Medicare under pays hospitals.  So larger hospitals increase prices on privately insurance patients, to subsidize the cost of Gov-Patients on Medicare and Medicaid.

Small rural hospitals don't have that as an option, because most of the people in rural towns are on Medicare.  The younger people generally move into the city to find work.






Now as you can see, every time that Medicare and Medicaid pay out less and less for care, the hospitals cost-shift that to private patients in higher and higher mark ups.

And what you just pointed out, was that they are not doing it because "they can", they are doing it because if they don't.... like rural hospitals can't... then they close.

The story goes on.......

In 1997 Congress authorized the Critical Access Hospital system to help fix these problems. The new bargain was, if a hospital of up to 25 beds in a rural area would accept some limitations on how long a patient could stay (a practical way to require them to transfer complicated cases), Medicare would pay them what the hospital reported it cost to take care of Medicare patients.

When Congress drafted the Affordable Care Act, it scheduled phase out of most of those special payment programs.​Have you ever wondered why you go to an inner city hospital, and find people there from an hour away?   I've worked in hospitals, and that always confused me.   This is why.     The smaller hospitals were transferring patients out of their hospital, to bigger hospitals that could cost-shift the lack of payment from Medicare.

But Obama Care has started phasing out those programs.  Why?   Again, it's too expensive.  They had to make Obama Care seem as though it wouldn't break the Federal Budget.  So they cut some of these programs, that kept those rural hospitals alive.

All of this is to point out the regulation, and government intervention, is what has caused all of this.    If every single patient, paid for their own care, we wouldn't be talking about this.   Hospitals wouldn't be cost-shifting to private patients, jacking up prices.   Rural hospitals would be charging what it cost to provide care, and not be closing.     No one would be transferred hours away from friends and family.

*What cost do I propose to eliminate through the elimination of regulation?*

Well... everything I just listed above, for starters.   I think we can hire interns and trainees to hand out cups of water and aspirin, instead of a $80,000 Registered Nurse.    How about eliminating all the controls on Medical Schools?    Supply of doctors goes up, cost of doctors goes down.    Simple economics.

If it didn't cost $300,000, and take 10 years, to go through medical school, I wager doctors would be willing to work for less.

And honestly, we don't know what all could be done to lower cost, because no one can do anything to lower cost under the current system.

But you can't tell me that reducing or eliminating regulation can't possibly result in lower cost, because we can look around the world, and see that hospitals that do not have the regulations we do, operate at a fraction of our cost.

Who knows what new method of health care could be developed in a system where they are not constrained by government controls?

*The exchanges have already shown very clearly that insurers competing in a real market on premium (which, granted, is a pretty new phenomenon for them) will either negotiate down prices with providers or exclude high priced providers from certain networks entirely.*

They were doing that before the exchanges existed.   That's actually part of the problem.  Hospitals increase prices, to account for the negotiated discount.   If a treatment costs $1,000, and the insurance companies have a 50% discount, how much does the hospital charge?   $2,000. 

This system harms the uninsured the most, because they have to pay the full, made up, price.

This is one of the reasons we don't have a transparent market.   All of those costs on those bills are made up numbers, to account for the cost-shifting regulations, and the negotiated discounts.   Again, if we had zero regulations..... all of that would go away.

*The ACA has created a structured individual market, and price competition had been extremely robust (lower-than-projected premiums are one of the reasons the law is coming in hundreds of billions under budget.)*

How do you claim, a market that has shrunk in size, is 'robust'?  I just posted the raw numbers.  The individual market has declined.

And no, the reason the law has come in under the budget, is because very few of the uninsured, got insurance.  The budget was based on the idea that all 45 Million of the uninsured, would get insurance.  That hasn't happened.

And I don't think price competition has been so great.    The only reason prices have no gone up... is because benefits have declined.    The base deductibles have increased dramatically.

Pretty easy to hold prices down, when you cut benefits by a ton.


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## Billo_Really (Aug 25, 2015)

Andylusion said:


> Billo_Really said:
> 
> 
> > Andylusion said:
> ...


We need to cut the defense budget in half.  We also need to end these bullshit wars we've been fighting for over a decade. And we also need to close these over a 1000 bases all over the world.  If a country wants our base there, then they can pay for it.  We'll send them a bill for all costs incurred.

Then we need to raise the tax rate on capital gains and dividends to 25%.  Then we need to create a Financial Transactions Tax on all traded instruments and close the loop holes allowing corporations to offshore their profits.  We also need to make derrivitives illegal again.

Keep the ACA, but add the "public option" to the bill.  That'll drive medical costs down and the for-pay medical industry can't do a thing about it, except make their rates more competitive.

Don't touch Medicare and SS.


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## Greenbeard (Aug 25, 2015)

Andylusion said:


> Have you ever wondered why you go to an inner city hospital, and find people there from an hour away?   I've worked in hospitals, and that always confused me.   This is why.     The smaller hospitals were transferring patients out of their hospital, to bigger hospitals that could cost-shift the lack of payment from Medicare.
> 
> But Obama Care has started phasing out those programs.  Why?   Again, it's too expensive.  They had to make Obama Care seem as though it wouldn't break the Federal Budget.  So they cut some of these programs, that kept those rural hospitals alive.



The fact that they need inflated payments to be "kept alive" should be a red flag that we're talking about an inefficient model. The organization of a health system will impact cost. As I already said, hospitals have high fixed costs. Having more just to have more--be it duplicating services in more populated areas or offering them in areas where it isn't cost effective to do so--doesn't axiomatically lower costs, it often increases them. If a community can't sustain the fixed costs of having its own inpatient facility, then if you want to keep costs in check you'll have to do exactly what you're saying: divert cases to places where those facilities _can_ be sustained.

You bring up India, which illustrates this very principle.

India’s Secret to Low-Cost Health Care


> In order to reach the masses of people in need of care, Indian hospitals create hubs in major metro areas and open smaller clinics in more rural areas which feed patients to the main hospital, similar to the way that regional air routes feed passengers into major airline hubs.
> 
> This tightly coordinated web cuts costs by concentrating the most expensive equipment and expertise in the hub, rather than duplicating it in every village. It also creates specialists at the hubs who, while performing high volumes of focused procedures, develop the skills that will improve quality. By contrast, hospitals in the U.S. are spread out and uncoordinated, duplicating care in many places without high enough volume in any of them to provide the critical mass to make the procedures affordable. Similarly, an MRI machine might be used four to five times a day in the U.S. but 15 to 20 times a day in the Indian hospitals. As one CEO told us, “We have to make the equipment sweat!”



You don't just tack on additional fixed cost after additional fixed cost in the hopes that competition (and if you don't think consumer cost-sharing is "so great" I don't know where you think provider price competition comes from anyway) somehow undoes it. Not here, not in India.



			
				Andylusion said:
			
		

> Now maybe there is some other part of the law, that I don't know about.....   but....  based on what I read, CON laws cover every single bed in any hospital in the state of Ohio.



You don't need another part of law. The regulations you quote are very clearly, very explicitly about _long-term care facilities_, not acute care hospitals and certainly not emergency departments. I honestly don't know what the source of your confusion is.



			
				Andylusion said:
			
		

> Now as you can see, every time that Medicare and Medicaid pay out less and less for care, the hospitals cost-shift that to private patients in higher and higher mark ups.



Accepting that theory requires assuming that hospitals are not profit maximizers (that is, they can always command higher prices than they do but opt not to). Even for nonprofit hospitals, that's a tough one to swallow, since even if their margins aren't going to investors they're going back into the community or the hospital. Why leave money on the table? The literature on the cost shifting theory is ambiguous at best.

One could just as easily look at the figure and ask: what if, when Medicare signals through a policy change that a new era of cost containment is upon us, hospitals sit up and take note? It's arguably the most important payer in the country, it's not so hard to imagine that providers will respond to the signals it sends by changing behavior. If providers begin to better control their costs as Medicare payment growth declines, and if private insurers' prices continue on their same trajectory (since private insurers are generally locked into multi-year contracts) then of course their payment-to-cost ratios will rise since costs are falling on a relative basis.

Indeed, Chapin White pointed out in ""Slower Growth in Medicare Spending — Is This the New Normal?" just a few years ago that Medicare's switch under Reagan to prospective fee setting was extremely effective at getting hospitals to contain their costs.


> There is a historical precedent for harsh, simple-minded cuts setting the stage for broad-based payment reform. Up until the early 1980s, Medicare reimbursed hospitals for costs incurred, subject to ceilings. The Tax Equity and Fiscal Responsibility Act of 1982 substantially tightened those limits, leaving hospitals with no upside — they could not earn a profit by reducing costs — and a growing downside for those whose costs exceeded the limits. The next year, legislation was passed, with the support of the hospital industry, replacing cost reimbursement with the inpatient prospective payment system (IPPS), with rates initially calibrated to leave Medicare outlays unchanged. Hospitals then had the opportunity to reduce costs per admission by shortening lengths of stay and to earn a positive margin in the process.
> 
> The IPPS is generally viewed as a major policy success: it encouraged hospitals to seek efficiencies, and when they found those efficiencies, it allowed the federal government to share in the savings. Should ACOs and other reforms prove effective, they will provide broader opportunities to increase the efficiency of delivery beyond shortening lengths of stay, such as managing chronic disease more effectively so as to keep beneficiaries out of the hospital in the first place. But our current challenge is more complex than the one faced in the early 1980s. Broadening the unit of payment will require reaching across different types of providers and helping to stitch together real delivery systems in places where now there are none.






			
				Andylusion said:
			
		

> All of this is to point out the regulation, and government intervention, is what has caused all of this.    If every single patient, paid for their own care, we wouldn't be talking about this.



You've taken exception to rising patient cost-sharing so I'm not sure I follow. Patients are sharing in the costs and prices of their care more now than ever before. Price sensitivity is more prevalent now than ever.



			
				Andylusion said:
			
		

> But you can't tell me that reducing or eliminating regulation can't possibly result in lower cost, because we can look around the world, and see that hospitals that do not have the regulations we do, operate at a fraction of our cost.



I haven't argued that. What I've said is that an _insurance_ market without structure (in which there are no particular prices for products, opacity is the seller's primary weapon, and the incentive to cost shift dominate the incentive to cost contain) won't work.

It didn't work for the past half century in the individual market and it won't work now.



			
				Andylusion said:
			
		

> They were doing that before the exchanges existed.   That's actually part of the problem.  Hospitals increase prices, to account for the negotiated discount.   If a treatment costs $1,000, and the insurance companies have a 50% discount, how much does the hospital charge?   $2,000.
> 
> This system harms the uninsured the most, because they have to pay the full, made up, price.



If "this system" refers to private contracts between private insurers and private providers, I don't know how you propose to abolish that. Indemnity plans used to dominate health insurance and spending and costs soared. The rise of managed care--that private insurer-provider negotiation over prices--led to the only period in the last half century (other than the last five years) in which cost growth was contained, the mid-1990s. This was a market innovation. In fact, most of the old state-based all-payer systems of the '70s and '80s were deregulated on the theory that private competition manifested in the negotiations behind those private contracts would better control costs than the heavy-handed government regulation that preceded them. 

The relaxation of managed care by the payers at the end of the '90s was followed by the escalation in health care costs and prices of the 2000s. More aggressive network management to tackle prices and costs has returned now in a big way, particularly in the individual market, and lo and behold provider price growth has neared all time lows.



			
				Andylusion said:
			
		

> This is one of the reasons we don't have a transparent market.   All of those costs on those bills are made up numbers, to account for the cost-shifting regulations, and the negotiated discounts.   Again, if we had zero regulations..... all of that would go away.



If "regulations" go away, Aetna isn't going to try and negotiate the lowest prices it can from health care providers?



			
				Andylusion said:
			
		

> How do you claim, a market that has shrunk in size, is 'robust'?  I just posted the raw numbers.  The individual market has declined.



First of all, I'm talking about the market dynamics. Insurers are competing, price leaders are changing, and consumers are actively shopping. That is what's "robust" about it. It's working as an insurance market ought to.

Second, what you're saying is incorrect. Individual market enrollment was up about 50% (and growing) as of last year.







			
				Andylusion said:
			
		

> And no, the reason the law has come in under the budget, is because very few of the uninsured, got insurance.  The budget was based on the idea that all 45 Million of the uninsured, would get insurance.  That hasn't happened.



Insurance really is substantially cheaper than anticipated. Competition works, you should feel vindicated.

Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act, April 2014


> The current projection of the average premium for the benchmark silver plan in 2016 of about $4,400 is 15 percent below the comparable estimate of $5,200 published by CBO in November 2009.



Updated Budget Projections: 2015 to 2025


> *Reduced Costs for Exchange Subsidies* CBO and JCT now project that the government’s net costs for exchange subsidies and related spending and revenues over the 2016–2025 period will be $849 billion— $209 billion (or 20 percent) below the previous projection. That reduction is largely a result of projections of slower growth in premiums and, to a lesser extent, slightly lower exchange enrollment (as discussed above). Relative to CBO and JCT’s previous projection, the agencies now anticipate that, in most years, premiums in the exchanges will be roughly 10 percent lower and about 1 million fewer people will obtain health insurance through the exchanges.



That's why spending _per enrollee_ (a number independent of actual enrollment) has fallen so much--about 24%--relative to pre-ACA projections.

Back in March 2010 it was supposed to cost $5,200 to insure someone through an exchange this year.






Yet in reality it's costing $3,960 per person. The coverage really is much cheaper than anticipated.










			
				Andylusion said:
			
		

> And I don't think price competition has been so great.    The only reason prices have no gone up... is because benefits have declined.    The base deductibles have increased dramatically.
> 
> Pretty easy to hold prices down, when you cut benefits by a ton.



Covered benefits have gone _up_, not down, where they've changed at all. If you mean the consumer has more cost-sharing for covered benefits in many cases--well, yes. That's been a goal of market reformers for decades. Make the consumer price-sensitive at the point of care and they'll introduce competition into the provider market.


----------



## Andylusion (Aug 26, 2015)

Billo_Really said:


> Andylusion said:
> 
> 
> > Billo_Really said:
> ...



But here's the problem.   For several years, if we had a defense budget of ZERO.....   We still would have had a deficit.

Do you not see a problem there?   If the Defense budget had been ZERO, there still would have been a deficit.   

Greece has a defense budget that is a much smaller portion of their GDP, than ours is, and they still crashed.

Point being,  if you think we should cut defense spending, I'm ok with that.   Saying in half is garbage.  You are crazy.   But ok, maybe we should cut defense spending by some amount....  Ok.  We can debate that.

But if you think cutting defense is going to solve the budget problem, you are nutz.   Sorry, but that's crazy talk.

I just posted, that the unfunded liabilities of Medicare, Medicaid, and Social Security, are well over $100 Trillion.    If you think slimming down the Defense budget by $300 Billion, is going to fix that, you either can't do math, or you need medication.

As for international bases, many of them are funded by international dollars, and the UN.   Some, we have treaties with countries to maintain those bases.   Others, we pay the full cost, but they are often important bases that we really need.

Take South Korea, for example.  The only reason that war hasn't broken out, is because the North Koreans know that a full scale attack, would activate American troops, and the results would be devastating.  

You really want us to pull out of that area, knowing that war would be the result, and we'd be sucked back in, only this time under heavy fighting?   Bad plan.

Now if you want to eliminate the UN.....   ok!   I'm in favor of that myself.   But you can't simultaneously say "I want the UN!" and at the same time "I don't want to fund military bases that the UN says we should have".... That doesn't work.


----------



## Andylusion (Aug 26, 2015)

Greenbeard said:


> Andylusion said:
> 
> 
> > Have you ever wondered why you go to an inner city hospital, and find people there from an hour away?   I've worked in hospitals, and that always confused me.   This is why.     The smaller hospitals were transferring patients out of their hospital, to bigger hospitals that could cost-shift the lack of payment from Medicare.
> ...



*The fact that they need inflated payments to be "kept alive" should be a red flag that we're talking about an inefficient model.*

Yes.  The government mandate, regulate, and subsidize model.    I just explained all that in detail, with evidence to support my statements.

*You bring up India, which illustrates this very principle.
India’s Secret to Low-Cost Health Care*

From your own link:

Task Shifting

The Indian hospitals transfer responsibility for routine tasks to lower-skilled workers, leaving expert doctors to handle only the most complicated procedures.​I just posted the law, which prevents US hospitals from doing that.   You can't shift routine basic tasks, like say handing out Aspirin and water, to an intern.  The law requires that Hospitals must only have an RN, or LPN, do that job.  Which of course, costs tons of money.

And there are hundreds of such examples.

*The regulations you quote are very clearly, very explicitly about long-term care facilities*

And I very explicitly pointed out the specific law that defined what 'long-term care facilities' is.   And the definition, according to the Ohio code, was any bed that had a nurse, or skilled nurse, assigned to it.

Are you telling me that acute care beds do not have a nurse or skilled nurse assigned to it?   Do you have anything else to back up this claim?  Anything at all?

*Indeed, Chapin White pointed out in ""Slower Growth in Medicare Spending — Is This the New Normal?" just a few years ago that Medicare's switch under Reagan to prospective fee setting was extremely effective at getting hospitals to contain their costs.*

Medicare's switch to fee setting did not get hospitals to contain their cost at all.   The whole point of that graph is proof that they didn't contain costs.

Yeah, they contained medicare costs.... but cost-shifting to private patients.   The cost to private patients went up, to pay for the treatment of government patients.   Was that graph difficult to understand?  Or are you simply ignoring evidence that doesn't fit your theory?

The only reason the growth in Medicare costs has slowed down, is because hospitals have shifted more costs onto private patients.

You are the only one thus far, that I have presented this evidence to, that hasn't been able to grasp it.  I'm really confused by your nonsensical answer.

*You've taken exception to rising patient cost-sharing so I'm not sure I follow. *

Well yeah.  That's the whole problem.   Why do you think everyone is pissed off?  Why do you think we're complaining about high prices?

I worked at this company a few years back, and there was this 300 lbs girl, who drank constantly, and was always in the hospital.   We tried to get her to cut back on the booze, and she didn't care.   We tried to have a company "health wellness" thing, and she didn't care.    She was in and out of the hospital so much, she had the hospital and doctors saved on her cell phone.

The company was only 20 people, yet our company health care premiums doubled two years in a row.   Why?  That alcoholic obese chick was driving up health care costs on everyone in the entire company.

This is cost sharing at it's finest.     Cost sharing is one of the primary reasons costs are going up.

When you go medical tourism, to an Indian hospital, you are not cost sharing at all.   That's why the prices are lower.  You are not paying for that other guy in the bed next to you.  You are not paying for the other people in your companies 'group plan'.  You are not paying for the Medicare Patient down the hall.

You are just paying for one person's care.  YOURS.   Shockingly... the price is lower.  Why is that surprising?

*If "this system" refers to private contracts between private insurers and private providers, I don't know how you propose to abolish that*

I already explained that.   The reason that system exists, is because of government regulations.  Eliminate the regulations, and those contract will disappear too.

If there were 50 competing hospitals in the Columbus Ohio area, there is no possible way, that an insurer could form contracts with all fifty of them.    But when the regulations and mandates, and controls, and CON Laws (you still haven't made your case), prevent entry into the market..... so that there are only 3 major health service providers, then it's easy for insurance companies to make three contracts, and lock down the market.

Get rid of the regulations, and competition will open up.  More competition, and those contracts will disappear.

*Individual market enrollment wasup about 50% (and growing) as of last year.*

If it is, then that is somewhat positive.   I have a feeling that's not as true as you think it is.   I wager most of that is subsidized, or due to quality plans being unaffordable now.

*Insurance really is substantially cheaper than anticipated. Competition works, you should feel vindicated.*

Not true.   Just simply not true.

Obamacare sends health premiums skyrocketing by as much as 78 percent - Washington Times

I don't even know how you can even pretend that's an honest statement to claim insurance is cheaper... unless you anticipated it being hideously more expensive, and only got horribly more expensive.    The only way you think it's cheaper, is if you expected a 200% rise in costs, and it was only 100% rise in costs.

My personal experience mirrors what the reports are.    Back in the mid 2000s, I got a policy for only $67 dollars, that had a $2,000 deductible.   I'm now looking at a policy for the same amount, that has a $7,500 deductible.

The price may not have changed, but coverage is a ton lower.

It's interesting that you quote the CBO....    I don't give a crap if the cost to the government is lower than they expected.  How the heck does that help me?   So ACA was cheaper for government, while my bills double?  How is that a 'vindication' of anything?   I suppose it vindicated my belief that the Affordable Care Act would make Care Un-affordable.
*
Covered benefits have gone up, not down, where they've changed at all.*

Well that certainly isn't the reality that I face, or anyone I know has faced, or what the numbers show.


----------



## Billo_Really (Aug 26, 2015)

Andylusion said:


> But here's the problem.   For several years, if we had a defense budget of ZERO.....   We still would have had a deficit.
> 
> Do you not see a problem there?   If the Defense budget had been ZERO, there still would have been a deficit.


You said that.  Twice.  We might still have a deficit, but we'd be able to pay it down a little more.




Andylusion said:


> Greece has a defense budget that is a much smaller portion of their GDP, than ours is, and they still crashed.


That's another thing we need to do, break up the big banks into little banks.  That way when they fail, they don't affect the global economy.




Andylusion said:


> Point being,  if you think we should cut defense spending, I'm ok with that.   Saying in half is garbage.  You are crazy.   But ok, maybe we should cut defense spending by some amount....  Ok.  We can debate that.


Maybe more than half.  We have enough nuclear weapons to kill the population of the planet 37 times.  I think we're safe.




Andylusion said:


> But if you think cutting defense is going to solve the budget problem, you are nutz.   Sorry, but that's crazy talk.


I didn't say that.




Andylusion said:


> I just posted, that the unfunded liabilities of Medicare, Medicaid, and Social Security, are well over $100 Trillion.    If you think slimming down the Defense budget by $300 Billion, is going to fix that, you either can't do math, or you need medication.


At least with Medicare and SS, we get something in return.

What did we get in return for the over 6$ trillion we paid out for the Afghanistan and Iraq wars?  Nothing.  We got nothing in return for that investment.  We spent all that money and the average American got no direct benefit as a result.




Andylusion said:


> As for international bases, many of them are funded by international dollars, and the UN.   Some, we have treaties with countries to maintain those bases.   Others, we pay the full cost, but they are often important bases that we really need.


How does our military protect this country, when they are not physically in the country they're defending?




Andylusion said:


> Take South Korea, for example.  The only reason that war hasn't broken out, is because the North Koreans know that a full scale attack, would activate American troops, and the results would be devastating.


So.  We let South Vietnam go, we're all still here.




Andylusion said:


> You really want us to pull out of that area, knowing that war would be the result, and we'd be sucked back in, only this time under heavy fighting?   Bad plan.


Why would we be sucked back in?  That's on the other side of the planet, who gives a fuck?




Andylusion said:


> Now if you want to eliminate the UN.....   ok!   I'm in favor of that myself.   But you can't simultaneously say "I want the UN!" and at the same time "I don't want to fund military bases that the UN says we should have".... That doesn't work.


We should keep the UN.  But we need to stop protecting Israel with our veto in the UNSC.


----------



## Andylusion (Aug 27, 2015)

Billo_Really said:


> Andylusion said:
> 
> 
> > But here's the problem.   For several years, if we had a defense budget of ZERO.....   We still would have had a deficit.
> ...



You missed the point.   If you can completely eliminate the defense budget, and still have a deficit, by definition, you can't "pay it down a little".  That's not logical.  Unless you think somehow we can cut the defense budget to a negative amount, so that it is cut so much it brings in money, there is no possible way to cut it enough to have positive revenue.

There are over $100 Trillion dollars in unfunded liabilities in Social Security and Medicare.   There is no amount of cutting to any other, or ALL other aspects of the Federal Budget that is going to fix that problem.

*Breaking up the banks will cause there to be a bigger problem, not a smaller problem.*

Most of the banks that failed during the 2008 sub-prime crash, were banks that only dealt in mortgages.    In fact, the way the government 'fixed' the problem was to merge banks together.

How is doing the opposite of what the government did to fix the problem... going to fix the problem?

The solution isn't to break up the banks.  The solution is to allow the banks to fail.    It's worked before.  It worked in Estonia.  It worked in Iceland.  It worked in England.  It will work here to.

Breaking up the banks will only make them even more susceptible to failure.

*Yes we have a bunch of nukes.... so what?
*
First, you shouldn't assume we're safe.   There are some regimes in the world, that honestly do not believe we'll use them.  I am not even sure we would use them.

A weapon no one thinks we'll ever use, is a weapon that might as well not exist.   Under Reagan, it was a deterrent.  Because people thought that if push came to shove, Reagan would do whatever he thought he must.

Under Obama, no one is worried we'll drop a nuke.  If Russia began an invasion, we wouldn't drop a nuke. 

If you think we're going to isolate ourselves, and let the rest of the world burn....  I don't think so.   Not going to happen.   We need conventional forces to defend our allies.   Nukes are not useful for that purpose.

*Yes, we let millions of people die in Vietnam, our ally.*

That strikes me as an incredible injustice, and a terrible level of selfish arrogance.   That might be the attitude of the self absorbed, "me-first-and-only" American mentality.  But that's sick and twisted.

We used to be better as a people than that.

*Why would we be sucked back in? That's on the other side of the planet, who gives a fuck?*

A:  Because we were not always selfish spoiled brats.
B:  Because being an ally of the US used to mean something.
C:  Because the reputation of America as a people who stand by their word as a nation, involves us actually standing up for what we say we'll do if an ally is attacked.

I get it.  That honor and dignity, isn't something that applies to you.   But some of us, it does.   Hopefully there are more like us, than like you.

*How does our military protect this country, when they are not physically in the country they're defending?*

One spark in the wrong place at the wrong time, can send half of California up in flames.

Similarly, one fight in the wrong place, at the wrong time, can prevent the world from going up in flames.

You are constantly running on the basis that the US will never be sucked into an international war.   They most certainly will.  No doubt at all.

Our troop being a bulwark against the sparks, is preventing World War 3 from starting.

And again, I'm not completely against us having a discussion on cutting back military wise.

But I still remember having a thread on a proposal to shut down the last remaining tank plant in the US.   Fire all the employees.  Get rid of all the engineers and designers.   The plant would be closed, retooled for domestic production, and used for who knows what.

It wasn't the following year after that discussion, Russia confiscates Crimea, and rolls heavy units into Ukraine, and Putin says he's doing it for the benefit of the Russians in Ukraine.....  Exactly the same rational for Hitler taking over the Sudetenland.  A move the ultimately led to Germany sparking world war 2.

All of a sudden, we need heavy armor vehicles.

If we had followed the belief system of those like you, back during that Tank plant closure debate, we would be spending billions of dollars opening a new plant, new engineers, new retooling, new everything.

The cost to replace a manufacturing plant is tens of billions, compared to a few million to keep one we already have running.


----------



## Greenbeard (Aug 27, 2015)

Andylusion said:


> And I very explicitly pointed out the specific law that defined what 'long-term care facilities' is.   And the definition, according to the Ohio code, was any bed that had a nurse, or skilled nurse, assigned to it.



You need to go back and read the definition again (not your attempt to paraphrase it, the actual words used). An _emergency department_ is not a long-term care facility. If your read of a definition has an _outpatient_ unit somehow having long-term care beds, that's a good sign you need to go back and try again. This is getting absurd. Your world view doesn't need to collapse upon the realization that CON laws aren't why you don't have more ERs.



			
				Andylusion said:
			
		

> Medicare's switch to fee setting did not get hospitals to contain their cost at all.   The whole point of that graph is proof that they didn't contain costs.



The figure shows a ratio. Knowing a ratio went up tells you one of three things: 1) the denominator decreased (in this case, hospital costs), 2) the numerator increased (commercial reimbursements rose), or 3) some combination of the two.

You can make as plausible a case for (1) as for (2). In reality, I suspect the answer lies in (3).



			
				Andylusion said:
			
		

> I worked at this company a few years back, and there was this 300 lbs girl, who drank constantly, and was always in the hospital.   We tried to get her to cut back on the booze, and she didn't care.   We tried to have a company "health wellness" thing, and she didn't care.    She was in and out of the hospital so much, she had the hospital and doctors saved on her cell phone.
> 
> The company was only 20 people, yet our company health care premiums doubled two years in a row.   Why?  That alcoholic obese chick was driving up health care costs on everyone in the entire company.
> 
> This is cost sharing at it's finest.     Cost sharing is one of the primary reasons costs are going up.



To be clear, _cost-sharing_ refers to the amount the individual has to pay for their care the point of service (deductibles, copays, coinsurance, self-pay, whatever). More cost-sharing means you pay less for other people, and they pay less for you. Not the other way around.

Higher deductibles and cost-sharing mean the woman in your example is responsible for more of her costs and you're responsible for less of them. Which is why I'm trying to figure out your opposition to cost-sharing.

The concept behind moving to high deductible plans (including those that can be paired with an HSA to cover the increased cost-sharing) is that it makes the individual more price sensitive between competing provider services and more responsible for the services they consume.



			
				Andylusion said:
			
		

> If there were 50 competing hospitals in the Columbus Ohio area, there is no possible way, that an insurer could form contracts with all fifty of them.



Of course they could. The analog here is just solo practitioners or very small group practices today. In a given area of the state, there will be hundreds or more of such folks. Each is contracted with some group of insurers. But since they have zero market clout, they essentially get a boilerplate contract from the insurer that they have to sign if they want to be in network and have access to that patient pool (and it presumably goes without saying that they accept the rates and fee schedule offered them by the insurer). Larger hospitals--and particularly systems--on the other hand have clout to push back, which is why their contracts are more complex and actively negotiated. Including prices.

In the world you imagine where that's been taken away, a bunch of solo hospitals are still going to have contracts. They'll just be more tilted toward the insurer.



			
				Andylusion said:
			
		

> But when the regulations and mandates, and controls, and CON Laws (you still haven't made your case), prevent entry into the market..... so that there are only 3 major health service providers, then it's easy for insurance companies to make three contracts, and lock down the market.



As I just mentioned, you've actually got it backwards. In a world where providers have no clout relative to the insurer, the insurer can draw up a single boilerplate contract that all providers sign. It's only when you have providers with the clout to negotiate back that things get harder for the insurer and more varied or complex contracts begin to enter the picture.



			
				Andylusion said:
			
		

> I don't even know how you can even pretend that's an honest statement to claim insurance is cheaper... unless you anticipated it being hideously more expensive, and only got horribly more expensive.    The only way you think it's cheaper, is if you expected a 200% rise in costs, and it was only 100% rise in costs.



We don't really need to guess what was anticipated in the budgeting, we have that answer: *An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act (2009)*. Before the law passed, premiums for the coming open enrollment were expected to average about $5,200 (about $433/month) for single silver coverage. The actual numbers for next year actually look like they'll average more like $300-$350 per month. Significantly below budget. And below what comparable benefit packages cost in the employer space.



			
				Andylusion said:
			
		

> My personal experience mirrors what the reports are.    Back in the mid 2000s, I got a policy for only $67 dollars, that had a $2,000 deductible.   I'm now looking at a policy for the same amount, that has a $7,500 deductible.



A family plan for $67 would've been unusual a decade ago; today it's virtually unheard of. Congrats.



> It's interesting that you quote the CBO....



Who else would I quote? I said it came in _under budget_. They're the ones who budgeted it and are tracking actual spending so that's where you have to go to check in. Like I said, it's coming in hundreds of billions under budget and the slowdown in health spending growth (including premiums far lower than anticipated) is a big reason.



			
				Andylusion said:
			
		

> Well that certainly isn't the reality that I face, or anyone I know has faced, or what the numbers show.



What covered benefit does your plan (which apparently has the same premium it did a decade ago!) no longer have that it use to?


----------



## Andylusion (Aug 27, 2015)

Greenbeard said:


> Andylusion said:
> 
> 
> > And I very explicitly pointed out the specific law that defined what 'long-term care facilities' is.   And the definition, according to the Ohio code, was any bed that had a nurse, or skilled nurse, assigned to it.
> ...



I didn't say an Emergency department.  You are shifting terms.     But again, Emergency departments fit under a different set of laws, that still have negative effects.  Yeah, anyone could open an ER.  But.... you can't turn anyone away from the ER.   Which is great if you don't want to pay, and have a cough.   You walk in with a sore throat, and they can't turn you away.

Baton Rouge General Mid City ER is now closed, OLOL prepares for new patients

Notice the date...  Long after Obama care came into effect, they are closing their ER.   Why?

Again, the obvious...

Hospital officials said closing the Mid City ER was due to the influx of uninsured patients who had previously been treated at the Earl K. Long charity hospital in north Baton Rouge.
Officials said they were losing around $2 million a month and were projected to lose nearly $25 million this year if they kept the Mid City ER from shuttering its doors.​
Why don't they simply turn away people who refuse to pay?   Can't.    Don't have a choice.   So what do you suggest?

Here you were talking about how "Obama Care doesn't cost as much", and yet this right here is why.   They cut funding for hospitals, and yet the people refused to pay for even heavily subsidized Medicaid, and now hospitals are closing their ERs.

See, no matter what part of the hospital you want to talk about, I can cite government laws and regulations, that jack up costs.

I'll give you another example...  US ERs have on staff emergency trauma care doctors 24 hours a day, 7 days a week.   In the UK, they do not.

England trauma services 'not good enough'

Vice president of the College of Emergency Medicine Don MacKechnie said: "Currently only a minority of emergency departments have adequate consultant numbers to achieve a consultant presence beyond much more than 'normal office hours'.​
In other words, they don't keep the skilled staff on hand past 'normal office hours'.   Why?  That costs money.   See people keep saying we can cut costs, and pay less like in the UK.  And we can..... just send the expensive skilled staff home at 5, and if you break a leg, or have a crash... well... SOL dude.   Saved money though.   At least you didn't have a big medical bill right?

*Of course they could. The analog here is just solo practitioners or very small group practices today. In a given area of the state, there will be hundreds or more of such folks.*

We'll just have to agree to disagree.  I don't think so.

Ironically, my doctor before hand had no contracts with any insurance companies at all.  Just recently, he became a contract doctor with Grant Medical care, which really really ticked me off, because I hate Grant.  Always have.  They are the cheapest, and are subsidized by the government, but as is typical of government funded institutions, they are complete and total jerks.

So I asked him, why the heck he signed on with Grant.  He said very openly, the Obama Care law drove up his prices, and he couldn't practice as an independent office anymore.   Him and his 3 other doctors, all made the decision to sell to a medical provider, and now they are part of Mega-Corp Health.

Like have said many times before, all regulations benefit the mega-corporations.  Want to make the poor, poorer, and rich richer?   That's how you do it.
*
A family plan for $67 would've been unusual a decade ago; today it's virtually unheard of. Congrats.*

Not a chance.   I'm single for life.  I never meant to try and mislead anyone into thinking you can get a family plan for $67.   Crazy.

Now my co-worker at work, he was doing contract work before he got the job he has there, and he was able to find a family plan for just $130 a month.   That's him, wife, and two kids.  High deductible of course.  But otherwise, great coverage.  20/80, $5 Million lifetime.

Which is still pretty darn good honestly.     Of course, all those plans are gone.   Both me, and him, have been hunting around for alternative plans, because the employer plan had a 50% jump in premiums again.

*Who else would I quote? I said it came in under budget.*

Because again, I don't give a crap if it came in under budget for the government.  How does that help me?   My premiums double, and you sit there and say "Yeah but it's saving money",.... bull crap!   It's not saving any money!    "Yeah but it's holding down costs!"   Bull CRAP!    I can see my bill.... it's not lower... it's higher... but a TON!

And I just pointed out, ERs are closing, and the primary reason is that they cut funding.     Yeah, it came in under budget, and now people are dying in the streets because all the ERs closed?   That's a win?

*What covered benefit does your plan (which apparently has the same premium it did a decade ago!) no longer have that it use to?*

Wow.... ok..... I'm not trying to be sarcastic..... but you do grasp the idea that if the deductible goes from $2,000 to $7,000.... that's a loss of benefit?   Do you get that concept?   Because I posted how much the deductible was higher.  It wasn't 'hidden' somehow... so I'm confused by your question.

*premiums for the coming open enrollment were expected to average about $5,200 (about $433/month) for single silver coverage. The actual numbers for next year actually look like they'll average more like $300-$350 per month. Significantly below budget*

How does that change anything I posted?   Are premiums for the vast majority of the public, higher, or lower, than now?   Have the premiums for the vast majority of the public increased more under Obama Care, or less under Obama Care?

I don't care what they thought their whatever plan was going to cost.  Only a tiny fraction of the public is buying that stuff.  Most of us are in the real world out here.  What has Obama Care done to *US*?  Not them.   I don't care about them.   I have my own bills to pay.  That's what I'm concerned about.


----------



## Billo_Really (Aug 27, 2015)

Andylusion said:


> You missed the point.   If you can completely eliminate the defense budget, and still have a deficit, by definition, you can't "pay it down a little".  That's not logical.  Unless you think somehow we can cut the defense budget to a negative amount, so that it is cut so much it brings in money, there is no possible way to cut it enough to have positive revenue.


I didn't say defense budget cuts would pay off the deficit, I said it would contribute to paying it down.  If the defense budget was $900 billion and you cut that in half, that leaves you with $450 billion to go to paying off the deficit.




Andylusion said:


> There are over $100 Trillion dollars in unfunded liabilities in Social Security and Medicare.   There is no amount of cutting to any other, or ALL other aspects of the Federal Budget that is going to fix that problem.


A Financial Transactions Tax would bring in the necessary revenue to not only pay off the deficit, but provide healthcare to every citizen in the country.



Andylusion said:


> Most of the banks that failed during the 2008 sub-prime crash, were banks that only dealt in mortgages.    In fact, the way the government 'fixed' the problem was to merge banks together.
> 
> How is doing the opposite of what the government did to fix the problem... going to fix the problem?
> 
> ...


We need to bring back Glass-Steagall.




Andylusion said:


> First, you shouldn't assume we're safe.   There are some regimes in the world, that honestly do not believe we'll use them.  I am not even sure we would use them.
> 
> A weapon no one thinks we'll ever use, is a weapon that might as well not exist.   Under Reagan, it was a deterrent.  Because people thought that if push came to shove, Reagan would do whatever he thought he must.
> 
> ...


Except when we're the ones running around the world making up bullshit reasons to attack sovereign nations.




Andylusion said:


> That strikes me as an incredible injustice, and a terrible level of selfish arrogance.   That might be the attitude of the self absorbed, "me-first-and-only" American mentality.  But that's sick and twisted.
> 
> We used to be better as a people than that.


Used to be, but then we elected Reagan.




Andylusion said:


> A:  Because we were not always selfish spoiled brats.
> B:  Because being an ally of the US used to mean something.
> C:  Because the reputation of America as a people who stand by their word as a nation, involves us actually standing up for what we say we'll do if an ally is attacked.
> 
> I get it.  That honor and dignity, isn't something that applies to you.   But some of us, it does.   Hopefully there are more like us, than like you.


We used to be the bastion of democracy, now were the bastion of hypocrisy.

We gave our word that _"a man is presumed innocent, until proven guilty"_ and that everyone receives_ "due process of law".  _Now the government can pluck anyone off the street and indefinitely detain them without charges for the rest of their life.




Andylusion said:


> One spark in the wrong place at the wrong time, can send half of California up in flames.
> 
> Similarly, one fight in the wrong place, at the wrong time, can prevent the world from going up in flames.
> 
> ...


Funny you mentioning Hitler and the Ukraine, since we're providing material support to the Nazis in Kiev.




Andylusion said:


> All of a sudden, we need heavy armor vehicles.
> 
> If we had followed the belief system of those like you, back during that Tank plant closure debate, we would be spending billions of dollars opening a new plant, new engineers, new retooling, new everything.
> 
> The cost to replace a manufacturing plant is tens of billions, compared to a few million to keep one we already have running.


Did you know all the helmuts the military wears, are exclusively made from prison labor?  100% of them.

The manufacturing plant can re-tool for commercial use.


----------



## Greenbeard (Aug 27, 2015)

Andylusion said:


> I didn't say an Emergency department.  You are shifting terms.     But again, Emergency departments fit under a different set of laws, that still have negative effects.  Yeah, anyone could open an ER.



This is actually specifically why we're talking about CON laws. You said ERs are subject to CON laws in Ohio (they aren't) and that's why there aren't more. Before "anyone could open an ER" it was "If you and I got together, pooled our money, got some investors, and tried to open an Emergency Room service.... we couldn't do it." 



			
				you said:
			
		

> There are only about a half dozen Emergency rooms in Columbus Ohio. Of those, there are actually only four total providers. Riverside Methodist, Mount Carmel, Grant, and OSU University Hospital (which is terrible gov-care).
> 
> In an area of 2 Million people, why are there only a whooping four Emergency Health care providers?
> 
> Because government controls that market. If you and I got together, pooled our money, got some investors, and tried to open an Emergency Room service.... we couldn't do it. The government prevents outsiders from competing. It's called 'certificate of need'. Its a method to have a "structured market". You can't just let anyone into the market! That would be chaos!



But it sounds like we're done talking about that so that's great. Let's move on.



			
				Andylusion said:
			
		

> But.... you can't turn anyone away from the ER. Which is great if you don't want to pay, and have a cough. You walk in with a sore throat, and they can't turn you away.



They have to stabilize individuals with emergency medical conditions (if they want to be eligible for Medicare reimbursement, which they generally do). They don't have to be your primary care doctor because you have the sniffles. They might choose to be, but they're under no requirement to be.



			
				Andylusion said:
			
		

> See people keep saying we can cut costs, and pay less like in the UK.  And we can..... just send the expensive skilled staff home at 5, and if you break a leg, or have a crash... well... SOL dude.   Saved money though.   At least you didn't have a big medical bill right?



It sounds like you're ridiculing the idea of relaxing requirements on ERs in the name of saving money. And yet I thought everything you're saying is in service of the idea that we need to relax requirements on medical facilities to save money. So I'm really not sure what you're saying or what your point is.




			
				Andylusion said:
			
		

> Not a chance.   I'm single for life.  I never meant to try and mislead anyone into thinking you can get a family plan for $67.   Crazy.



Odd. A deductible can't be higher than the total out-of-pocket maximum for a plan (obviously), and yet the legal OOP max for ACA-compliant single coverage this year is $6,600. So it isn't really possible to have a deductible as high as the one you quoted for an individual plan. Unless of course you're in a grandfathered plan that isn't even subject to the ACA, in which case I don't know why it's even entered into this conversation.



			
				Andylusion said:
			
		

> How does that help me?  My premiums double, and you sit there and say "Yeah but it's saving money",



You said your premiums are the same as they were ten years ago. You said they're $67. Doesn't particularly sound to me like you need help.



			
				Andylusion said:
			
		

> And I just pointed out, ERs are closing, and the primary reason is that they cut funding.     Yeah, it came in under budget, and now people are dying in the streets because all the ERs closed?   That's a win?



"People are dying in the streets because all the ERs closed"? Get a grip.



			
				Andylusion said:
			
		

> Wow.... ok..... I'm not trying to be sarcastic..... but you do grasp the idea that if the deductible goes from $2,000 to $7,000.... that's a loss of benefit?   Do you get that concept?   Because I posted how much the deductible was higher.  It wasn't 'hidden' somehow... so I'm confused by your question.



It sounds like you haven't lost any _benefits_ (i.e., services covered by your insurance), you just have to pay more of the costs of those services when you access them. For someone complaining about the health habits of co-workers (they should pay their own costs!), I'm failing to see why you view this as a bad thing. Particularly when it's been effective at freezing your premiums for the last decade.



			
				Andylusion said:
			
		

> How does that change anything I posted?   Are premiums for the vast majority of the public, higher, or lower, than now?   Have the premiums for the vast majority of the public increased more under Obama Care, or less under Obama Care?



For the vast majority, they've increased less than the historical average.



> Premiums for job-based insurance rose modestly for the third consecutive year, reflecting slowed spending, even as key elements of the federal health care law went into effect.
> 
> Family premiums rose 3 percent in 2014, one of the lowest increases tracked since the Kaiser Family Foundation and the Health Research & Educational Trust began surveying employers in 1999.


----------



## playtime (Aug 28, 2015)

Claudette said:


> Yup and everyone will be paying more for their benefits.
> 
> My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?



Your costs went up because the insurance companies still want to make a profit off of your health, or lack of.


----------



## Andylusion (Aug 28, 2015)

Billo_Really said:


> Andylusion said:
> 
> 
> > You missed the point.   If you can completely eliminate the defense budget, and still have a deficit, by definition, you can't "pay it down a little".  That's not logical.  Unless you think somehow we can cut the defense budget to a negative amount, so that it is cut so much it brings in money, there is no possible way to cut it enough to have positive revenue.
> ...



Well first off, the Defense Budget isn't even close to $900 Billion.  It's more like $670 Billion.

If you cut that in half, that's $335 Billion, and the current deficit is over $400 Billion, and is projected to increase to $800 billion in the next decade based on the social programs and expenses the government has committed to pay in the future.

In other words, cutting defense spending in half, isn't going to eliminate the deficit or pay down the debt at all period.  The math is not on your side.
*
A Financial Transactions Tax would bring in the necessary revenue to not only pay off the deficit, but provide healthcare to every citizen in the country.*

Nice theory.   It's wrong theory, but it's a nice theory.  When they jacked up taxes on Yachts, rich people stopped buying yachts.  The yachting industry went in a free fall.    Revenue was a tiny fraction of what they claimed it would be.

The failure in your theory is that you assume that financial transactions would continue as they do now without the tax.   That's wrong.  When you tax something, people change their behavior to avoid the tax.   Just like major companies move their operations outside the US, to avoid Corporate Taxes.

No, the financial tax will not bring in all the revenue in the world to pay for all your little programs.

*We need to bring back Glass-Steagall.*

Why?  Glass-Steagall would have done nothing to prevent the crash of 2008.   Glass-Steagall would have prevented the government from fixing the crash of 2008.     No other country has ever had a Glass-Steagall act, and yet the problem started here in the US.

It will do nothing solve anything.    So.... why?

*Used to be, but then we elected Reagan.*

So in your world, completely abandoning our ally to be overthrown, proving to the world we couldn't be trusted, resulting in a brutal, and insane dictator who is developing nuclear weapons, with the intent and purpose of attacking another of our ally.....

that to you is "honorable".   But Reagan standing up to the Soviet Union, and helping the Germany people escape socialistic hell.... that's dishonorable.

You are a moron if you think that.

*We used to be the bastion of democracy, now were the bastion of hypocrisy.*

No, we were never supposed to be a democracy.   You clearly haven't read the Federalist papers and what the founding fathers said of democracy.   As for being a hypocrite.... you would be in the know.

*Funny you mentioning Hitler and the Ukraine, since we're providing material support to the Nazis in Kiev.*

Only if you are a Russian media plant.   The BBC did a documentary about the whole thing.   Are there Nazis in Kiev?  Yes.   Are there Nazis in the Russian Rebels?  Yeah, actually most of them are.    Why the heck do you think they believe Ukraine is rightfully part of mother Russia.  It's a national socialist belief system.

*We gave our word that "a man is presumed innocent, until proven guilty" and that everyone receives "due process of law". Now the government can pluck anyone off the street and indefinitely detain them without charges for the rest of their life.*

So that needs to end, assuming it's true.   Great.  What's it go to do with the topic at hand?


----------



## Andylusion (Aug 28, 2015)

Greenbeard said:


> Andylusion said:
> 
> 
> > I didn't say an Emergency department.  You are shifting terms.     But again, Emergency departments fit under a different set of laws, that still have negative effects.  Yeah, anyone could open an ER.
> ...



You are correct.  I made a mistake.   I meant a hospital service, not an ER.   We couldn't open an ER, because we can't turn away people who don't pay, and thus we would go bankrupt.

I meant a hospital service.   A service where you have people in a bed, with a nurse watching them.  Can't do that without certificate of need.      Which of course, the government limits, which drives up prices.

I guarantee the average price of a hospital stay wouldn't be $9,000, if anyone could open a hospital bed service, without any regulation.

But you are correct. I looked it up, and I did say "emergency", which was an error on my part.

*They have to stabilize individuals with emergency medical conditions (if they want to be eligible for Medicare reimbursement, which they generally do). They don't have to be your primary care doctor because you have the sniffles. They might choose to be, but they're under no requirement to be.*

Ok?  So why are they closing for lack of reimbursement?   Why don't they turn those people away?
*
It sounds like you're ridiculing the idea of relaxing requirements on ERs in the name of saving money. And yet I thought everything you're saying is in service of the idea that we need to relax requirements on medical facilities to save money. So I'm really not sure what you're saying or what your point is.*

No, I am ridiculing that idea that having government funded health care is cheaper.   It's not cheaper.     It not only costs more money, but it also provides worse service.

People think they are going to 'save money' by having government pay for health care.    No, taxes in the UK are massively higher than the US.  The standard of living is lower, and ultimately their health care is worse.

That's where the problem is.

*Odd. A deductible can't be higher than the total out-of-pocket maximum for a plan (obviously), and yet the legal OOP max for ACA-compliant single coverage this year is $6,600. So it isn't really possible to have a deductible as high as the one you quoted for an individual plan. Unless of course you're in a grandfathered plan that isn't even subject to the ACA, in which case I don't know why it's even entered into this conversation.*






The Deductible on this plan is $10K.





That one only lasts 6 months.

That's another thing that is bugging me.   All the policies I see that I can afford now, have a limited duration.

Before, I just has a flat out insurance policy that lasted as long as I kept paying the premium.   Perhaps that's the key to your problem.   Maybe limited duration policies are exempted from all the regulations.   But that is also a problem, I hate the idea that I'll have to keep re-applying for health care.
*
You said your premiums are the same as they were ten years ago. You said they're $67. Doesn't particularly sound to me like you need help.*

Ok, I'll explain this again.... I can see how it could be confusing.

Back in 2006.... I purchased an individual insurance plan for $67 a month.    That was 2006.   Not last year... not the last 5 years.

I had that policy for about 2 years I think.    In 2012, I got this job where I am now.   At this job, the premiums doubled.    They doubled in 2013, and 2014.

That brings us to today.   So I punched in the same information that I did back in 2006, and now as you can see, I can in fact get a policy for $67 a month.....  but... it only lasts for 6 months, or 12 months.... the deductibles are $7,500 or $10,000, and the co-insurance is 30% on one of them.

To get the exact same policy I had before, well actually I can't.   The cheapest I can find of the other plans, is $80 a month, and that's with a $6,300 deductible.




The one positive there is, I love the idea that I'm making other people pay for most of my health insurance.   I disagree with the concept, but if people are stupid enough to pay for my health insurance... peachy.   The more I can soak the left-wingers, the better.

*"People are dying in the streets because all the ERs closed"? Get a grip.*

Well if all the ERs close... what do you think is going to happen?   Did you read the article?   The reason that hospital closed their ER, is because the other hospital in the same area, closed theirs.

All the people that went to the first hospital, ended up at the second, and the second closed their ER too.   So now I'm sure they are swamping a third ER, which of course will be forced to close as well.

Eventually......    people are going to start dying.   How else do you see this pattern ending?   Have you read Code Blue, about the ERs in Canada closing?   People died.   Welcome to reality.   This is how it works.

*It sounds like you haven't lost any benefits (i.e., services covered by your insurance), you just have to pay more of the costs of those services when you access them. For someone complaining about the health habits of co-workers (they should pay their own costs!), I'm failing to see why you view this as a bad thing. Particularly when it's been effective at freezing your premiums for the last decade.*

Again, every single time you say "It's been effective at freezing your premium", I'm going to respond with, you are wrong....    When the benefits are cut..... that's a rise in premiums.

When the amount that the insurance covers is LOWER..... that is an increase in cost.

A higher deductible.... is a cut in benefits.   Example:   If my premium is $67/mo and the deductible is $2,000... and then you pass a law, and now my premium is $67/mo, and the deductible is $7,500......  that's not holding premiums down.

Premiums have gone up drastically.     Now I have to pay $221 a month to get a $2,000 deductible.    $67/mo gets me LESS coverage.

I'm confused why that's difficult to understand.  If the insurance covers less.... prices have increased.

I don't care about "it covers more services".   I'd rather have an insurance policy that covers LESS services, at a more reasonable price.   Cover just the services that I actually want... at a price I can afford.    If it covers a hundred more services, at a price I can't afford....  that's fail, not a win.

You people screwed me, and most of the country.


----------



## Andylusion (Aug 28, 2015)

playtime said:


> Claudette said:
> 
> 
> > Yup and everyone will be paying more for their benefits.
> ...



All companies make a profit off of us.  If they didn't, they wouldn't provide us anything.

The question is which system is better.  I maintain that the previous system was better at providing us care at a better price, than the current.

You mandated that they cover people with pre-existing conditions.   That drives up prices.
You mandated that they cover more services.   That drives up price.
You mandated that they have a lower out-of-pocket max.   That drives up price.

The more you require that insurance covers... the higher the price is on us.


----------



## playtime (Aug 28, 2015)

Andylusion said:


> playtime said:
> 
> 
> > Claudette said:
> ...



The fundamental problem is healthcare for profit. Remove the profit factor & that problem goes bye-bye. The mandate now requires 80-85% of your premium is spent directly on your  healthcare or you get a refund. You know what truly drives up cost?

Greed.


----------



## Billo_Really (Aug 28, 2015)

Andylusion said:


> Well first off, the Defense Budget isn't even close to $900 Billion.  It's more like $670 Billion.
> 
> If you cut that in half, that's $335 Billion, and the current deficit is over $400 Billion, and is projected to increase to $800 billion in the next decade based on the social programs and expenses the government has committed to pay in the future.
> 
> In other words, cutting defense spending in half, isn't going to eliminate the deficit or pay down the debt at all period.  The math is not on your side.


When you add in development projects, the costs of the wars, emergency funding from Congress, military programs buried in the DOE, Homeland Security and the intelligence agencies, the cost of military spending exceeds $1.2 trillion/yr.

Cut that in half and you have $600 billion to help pay down the deficit.
*
*


Andylusion said:


> Nice theory.   It's wrong theory, but it's a nice theory.  When they jacked up taxes on Yachts, rich people stopped buying yachts.  The yachting industry went in a free fall.    Revenue was a tiny fraction of what they claimed it would be.
> 
> The failure in your theory is that you assume that financial transactions would continue as they do now without the tax.   That's wrong.  When you tax something, people change their behavior to avoid the tax.   Just like major companies move their operations outside the US, to avoid Corporate Taxes.
> 
> No, the financial tax will not bring in all the revenue in the world to pay for all your little programs.


Really?  Do you really think people will stop trading on Wall Street over a $0.003 tax for each transaction?  That's ridiculous!




Andylusion said:


> Why?  Glass-Steagall would have done nothing to prevent the crash of 2008.   Glass-Steagall would have prevented the government from fixing the crash of 2008.     No other country has ever had a Glass-Steagall act, and yet the problem started here in the US.
> 
> It will do nothing solve anything.    So.... why?


In '29, we had a stock market crash.  Then Glass-Steagall was enacted.  For over half a century, we had no economic meltdown.  Then, few years after its repeal, we had another meltdown.

The 2008 crash was a direct result of deregulating the financial industry, the derrivitive bubble and predatory lending.  Glass-Steagall would've prevented that by not allowing investment banks and savings banks to do business under the same roof.



Andylusion said:


> So in your world, completely abandoning our ally to be overthrown, proving to the world we couldn't be trusted, resulting in a brutal, and insane dictator who is developing nuclear weapons, with the intent and purpose of attacking another of our ally.....
> 
> that to you is "honorable".   But Reagan standing up to the Soviet Union, and helping the Germany people escape socialistic hell.... that's dishonorable.
> 
> You are a moron if you think that.


I don't know who you're talking about above, but Reagan had nothing to do with the fall of the Soviet Union.  They ran out of money.  Which is the same thing we are going to do, if we continue this bullshit war on terror.



Andylusion said:


> No, we were never supposed to be a democracy.   You clearly haven't read the Federalist papers and what the founding fathers said of democracy.   As for being a hypocrite.... you would be in the know.


If the Founding Fathers wanted the Federalist Papers to be the law of the land, they would've included more of them in the Constitution.




Andylusion said:


> Only if you are a Russian media plant.   The BBC did a documentary about the whole thing.   Are there Nazis in Kiev?  Yes.   Are there Nazis in the Russian Rebels?  Yeah, actually most of them are.    Why the heck do you think they believe Ukraine is rightfully part of mother Russia.  It's a national socialist belief system.


I don't believe in supporting Nazi's military coup against a democratically elected government.




Andylusion said:


> So that needs to end, assuming it's true.   Great.  What's it go to do with the topic at hand?


If you're not sure if its true, then try reading the Patriot and Military Commissions Acts.  And for good measure, throw in the NDAA.

But you're right, we're getting off topic.


*Obamacare is a big success.*


----------



## Andylusion (Aug 29, 2015)

playtime said:


> Andylusion said:
> 
> 
> > playtime said:
> ...



Then why is food cheaper in the US than anywhere else?
Why is computers, housing, and transportation, cheaper here than anywhere else?

Why does computer technology fall in price?    Why has oil fallen in price?

Greed is the intellectually lazy way out, and it doesn't stand up to the facts.

If Greed was the answer, then every single apartment rental would be a million dollars a month.

That's not a valid explanation.


----------



## playtime (Aug 29, 2015)

Andylusion said:


> playtime said:
> 
> 
> > Andylusion said:
> ...



Food is 'cheaper' here for a variety of reasons.  Climate that is conducive for native crops & subsidies.

Technology, as it is mass produced naturally brings cost down.

Who is going to rent an apartment for a million dollars as an avg going price when most people can't naturally afford that?
The avg landlord would not be in business very long. Demographics & location dictate the mkt.  Housing in Bumfuck, Iowa will not be the same going rate as the exact same square footage of a dwelling in NYC.

Transportation is cheaper, yes.... but that is because a lot of taxes are built into gas & mass transit costs where there's a universal healthcare system... so the 'cost' is shared.  I'd rather pay $10 for a gallon of gas if that meant no premiums, no copays, no co insurance, no out of pocket expenses ever again. Oil, right NOW is cheaper because ISIS is pumping it & selling it on the open market, Iran will also be dumping more for consumption that will help keep the glut going.  And greed certainly factors in on the oil companies... BP is still fighting the decision to pay for causing the Gulf disaster.

Those are real facts.


----------



## Andylusion (Aug 29, 2015)

Billo_Really said:


> Andylusion said:
> 
> 
> > Well first off, the Defense Budget isn't even close to $900 Billion.  It's more like $670 Billion.
> ...



Funny how "wars" now turned into intelligence gathering, homeland security, some mystery project in the DOE, and whatever else you tossed in there.

Well you can argue that if you want, but you are wasting your time.  Those are not going away.  Period.     Not happening.

*Do you really think people will stop trading on Wall Street over a $0.003 tax for each transaction? That's ridiculous!*

Do you really think a $0.003 tax for each transaction is going to fund all the health care in the country?  That's ridiculous!

Any significant tax, would have a significant effect.  3/10ths of a cent, isn't enough to fund anything.  

*In '29, we had a stock market crash. Then Glass-Steagall was enacted. For over half a century, we had no economic meltdown. Then, few years after its repeal, we had another meltdown.*

You understand the concept that correlation doesn't equal causation?

I had a bowel movement today, and Obama was president.  Therefore Obama causes poop.

Instead of just mindlessly assuming that two unrelated events are automatically connected, how about you look at the facts.

Fact:  All the rest of the world, does not have a Glass-Steagal limitation.    UK doesn't.  Canada doesn't.  Europe doesn't.  China doesn't.   Nowhere else has a any similar restriction.

Yet, the crash originated in the US.

Fact:  The government in it's bid to fix the crisis, merged banks together.    For example Bank of America, and Countrywide Financial.    That merger, and dozens of other mergers the government brokered, would all have been illegal under Glass-Steagal, which in theory, would have made the crash many times worse than it was.

Fact:  Most of the banks that crashed during the 2008 sub-prime crisis, would not have been effected by Glass-Steagall had it still been in place.   Countrywide, was only a mortgage broker.   IndyMac was only retail.  Bear Stearns was only investment, Lehman Brothers was only investment, AIG was only insurance.

The vast majority of the banks that failed, were all banks that would not have been affected in any way, by Glass-Steagall.     It would have done absolutely nothing to any of them.

Fact:  Some of the banks that didn't fail, were banks that would have been broken up by Glass-Steagal.   Bank of America, JPMorgan Chase, Morgan Stanley, and numerous others, all of which were able to survive the recession, would have been broken up under Glass-Steagall, and thus more likely to have crashed.

Fact:  The housing price bubble that caused the crash to begin with, started in 1997, while the repeal of Glass-Steagall happened in 1999.   It is absolutely impossible to blame the crash, on legislation that was passed two years after the bubble started.

Bottom line.... Glass-Steagall would not have stopped anything.  If you want to put in back in place, fine, but you are not improving anything.   You may likely be making things worse.

*I don't know who you're talking about above, but Reagan had nothing to do with the fall of the Soviet Union. They ran out of money. Which is the same thing we are going to do, if we continue this bullshit war on terror.*

Carter and Iran.   He ditched our ally, which is why we have a huge problem with Iran right now.   That's where your line of thinking leads us.

Again, if there was no war on terror... if there was no defense budget... we would still be in trouble.   Math dude.  Use a calculator.    Social Security, and Medicare do not add up, period.   You can point fingers and blame everyone on the planet, but yourself, but that doesn't change the fact those programs are not sustainable.    None of the rest of your blaw blaw blaw, changes that they are not sustainable, no matter what else we do, or do not spend.

*If the Founding Fathers wanted the Federalist Papers to be the law of the land, they would've included more of them in the Constitution.*

The Federalist papers explain the Constitution, and the thinking behind the constitution, so that morons centuries later can't just make up whatever the heck they want, and claim that's what the constitution says.

*I don't believe in supporting Nazi's military coup against a democratically elected government.*

But clearly you do believe in tin foil hat conspiracy theories and Russian propaganda.  Carry on. 

*Obamacare is a big success.*

Again....     Yeah, perhaps more people have insurance.

But.... what about society as a whole?

Obamacare Insurance Premiums to Jump by up to 51%

51% increase in premiums?     Are you really saying that's a 'success'?    Screw over the public.... and get a few more people insurance?

And how exactly are they getting insurance?   Oh, right.... they are buying subsidized plans.   What does that mean?  It means taxes will have to go up to pay for those premiums!

So let's recap.    Insurance premiums have increased 51%, and now our taxes will have to go up to pay for those subsidized policies.

Success!  We screwed over the public from two directions at the same time!   Go Obama Care!  Screwing over the public for decades to come!   Yay!

Do you not see why the public isn't all happy about your "success"?


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## Andylusion (Aug 29, 2015)

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That can't be!   Greed should drive up the cost of technology, making food super expensive!   Doesn't matter what the climate is, greed should drive up the cost no matter how much is produced.... right?  Greed is the only answer.

Greed should drive up the cost of a rental, regardless... right?

So you are saying that greed isn't the dominating factor in the market?

Oh but you are wrong.....   sorry you are wrong.  There are co-pays and co-insurance, and there are out-of-pocket expenses in nearly all "universal" care systems.

But wouldn't greed keep the prices up?  Are you saying ISIS isn't greedy?    Iran isn't Greedy?   Doesn't greed drive up prices on everyone?   Or is greed not the defining factor of a market?

*Here's my problem....*

When you talk about health care, you completely ignore all market forces, and blame everything on "greed", as if there are no other relevant factors at play.

And yet, when we apply the "greed theory of economics" to any other situation, you instantly go to "well this market force prevents it", or "that market force stops it".     And you would be right.

Free-market Supply and demand, keep prices low for food, for oil, for rentals, for homes, on and on and on...........

You are correct.   But again, you magically eject your brain, dump your intelligence, and lemmingly go back to "greed" when we talk about health care.

My answer....  Greed isn't the problem.  There are market problems caused by government regulations and interventions, that have led to the issue.

Proof?    Well, why can you get $100,000 surgeries in India, for $18,000?   Greed.    They are greedy.  They want to earn a profit.   They want to make money.   So to attract customers, they found cheaper ways, to make a profit, for greed.

Greed isn't the problem.  Profit, isn't the problem.   It's government regulations and controls in this country, that have disabled the price suppressing system of competition for profit, that has led to exploding prices.


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## playtime (Aug 29, 2015)

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Nobody says that running a business does not mean not earning a profit.  I'm specifically saying healthcare shouldn't be profit driven.  You deflected by bringing in a slew of other 'reasons'  that has zero to do with healthcare.  Any business will mark up their product or service to get as much as they can without tipping it past affordability & staying competitive in any demographic or they will go bankrupt.  That's economics 101.  But to profit off of healthcare is morally wrong.

Obamacare is not universal healthcare. Any other so called copays etc in a real  universal plan drops that out of pocket expense to nearly zero in comparison to what it costs in this country.  & the healthcare corps are as greedy as they can get away with.  if the status quo were still in effect, people would STILL lose their homes for no other reason but for the misfortune of getting cancer or through no fault of their own, got involved in a bad car crash...  why would that be ok with you?  And if the ins companies thought that theirs was the best system, why did they fight tooth & nail... spending millions of dollars for their lobbyists to get rid of the public option?  because they knew they would not be able to compete & their greed would not survive.

So much for the capitalistic free market system.


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## Andylusion (Aug 29, 2015)

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Listen, if health care was not driven by profit, then you would have no health care.    No one spends billions to come up with a new technology to help people, if there's no profit.   Zero profit... zero care.

That's life dude.   Get over it.

All of those reasons DO have to do with health care.  There is nothing 'special' about health care that makes it exempt from the fundamentals of economics.  Nothing.    And every system that denies that, ends up with no health care.   Before the current reforms in Cuba, the average Cuban couldn't even get Aspirin in Cuba.   Aspirin.     You know, that space age technology.

There is nothing morally wrong with profiting off of health care.  That's mindless babbling.

I didn't say Obama Care is universal health care.  I said universal health care does have co-pays and out of pocket expenses.   You are wrong.

Patient co-payments - Help with NHS health costs in England - NHS Choices

UK Co-pays.

What's the cost of beating NHS waiting lists?

And if you want to not wait a year for some treatments, you have to pay a massive fee to be treated sooner.

See a doctor in France: hospitals, emergencies and the EHIC card
The impact of Hollande's healthcare reforms in France - PMLiVE

Now it used to be that all the fees and co-pays in France were reimbursed.   But they were going broke.   Now they are not reimbursed.   And it looks like reimbursements will be cut in the future.

Most of the "universal health care" countries  you think have free health care, all have co-pays and fees.

But even those that don't.....   Like France before, everyone said "well isn't this great", but in reality they were going broke the whole time, and eventually the system had to be reformed.

If they had not reformed their system, they would have ended up like Greece.   Greece's health care was free.... now it barely even exists.    Well done.  They followed your plan to the letter... and look where it got them.


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## dblack (Aug 29, 2015)

playtime said:


> Nobody says that running a business does not mean not earning a profit.  I'm specifically saying healthcare shouldn't be profit driven.  You deflected by bringing in a slew of other 'reasons'  that has zero to do with healthcare.  Any business will mark up their product or service to get as much as they can without tipping it past affordability & staying competitive in any demographic or they will go bankrupt.  That's economics 101.  But to profit off of healthcare is morally wrong.



I'm still not seeing why it's morally wrong. And if it is, would you also argue that it's morally wrong for any other necessities of life to be profit driven? (food, clothing, shelter, etc...)


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## Andylusion (Aug 29, 2015)

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> > Nobody says that running a business does not mean not earning a profit.  I'm specifically saying healthcare shouldn't be profit driven.  You deflected by bringing in a slew of other 'reasons'  that has zero to do with healthcare.  Any business will mark up their product or service to get as much as they can without tipping it past affordability & staying competitive in any demographic or they will go bankrupt.  That's economics 101.  But to profit off of healthcare is morally wrong.
> ...



I agree.    Oddly, it's less likely to be 'morally wrong', than other things.   Humans have survived for thousands of years without health care.    There are places in the world today that have no health care, and still survive.

But no food, no water?   See how long humans can go without either of those.

Is it wrong for food and water to be profit driven?    And yet which place has more food and water... profit driven America, or some of these third world countries?

Again, the left would rather people die, as long as no one profits from it.   Profiting from making people well.... that's morally wrong.   Makes absolutely no logical sense to be a leftist.


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## David_42 (Aug 30, 2015)

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Humans have survived with pitiful life spans and rampant disease without healthcare for thousands of years, how the hell is that something to bring up? I agree, humans need food and water, it's why we shouldn't have corporations polluting/wasting water and failing to distribute food.


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## Andylusion (Aug 30, 2015)

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I just explained this.    Try reading.

If you are going to say it's immoral to make a profit by supplying a service to heal people.... then how is it moral to provide food, without which we all die?  Or water, without which we all die?

And yet, the profit motive provides better, and more, food and water for people all over the planet.   pollution/wasting, that's a strawman.

Fact is, the profit motive has provided more food, to more people, than any socialized system.   There is a reason the Soviets were on the verge of mass starvation before the crash of the union.

There's a reason for mass graves in North Korea today.
There's a reason for the mass starvation of Communist China.
There's a reason for the massive food shortages in Venezuela.

And I'll give you at hint... it wasn't because people were profiting from it.

The leftist position isn't logical.


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## playtime (Aug 30, 2015)

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dblack said:


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> ...



To not help heal someone solely based on their affordability isn't immoral?  Unbelievable.


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## dblack (Aug 30, 2015)

David_42 said:


> I agree, humans need food and water, it's why we shouldn't have corporations polluting/wasting water and failing to distribute food.



So would you make the same argument against profit-driven agriculture that we're hearing against profit-driven health care?


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## dblack (Aug 30, 2015)

playtime said:


> To not help heal someone solely based on their affordability isn't immoral?  Unbelievable.



How many people did you let die today?


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## playtime (Aug 30, 2015)

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No system under 'universal healthcare' is perfect & I never said it was.  I also said, if I had my druthers, I'd rather have zero copays etc...  I suggest you watch this sometime.  5 countries compare their healthcare systems to ours at the time was completely in the hands of the healthcare corps.  Are their systems perfect?  No.   Did any claim they were?  No.  Is there room for improvements?  Always.   But  not one person interviewed... when asked if they would trade their healthcare system with that of Americans/United States- not one said they would.

In _Sick Around the World,_ FRONTLINE teams up with veteran _Washington Post_ foreign correspondent T.R. Reid to find out how five other capitalist democracies -- the United Kingdom, Japan, Germany, Taiwan and Switzerland -- deliver health care, and what the United States might learn from their successes and their failures. 

Watch The Full Program | Sick Around The World | FRONTLINE | PBS
*



*
*Each has a health care system that delivers health care for everyone -- but with remarkable differences.*

*United Kingdom*



An interview with an expert on the UK's system +
*Percentage of Gross Domestic Product (GDP) spent on health care:* 8.3

*Average family premium:* None; funded by taxation.

*Co-payments:* None for most services; some co-pays for dental care, eyeglasses and 5 percent of prescriptions. Young people and the elderly are exempt from all drug co-pays.

*What is it?* The British system is "socialized medicine" because the government both provides and pays for health care. Britons pay taxes for health care, and the government-run National Health Service (NHS) distributes those funds to health care providers. Hospital doctors are paid salaries. General practitioners (GPs), who run private practices, are paid based on the number of patients they see. A small number of specialists work outside the NHS and see private-pay patients.

*How does it work?* Because the system is funded through taxes, administrative costs are low; there are no bills to collect or claims to review. Patients have a "medical home" in their GP, who also serves as a gatekeeper to the rest of the system; patients must see their GP before going to a specialist. GPs, who are paid extra for keeping their patients healthy, are instrumental in preventive care, an area in which Britain is a world leader.

*What are the concerns?* The stereotype of socialized medicine -- long waits and limited choice -- still has some truth. In response, the British government has instituted reforms to help make care more competitive and give patients more choice. Hospitals now compete for NHS funds distributed by local Primary Care Trusts, and starting in April 2008 patients are able to choose where they want to be treated for many procedures.

*Japan*



An interview with an expert on Japan's system +
*Percentage of GDP spent on health care:* 8

*Average family premium:* $280 per month, with employers paying more than half.

*Co-payments:* 30 percent of the cost of a procedure, but the total amount paid in a month is capped according to income.

*What is it?* Japan uses a "social insurance" system in which all citizens are required to have health insurance, either through their work or purchased from a nonprofit, community-based plan. Those who can't afford the premiums receive public assistance. Most health insurance is private; doctors and almost all hospitals are in the private sector.

*How does it work?* Japan boasts some of the best health statistics in the world, no doubt due in part to the Japanese diet and lifestyle. Unlike the U.K., there are no gatekeepers; the Japanese can go to any specialist when and as often as they like. Every two years the Ministry of Health negotiates with physicians to set the price for every procedure. This helps keeps costs down.

*What are the concerns?* In fact, Japan has been so successful at keeping costs down that Japan now spends _too little_ on health care; half of the hospitals in Japan are operating in the red. Having no gatekeepers means there's no check on how often the Japanese use health care, and patients may lack a medical home.

*Germany*



An interview with an expert on Germany's system +
*Percentage of GDP spent on health care:* 10.7

*Average family premium:* $750 per month; premiums are pegged to patients' income.

*Co-payments:* 10 euros ($15) every three months; some patients, like pregnant women, are exempt.

*What is it?* Germany, like Japan, uses a social insurance model. In fact, Germany is the birthplace of social insurance, which dates back to Chancellor Otto von Bismarck. But unlike the Japanese, who get insurance from work or are assigned to a community fund, Germans are free to buy their insurance from one of more than 200 private, nonprofit "sickness funds." As in Japan, the poor receive public assistance to pay their premiums.

*How does it work?* Sickness funds are nonprofit and cannot deny coverage based on preexisting conditions; they compete with each other for members, and fund managers are paid based on the size of their enrollments. Like Japan, Germany is a single-payment system, but instead of the government negotiating the prices, the sickness funds bargain with doctors as a group. Germans can go straight to a specialist without first seeing a gatekeeper doctor, but they may pay a higher co-pay if they do.

*What are the concerns?* The single-payment system leaves some German doctors feeling underpaid. A family doctor in Germany makes about two-thirds as much as he or she would in America. (Then again, German doctors pay much less for malpractice insurance, and many attend medical school for free.) Germany also lets the richest 10 percent opt out of the sickness funds in favor of U.S.-style for-profit insurance. These patients are generally seen more quickly by doctors, because the for-profit insurers pay doctors more than the sickness funds.

*Taiwan*



An interview with an expert on Taiwan's system +
*Percentage GDP spent on health care:* 6.3

*Average family premium:* $650 per year for a family for four.

*Co-payments:* 20 percent of the cost of drugs, up to $6.50; up to $7 for outpatient care; $1.80 for dental and traditional Chinese medicine. There are exemptions for major diseases, childbirth, preventive services, and for the poor, veterans, and children.

*What is it?* Taiwan adopted a "National Health Insurance" model in 1995 after studying other countries' systems. Like Japan and Germany, all citizens must have insurance, but there is only one, government-run insurer. Working people pay premiums split with their employers; others pay flat rates with government help; and some groups, like the poor and veterans, are fully subsidized. The resulting system is similar to Canada's -- and the U.S. Medicare program.

*How does it work?* Taiwan's new health system extended insurance to the 40 percent of the population that lacked it while actually _decreasing_ the growth of health care spending. The Taiwanese can see any doctor without a referral. Every citizen has a smart card, which is used to store his or her medical history and bill the national insurer. The system also helps public health officials monitor standards and effect policy changes nationwide. Thanks to this use of technology and the country's single insurer, Taiwan's health care system has the lowest administrative costs in the world.

*What are the concerns?* Like Japan, Taiwan's system is not taking in enough money to cover the medical care it provides. The problem is compounded by politics, because it is up to Taiwan's parliament to approve an increase in insurance premiums, which it has only done once since the program was enacted.

*Switzerland*



An interview with an expert on Switzerland's system +
*Percentage of GDP spent on health care:* 11.6

*Average monthly family premium:* $750, paid entirely by consumers; there are government subsidies for low-income citizens.

*Co-payments:* 10 percent of the cost of services, up to $420 per year.

*What is it?* The Swiss system is social insurance like in Japan and Germany, voted in by a national referendum in 1994. Switzerland didn't have far to go to achieve universal coverage; 95 percent of the population already had voluntary insurance when the law was passed. All citizens are required to have coverage; those not covered were automatically assigned to a company. The government provides assistance to those who can't afford the premiums.

*How does it work?* The Swiss example shows that universal coverage is possible, even in a highly capitalist nation with powerful insurance and pharmaceutical industries. Insurance companies are not allowed to make a profit on basic care and are prohibited from cherry-picking only young and healthy applicants. They can make money on supplemental insurance, however. As in Germany, the insurers negotiate with providers to set standard prices for services, but drug prices are set by the government.

*What are the concerns?* The Swiss system is the second most expensive in the world -- but it's still far cheaper than U.S. health care. Drug prices are still slightly higher than in other European nations, and even then the discounts may be subsidized by the more expensive U.S. market, where some Swiss drug companies make one-third of their profits. In general, the Swiss do not have gatekeeper doctors, although some insurance plans require them or give a discount to consumers who use them.

Five Capitalist Democracies & How They Do It | Sick Around The World | FRONTLINE | PBS


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## playtime (Aug 30, 2015)

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I have no problem with my taxes being raised so others that can't afford it won't.

I already said that.   How about YOU?


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## dblack (Aug 30, 2015)

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You claim that not helping someone is immoral. You're not helping millions right now. Why not?


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## Andylusion (Aug 30, 2015)

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First off, I doubt that.  You say that now, but then if you don't have a problem with higher taxes to pay for others, why do you have a problem with higher premiums to pay for others?    The whole reason premiums are jacked up, is to pay for other people's care.

The fact is, most people do have a problem paying for everyone else's stuff.  AND THEY SHOULD.   It's morally evil to force people to pay for everyone else's care.

And you self-righteous arrogant types are all hypocrites too.   Tell me, how much money have you donated to charity health care?   I have.... have you?

Besides that, we still have the best quality care in the world.

But the bottom line is.... government health care sucks.    We've seen that with the VA.  We've seen that in Canadians coming to hte US for care.  We've seen that in the UK, which has one of the highest rates of people going for medical tourism.     We've seen that around the world.

So you, while trying to claim moral superiority, or dooming people to terrible care.   How is that a win?


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## Andylusion (Aug 30, 2015)

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So you just proved my entire point.  Thanks.

The idea that Universal Health Care, involves no out of pocket expenses, is false.  I provided evidence, now you provided evidence.

So we can clearly state with certainty, that this idea of "government will provide us with free health care" is false.

Please continue.


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## David_42 (Aug 30, 2015)

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American tax rates are low compared to other countries that live longer, and how much debt do we have? Raising taxes is a way to help this. Universal healthcare is a different animal then the ACA bud. Morally evil? Welcome to a civilized society where people pay taxes to help those less advantaged, sorry about that. Best quality care? Sure, if you're loaded. The VA is underfunded and mismanaged, not a good way to attempt to judge government healthcare worldwide bud. Oh, the Canadian myth.. You see, countries with UHC put back more cosmetic problems, those are the people who come here, and they're not coming in droves. People in Britain and Canada don't want a different healthcare system, they know ours fucks over those who aren't rich.


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## David_42 (Aug 30, 2015)

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Of course nothing is free, but it's a hell of a lot better then our current healthcare system, even though they pay higher taxes, and they're ok with it.


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## David_42 (Aug 30, 2015)

Also, Andy, having healthcare be profit driven in a place like INDIA is horrible.


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## dblack (Aug 30, 2015)

I'm still wondering how the anti-profit folks think health care is any different than any of the other necessities of life. If you don't think doctors should be allowed to make a profit, why should farmers?


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## Andylusion (Aug 30, 2015)

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The VA is typical of socialized care.  Every gov-care system is overloaded and underfunded.   That's how socialism is.  There is not enough taxes in the world to fix a ponzi scheme.

Yes it is morally evil.  IF that's what "civilized society" is, then you have redefined "civilized society" to mean tyrannical oppression in the name of moral arrogance.

I never said that Universal Health care was the same as the ACA.  Can I just make up what you say, and attack you for it?

EXCLUSIVE 200,000 desperate Britons go ABROAD for medical care as NHS waiting lists spiral

200,000 people travel out of Britain to get away from "Free" health care, to pay for health care out of the country.

In nation of only 65 Million people, 200,000 a year, is pretty close to "droves".


Canadians hate our health care system?

http://dailycaller.com/2012/07/11/report-thousands-fled-canada-for-health-care-in-2011/

A Canadian study released Wednesday found that many provinces in our neighbor to the north have seen patients fleeing the country and opting for medical treatment in the United States.
The nonpartisan Fraser Institute reported that 46,159 Canadians sought medical treatment outside of Canada in 2011, as wait times increased 104 percent — more than double — compared with statistics from 1993.​46,000 patients a year, leaving their "free" health care system in order to PAY for health care outside their country.... and with a population of only 35 Million.   Not quite as bad as the UK, but pretty terrible.

Do you not see a problem here?

U.S. Hospitals Worth The Trip

*Most of those patients in search of the best care, including 38% from Latin America, 35% from the Middle East, 16% from Europe and 7% from Canada, are heading to the United States. Additionally, it’s estimated that 32% of all medical travelers simply want better care than is available in their home countries, mostly those in the developing world, and 15% want quicker access to medically necessary procedures. That’s compared to only 9% of medical travelers seeking medically necessary procedures at lower prices and 4% seeking low-cost discretionary procedures.*

Notice.... of all medical tourism coming to the United States.... 16% from Europe, and 7% from Canada.   1st world, so called Universal Healthcare countries? 

Notice the reasons....  Better quality in the US.  Faster treatment in the US.

Better, faster than what?    Their "free" health care systems at home.

Sounds like the VA system is operating in other countries.   And... that's basically the truth.   The same problems we seen in the VA, are the problems that are happening in all government run health care systems.... and it doesn't work.  That's why they are coming here.


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## Andylusion (Aug 30, 2015)

David_42 said:


> Also, Andy, having healthcare be profit driven in a place like INDIA is horrible.



Really?  Then why do millions of people go to India every single year for health care?   They clearly don't see it as horrible as you do.


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## Andylusion (Aug 30, 2015)

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Then why do hundreds of thousands leave the country every year for care?


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## playtime (Aug 30, 2015)

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You & I & the smuck down the street already were paying (thru higher premiums) for people who were not insured.  All those trips to the ER people have made, for silly things like a  cold all help drive the costs up. It's common sense that preventative medicine now saves a whole lot of dollars in the long run. Something the status quo was not mandated to do.  A covered yearly mammogram now that might  catch an early cancer now & treatment is less costly with a better outcome is a lot better than it not being a covered expense.... so it's ignored ( because a mammogram is expensive enough & may not be affordable) by a low income woman  until that cancer spreads & costs a lot more to the taxpayer.   I really don't give a God damn whether *you* believe me or not & I say exactly what I think with no worries about the opinions of posters such as yourself.  'Moral superiority'?  LOL.  naw... just being humane.   Try it sometime.


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## playtime (Aug 30, 2015)

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I voted for Obama.  I personally would have liked a public option.  The status quo would have kept millions uninsured.  The attempt by the right to repeal the ACA some 50+ times cost the taxpayer how many millions of $$$ ?  And it's STILL the law.  So much for fiscal responsibility & compassionate conservatism.


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## playtime (Aug 30, 2015)

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I didn't say  free.... or if I did, I didn't mean to say that.   I said I ( I as in *me* ) would pay $10 a gallon of gas to never  have copays, co ins ,premiums... I *did *say taxes on gas & public transportation spreads the cost & I* also said *that that copays etc, are nothing compared to this country.


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## playtime (Aug 30, 2015)

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We ranked below many countries 'socialized' heathcare systems & our birth mortality rate is higher than Costa Rica.  Costa Rica is in the middle of the friggin rain forest.


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## playtime (Aug 30, 2015)

dblack said:


> I'm still wondering how the anti-profit folks think health care is any different than any of the other necessities of life. If you don't think doctors should be allowed to make a profit, why should farmers?



Farmers are subsidized by the government so they can survive.


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## playtime (Aug 30, 2015)

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Because it's cheaper & a lot of Americans can afford procedures there that couldn't afford it here even with the cost of air travel factored in. If an untouchable becomes ill, they cannot afford the same level of  healthcare as a Brahman.  Sound familiar?  Plus given the wages &  cost of living there,  the same procedures there will naturally cost less than here.


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## Andylusion (Aug 30, 2015)

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*First off*, preventative medicine is more widely used in America, than anywhere else in the world.  You go to Canada, UK, and elsewhere, preventative medicine is a fraction of what it is here.

*Second*, preventative medicine is not an automatic win.  In fact, it's generally a money loser.    When you add up the costs to provide preventive medicine to 310 Million people, compared to the cost of simply giving care to the people who get sick, the cost for preventative medicine is billions of dollars more expensive.

If *YOU* are paying for preventative care, then yes, it makes sense.  Take the average flu season.  The cost for a flu shot is $30.   Compare that to the cost of being treated by a severe flu illness, it makes sense.

But the cost of providing flu shots to the entire country, would be over $9 Billion dollars.   The cost of treating flu patients every years, is only about $300 Million dollars.

Spending $9 Billion, to save $300 Million, is not a wise or "common sense that preventative medicine now saves a whole lot of dollars in the long run".  It's not.  It does not save money in the long run.

Same is true of breast cancer.  To provide every single female of age, with breast cancer screening, would cost more than $30 Billion dollars.  We only spend $16 Billion on treatment for Breast Cancer now.

Over and over, there are actually very few "preventative care" treatments that are cost effective.

Which goes back to my first point.  The whole reason preventative care is uncommon in the UK and Canada, is because..... the government knows it's not cost effective, and can't afford it.   Here in the US, the majority of preventative care is paid for by private individuals.

What was the first thing that happened after Obama care was passed?

http://www.nytimes.com/2009/11/17/health/17cancer.html?_r=0

See, when government pushed to expand Medicare and Medicaid, knowing they'd have to foot the bill for more of these preventative care expenses......  they suddenly "oh, you only need to screen at age 50".

Oddly I fully expected the move, and wasn't surprised at all.   All the media leftists were screaming "how could they possibly recommend less care?!?".... um... because when you have someone else pay for your services, they tend to say you don't need as much?  You know, like all the other gov-care countries in the world?

*And lastly, you are not being more humane.*

You think you are.  You pretend you are.  But your system has failed every single time it's tried.   Tell those people in Greece, that your ideology is more "humane".

Greek Socialized Health Care is Pushing Amputations for Diabetics to Cut Costs

Greece has had a socialized medical system since the early 1980's, and it is likewise struggling in the current economic depression. Thus, it is going to use a similar tactic. It is denying diabetic shoes to patients, a service that would allow patients to keep their legs for several more years at least, and perhaps even avoid amputations completely. The Greek Department of Social Security maintains that diabetic patients will eventually lose their limbs anyway, and it is a waste of money to delay the inevitable.​*"... not avoid amputation of the leg, just delayed for a couple years and the expected benefit would be less than the estimated cost."*
— Benefits Division of the Greek Department of Social Security

That's your "Humane" system.   Tax the hell out of people, so they are impoverished, and then deny them health care because it's too expensive.   Let the rest of society suffer to cover the cost.

Brilliant move.   That's the future of America, if you have your "humane" way here.


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## Andylusion (Aug 30, 2015)

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Well... yeah, the ACA is fiscally irresponsible.   I don't understand your dumber than forest gump comment.

We are trying to repeal a bad fiscally irresponsible law... and then you say 'so much for fiscal responsibility conservatism?    Are you so oblivious that you don't even realize what danger you have placed the future fiscal state of the country?



 

You have screwed us.   We have to undo this.  There is no other option.   You people made the country worse off.  Not better off.


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## Andylusion (Aug 30, 2015)

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Nah, the care they get in India is good high quality care.  If it wasn't, they wouldn't take a trip to risk dying.

And I wasn't talking about Americans either.   Americans go to India for health care, because they are engaging in free-market capitalism.   It's the same reason I drive into town when I buy computer equipment.    The store in town has better products, at a lower price, than the mom&pop shop where I live.

I posted why people go to India for health care.  It isn't because of the price generally.    It's faster service, and better quality service.

http://krex.k-state.edu/dspace/bitstream/handle/2097/16193/sumanthreddy2013.pdf?sequence=1

Number one reason for going to India-  Quality.

Research got this response from a patient who traveled to India for care:

“I feel that the treatment I received in India will allow me to lead a much
fuller life than I would have been able to had I gotten an FDA approved device in
the US.”​
There you go.   The socialized aspect of our own health care system, is hindering good care even in the US.  But you can't deregulate can you?  Can't let the public control their own lives.  Gotta have the FDA "Protecting" us from good health care.  Have to fly to India for that.   Sad.....

But the primary reason 200,000 UK patients go abroad, is not because they are looking at the market, and finding a better alternative.... it's because if they don't, they'll die on a waiting list.

The scandal of the patients condemned to die by waiting list shambles: Day 3 of the Mail's expose of the Labour-run Welsh NHS

Hospital waiting lists at seven-year high as 3.4m need treatment

Year long wait for necessary treatment.  Hundreds dying on waiting lists.

This is why people in other countries go to India and other medical tourism locations.

And they have to save up the money and pay for it.... even while paying the taxes and fees, for a system they are leaving the country to escape from.

That's your system.  That's how "humane" it is.


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## David_42 (Aug 30, 2015)

Andylusion said:


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Hey, genius, that was satire, the government in india makes sure drug prices are low. LOL.


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## David_42 (Aug 30, 2015)

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The government of India helps to maintain low drug prices and is planning to roll out UHC.


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## Andylusion (Aug 30, 2015)

playtime said:


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This is one of those things I was mad that Republicans helped pass, was the Farm bill.

Members of Congress Get Millions in Farm Subsidies | AFP

The federal payments to the lawmakers—13 Republicans and two Democrats—ranged from $339 to Rep. Randy Neugebauer (R., Texas) to $70,574 to Rep. Stephen Fincher (R., Tenn.) [in 2012]. […] The payments to all but two of the lawmakers were well above the average of $604 paid to the lowest-subsidized 80% of farmers between 1995 and 2012, the group said.​
Yeah, you are helping farmers.... and those poor farmers in Congress, thank you.

‘The Bachelor,’ billionaires and the problem with farm subsidies for the rich

If you watch that idiotic show, The Bachelor, the star of the show is Chris Soules.   Soules claims to be a 'small town Iowa farmer', but in reality (unlike the reality show), he's a multi-millionaire.   Yet he collected $370 Million dollars from the government farm subsidies..........  to stay afloat.

Millionaire Chris Soules, would like to thank you for your tax money.... it's hard getting by on millions I'm sure.

Farm bill beneficiaries include urban dwellers

Cargill, with $60 Billion in assets, got $51 Million in farm subsidies.... to keep them afloat apparently.

Irwin Jacobs, co-founder of Qualcom, net worth $1.8 Billion, gets farm subsidies for not farming.... good thing too... who know if he could stay afloat without it.

There are over 50 Billionaires that collect large farm subsidies, from the Waltons, to the co-founders of Microsoft, the CEO of Cox Communications, and on and on.

At least they are afloat.

You people tend to talk a lot about corporate welfare, and making the poor poorer and rich richer.... and suddenly spin right around and support the very legislation that does that.


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## Andylusion (Aug 30, 2015)

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As far as I know, they do not subsidize drug prices.   The reason drugs are cheaper there, is simply free-market capitalism at work.

Again, people do not go to India's government run hospitals.  Those suck terribly.   They go to the pay-for-service, free-market Capitalist based hospitals.... which are fantastic.


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## Andylusion (Aug 30, 2015)

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Ranked by who exactly, and on what grounds?   Tell me you are not citing the World Health Organization again?    That whole ranking was absolute trash.   They had Cuba on the list.   Cuba.... where people can't even get Aspirin from their "free" gov-care system?

The fact Cuba was even on the list, proves that the whole ranking was invalid.


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## David_42 (Aug 30, 2015)

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LOL. Reduction in prices of 886 drugs from India | Medindia
National Pharmaceutical Pricing Authority
India expands drug pricing with caps for two antibiotics


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## David_42 (Aug 30, 2015)

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Oh dear lord, another self proclaimed genius who believes he knows more about healthcare then the world health organization, while sitting in central Ohio. Get out of here. Cuba is a horrible dictatorship, but they are praised for there healthcare, given the circumstances they are in. Do you think healthcare was better for the poor in cuba before the castro's? It wasn't. Hell, fuck the castro's, but cuba's healthcare system isn't something to laugh at.


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## David_42 (Aug 30, 2015)

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Regardless, we have a self proclaimed "rational" capitalist who believes he knows more then the world health organization.


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## Care4all (Aug 30, 2015)

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What are the Federal Health Care ProgramS, with an 's', as in more than one federal health care program, as in more or other programs, in addition to the ACA, that is in your charts figures and how does it break down....what federal health care program is adding the most to this number in the chart, do you know or have a link on where the numbers came from Andy?

I'm thinking the fed healthcare programS could be:

the ACA?
the VA?
Medicare?
Medicaid?
Childrens healthcare CHIP?
TRICARE for retired Military?


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## Andylusion (Aug 30, 2015)

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I was unaware of this.  So I really didn't know.

That said, as soon as I read through the articles you posted, I imagined that price controls would likely cause drug companies to stop, or reduce roll-outs of new drugs. 

Why invest the money to produce a drug for a market, if you can't make enough money off of that drug, to make it worth the effort?

Second, I predicted that the use of price controlled drugs would see a decline, because companies would naturally not have an incentive to keep up supplies of price controlled drugs, when they can't make as much profit as other drugs.

So I decided to determine if my theory was true, and started searching for "effects of India drug price controls".

Price Controls for Drugs in India Fail to Improve Access for Patients: Report

What do you know..... it's almost like I'm clairvoyant.

There was also a drop in R&D resulting in fewer new introductions of generic drugs and there has been reduced competition since India expanded its list of priced-controlled medicines two years ago. These trends can strengthen “oligopolistic behavior, which will result in reduced set of choices for the doctors and patients,” according to the report, which was conducted by IMS Health, the market research firm.​
So the regulation drove out competition, leading to oligopolies.   Sounds like regulations on hospitals leading to only 3 major chains in Ohio.   Fewer new drugs coming to market, because why invest money in new drugs, when profits will be reduced by price controls?

Oddly.... similar regulations, have similar effects.   What a shock.  Who thunk it?

Moreover, there was no significant penetration of price-controlled medicines in various markets.
For instance, usage of drugs with price controls declined 7% since 2013, when the Department of Pharmaceuticals published its Drug Price Control Order and boosted to more than 650 the number of drugs that are subject to a price ceiling. Similarly, there was “muted” growth for price-controlled medicines outside metropolitan areas compared with 5% growth for drugs not subject to price controls.​
Well fancy that....   while the price controls were supposed to lead to more people having access to those drugs, the result was that usage of price controlled drugs fell by 7%, while usage of non-price-controlled drugs increased by 5%.

Really?   The companies spent their money investing in drugs that were not price controlled, instead of those that were, resulting in fewer people using them, as opposed to more people using the non-price-controlled drugs?

Wow... what a shock!   This has been such a shocking discovered.   How could I be more shocked without using wires, is beyond me!

Like I said before.... the Fundamentals of economics do not change, because you are a leftists, and you demand such and such.

Nor do they change because "it's health care!  It's different!".

If you introduce price controls in the US, you will have the same effect here.   It will reduce health care, not improve it.

By the way....  Massachusetts, under Mitt Romney, tried price controls.   The drug companies started closing down shop under Mass Health.  Funny how the fundamentals of economics are universal.  Every time, Republican or Democrat, you try deny how the market works, you are the one who fails.  Not the market.


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## Care4all (Aug 30, 2015)

the last i read from the GAO or CBO is if the ACA were repealed it would ADD 300 billion to the National debt...over 10 years...


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## Andylusion (Aug 30, 2015)

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No, the World Health Organization, was dead on correct.  You read up the methodology of the ranking system, and they were absolutely right.

They didn't look at the quality of the care.   They looked at how socialized it was.  How "equal" it was.   How "fair" it was.  Not survival rates.... not quality of care.... no no.  That wasn't a factor.

Cuba is very socialized, very equal, and very fair.   When that is the standard you are ranking countries by, that makes perfect sense.

It was completely logical.

That said... the ranking was crap.    You can have a system like Cuba, where people couldn't even get Aspirin.... and that was good.... as long as it's Equal.... Fair... and Socialized.....

When I go to the hospital.... I don't give  crap if it is fair.  I want quality care.  If I have to pay for it.... great.  Rather pay and live, than have it 'equal', 'fair', and 'socialized' and die because its terrible care.

I wager none of you people on the left, ever bothered to download the data, look up the methodology, and read it for yourself....... have you?   Nope.   You have not.  Don't even try to lie to me.


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## Andylusion (Aug 30, 2015)

Care4all said:


> the last i read from the GAO or CBO is if the ACA were repealed it would ADD 300 billion to the National debt...over 10 years...



It would.   Not repealing it, will hundreds of billions more.

Both are true statements.    That's the grain of truth in the lie.

The prior system DID in fact, need reformed.   But the ACA made the problem worse, not better.

Repealing it would add hundreds of billions to the debt in the short term.  That's true.

Not repealing it will add trillions of dollars in the long term.

We need to eliminate Medicare and Medicaid.  That's what needs to be done.

But short of that, you have bad legislation, and worse legislation.   The ACA is 'worse'.   We need to repeal it, and have something that actually improves things.


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## Andylusion (Aug 30, 2015)

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What difference does it make?  VA care is horrible.  CHIP is bad, but at least limited.   Medicaid is horrific.  Medicare is a long term bankruptcy.    The ACA made things worse, increasing bad programs.

Regardless... things were bad before, and are worse now.   What difference does it make, which program has the majority?

But the answer of course is Medicare.  It's the largest, with largest liabilities, and was mandated to increase the most.

President’s Health ‘Reform’ Grows Unfunded Obligations By $17 Trillion - Budget Background - Research - U.S. Senate Budget Committee

This comes from the CBO, calculated total future liabilities of Medicare, Medicaid, CHIP, the Exchange subsidies.   So this figure is not including the VA, or TriCare.   That's even more unfunded liabilities.

Does the United States have $128 trillion in unfunded liabilities?

Report: Federal unfunded liabilities total $84 trillion

Economist Laurence Kotlikoff: U.S. $222 Trillion in Debt | RealClearPolicy

Now I posted these links for specific purpose.

All unfunded liabilities with the government are all.... fuzzy numbers.

If you sign a contract for a home purchase, that is a very specific clear cut contract.     You have a clear defined amount that you owe the bank.  Nothing change that amount.

So you know what your future liabilities are, and you also know what your interest rate (unless you moronically got an adjustable rate mortgage.  Don't do that), which is also set in stone.

The government doesn't have this.   They don't know how much they will collect in taxes, and they don't know how much they will pay out in benefits.  They don't know how fast, or slow, the economy will grow.  They don't know what the population will do.   We may start shrinking like Japan.  Will more states expand medicare and medicaid?  Will more states reduce and limit medicare and medicaid?

It's all hard to say.

So the government generally comes out with Short range, Mid Range, and Long range numbers.  Then they also come out with Low-cost numbers, mid-cost numbers, and high-cost numbers.

The numbers we're looking at, are the long range mid-cost numbers.

Depending on which estimates you go with, the unfunded liabilities could be in the $60 Trillion, to $120 Trillion, to $220 Trillions.

But here's the real point....   No matter which numbers you want to run with, long or short, low or high.... the estimates for all of them, every single one, went *UP* after Obama Care was passed.     There is no estimate that I know of, where the ACA showed a decline of our unfunded liabilities.

If you have one, I'll look at it.


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## David_42 (Aug 30, 2015)

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Yeah, you're literally wrong. I'll trust me European friends and experts on healthcare, not a self proclaimed Christian capitalist.


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## dblack (Aug 30, 2015)

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That's nice, but it has nothing to do with the question. How is not helping someone immoral? How do you deal with the fact that you're not helping people, people you could be helping, right now?


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## dblack (Aug 30, 2015)

playtime said:


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What? Can you just answer the question?


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## playtime (Aug 31, 2015)

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In case you didn't realize it, this isn't Greece.  The VA has problems because of fraud & abuse.  So does Medicare.

Do you also think Sharia law is coming to America?


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## playtime (Aug 31, 2015)

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India has price caps on drugs. 

india-administers-price-cap-dose-to-drug-companies-1411135826


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## playtime (Aug 31, 2015)

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Will this do?  These stats were taken from the  WHO, but also from 2 other notable sources:

Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally

As for Cuba, no system is perfect- but hardly the disaster you seem to think it is.  BTW, Cuba has a 99% literacy rate, not bad for such a backwards country 'eh?  Can you say the same for our nation?:
*Cuba's health care policy: prevention and active community participation.*

*Abstract*
In Cuba, health care is considered a human right for all citizens; health care is therefore a national priority. Cuba's health policy emphasizes prevention, primary care, services in the community, and the active participation of citizens. These emphases have produced an impressively high ranking on major health indicators, despite economic handicaps. The Cuban experience demonstrates the influence of ideological commitment and policy-making on the provision of health care and challenges the assumption that high-quality care for all citizens requires massive financial investment. The evolution of the Cuban health care system since the revolution thus has implications for the U.S. health care system; specifically, it suggests that the equitable distribution of health care services in the United States requires a national health insurance and service delivery system.

Cuba's health care policy: prevention and active community participation.  - PubMed - NCBI

*A Different Model — Medical Care in Cuba*
Edward W. Campion, M.D., and Stephen Morrissey, Ph.D.

N Engl J Med 2013; 368:297-299January 24, 2013DOI: 10.1056/NEJMp1215226


For a visitor from the United States, Cuba is disorienting. American cars are everywhere, but they all date from the 1950s at the latest. Our bank cards, credit cards, and smartphones don't work. Internet access is virtually nonexistent. And the Cuban health care system also seems unreal. There are too many doctors. Everybody has a family physician. Everything is free, totally free — and not after prior approval or some copay. The whole system seems turned upside down. It is tightly organized, and the first priority is prevention. Although Cuba has limited economic resources, its health care system has solved some problems that ours has not yet managed to address.1,2

Family physicians, along with their nurses and other health workers, are responsible for delivering primary care and preventive services to their panel of patients — about 1000 patients per physician in urban areas. All care delivery is organized at the local level, and the patients and their caregivers generally live in the same community. The medical records in cardboard folders are simple and handwritten, not unlike those we used in the United States 50 years ago. But the system is surprisingly information-rich and focused on population health.

All patients are categorized according to level of health risk, from I to IV. Smokers, for example, are in risk category II, and patients with stable, chronic lung disease are in category III. The community clinics report regularly to the district on how many patients they have in each risk category and on the number of patients with conditions such as hypertension (well controlled or not), diabetes, and asthma, as well as immunization status, time since last Pap smear, and pregnancies necessitating prenatal care.

Every patient is visited at home once a year, and those with chronic conditions receive visits more frequently. When necessary, patients can be referred to a district polyclinic for specialty evaluation, but they return to the community team for ongoing treatment. For example, the team is responsible for seeing that a patient with tuberculosis follows the assigned antimicrobial regimen and gets sputum checks. House calls and discussions with family members are common tactics for addressing problems with compliance or follow-up and even for failure to protect against unwanted pregnancy. In an effort to control mosquito-borne infections such as dengue, the local health team goes into homes to conduct inspections and teach people about getting rid of standing water, for example.

This highly structured, prevention-oriented system has produced positive results. Vaccination rates in Cuba are among the highest in the world. The life expectancy of 78 years from birth is virtually identical to that in the United States. The infant mortality rate in Cuba has fallen from more than 80 per 1000 live births in the 1950s to less than 5 per 1000 — lower than the U.S. rate, although the maternal mortality rate remains well above those in developed countries and is in the middle of the range for Caribbean countries.3,4 Without doubt, the improved health outcomes are largely the result of improvements in nutrition and education, which address the social determinants of health. Cuba's literacy rate is 99%, and health education is part of the mandatory school curriculum. A recent national program to promote acceptance of men who have sex with men was designed in part to reduce rates of sexually transmitted disease and improve acceptance of and adherence to treatment. Cigarettes can no longer be obtained with monthly ration cards, and smoking rates have decreased, though local health teams say it remains difficult to get smokers to quit. Contraception is free and strongly encouraged. Abortion is legal but is seen as a failure of prevention.
MMS: Error


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## playtime (Aug 31, 2015)

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Americans flock to Canada or get them via the internet for the same exact drugs they otherwise cannot afford.  I remember Bush saying that it was 'dangerous' to do that because of the lack of 'quality control' blah blah blah & soon after, we as the almighty USA, had flu shot vaccination shortages, & were rationed to just include children, seniors & the physically compromised.  Guess where we got them shipped in from so more than just the vulnerable were able to get one?  Yaaaaaaaaaaa......... that's right....  Canada.


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## playtime (Aug 31, 2015)

Care4all said:


> the last i read from the GAO or CBO is if the ACA were repealed it would ADD 300 billion to the National debt...over 10 years...



I wonder how citizens of those red states feel that could have had coverage through expanded Medicaid, but can't because their Governors denied it to them?


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## playtime (Aug 31, 2015)

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2 separate posters I've known over the years from other forums have both said they would not trade their Canadian healthcare system for ours & overall are very satisfied & one said the longest she ever had to wait for a doctor's visit was 2 1/2 weeks  & that was because she needed a 'booster' shot.  She wasn't 'sick', so that was why she had the wait.  I've tried to make an apt to a dermatologist & that was a 4 month wait.


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## playtime (Aug 31, 2015)

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I don't think people should remain ill, or eventually die because they could not afford medical help.  To me, having the attitude  of 'oh well, tough shit' is immoral.  And since I am not  a doctor, the best I could do is vote in people that have the same mindset as me.  Obama ran on the ACA as part of his platform, which was one reason why I voted for him.


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## playtime (Aug 31, 2015)

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Because I never said that doctors shouldn't make a profit ... a living.  But certain things shouldn't go completely unchecked in the way of cost- things that are necessary to sustain life.  Farmers are subsidized, because the ratio between cost of raising crops or animals versus what people could afford to buy versus the hard work put into it would not be worthwhile to them to be farmers... so they are subsidized to ensure they remain doing vital work & they can make a profit.   Does that satisfy you?  If not too bad I answered the way I did.


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## Andylusion (Aug 31, 2015)

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Flu shots, are exactly the wrong thing to bring up.   Flu Shots in the US are effectively price controlled.   The US Government buys up 70% of all vaccines, and they do this at their own set prices.    As a result, the private vaccine market barely exists.  Why pay the market price for a flu shot, when the government is selling them for a fraction of the cost?

As a result, vaccine companies in the US have left the market.  In the 1980s there were over 20 different vaccine manufacturers.  Today there are only about 4.

So as with all price controls, shortages follow.  Why spend money investing in more capacity in vaccine manufacturing, when you can't profit from it?

Same thing happened with Ebola.  Ebola was known to exist for decades, but no one bothered to work on a vaccine.  Why spend hundreds of millions on R&D for a product you'll lose money selling?

So you bringing up Vaccines, is just more evidence of my point.

But that's not all.

Yes, it is true that some drugs in Canada.... *SOME* drugs, are cheaper.   Some drugs are vastly more expensive in Canada.

And MANY drugs are not available at all.

Government Price Controls on Prescription Drugs May Be More than Patients Bargain For - HealthCare Institute of New Jersey

Patricia Danzon, a professor at the University of Pennsylvania’s Wharton School of Business, conducted a study comparing drug costs in several countries.  Here’s what she found, “Canadian prices are between 13 percent lower and 3 percent higher than the U.S., depending on the price index used. ”  

However, her study also concluded that generic drugs — which make up 45 percent of the U.S. prescription drug market — tended to be more expensive in Canada than in the U.S.  The biggest problem with implementing price controls, however, may be access.  Most Canadian provinces have a review committee that must approve any drug offered for sale.  These approved drugs, also known as “formularies,” are an integral part of the price control regime.  Between 1998 and 1999 only 25 drugs were listed on the formulary for the province of Ontario, even though nearly a hundred drugs were available.  Similarly, the Canadian government ruled that only 24 new drugs could be added to the formulary, even though they reviewed 400 drugs!

The end result is that Canadians are forced to pay extraordinarily high costs for drugs that don’t appear on the formulary and some Canadians actually have to travel into the U.S. to purchase the drugs they need.  Another even more important consideration is that price controls stifle innovation and can lead to supply shortages in both the quality and quantity of medications.​
So while some Americans are buying cheaper drugs in Canada, many Canadians are buying drugs in America, not because it's cheaper, but rather because they can't buy them at all, at any price, in Canada.

Again, price controls result in shortages and lack of availability.

Tracking the problem | Canadian Drug Shortage

Canadian Pharmacists Association detailing the drug shortage in the country.

Prescription Drug Costs: Has Canada Found the Answer?

This paper also shows how the Canadian government is paying for US Citizens drugs.

When a Canadian buys drugs, they have to pay for the first $800 worth of drugs each year.  But beyond that, they get 70% of the cost paid for by the government.

What happens is, people buy the drugs at the discounted price, and then open online drug sales.   We buy from them, the drugs that the government paid 70% of cost on.

So in essence, the government is taxing Canadians, so that US citizens can buy the drugs at a discount.... illegally of course.

So yes, Americans are in some cases able to buy some drugs at discount prices from Canada.   That generally costs Canadian tax payers tons of money, and the price controls cause many drug shortages, resulting in Canadians coming to America to get drugs they can't get in Canada.

This is lose-lose for Canada.   Not a win.    Great for US citizens though.


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## dblack (Aug 31, 2015)

playtime said:


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I agree. But that's not what's in question. The issue is whether we can force others to join our efforts to help out people in need.



> Obama ran on the ACA as part of his platform, which was one reason why I voted for him.



He ran _against_ the individual mandate too. If he'd stuck to his guns, I would be much more accepting of ACA. As it is, it's the worst kind of corporatist government.


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## dblack (Aug 31, 2015)

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Hmmm... well, I guess I need some clarification on what it means to say that health care shouldn't be "profit-driven". And I'm still not clear if you feel the same way about the other necessities of life.

I guess I understand the basic sentiment that people shouldn't be allowed to benefit from the suffering of others. But that's not what's going on. Quite the opposite, actually. People in health care profit from curing people. And I can't see how that's a bad thing.


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## Andylusion (Sep 1, 2015)

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No,  I am not wrong.    Go read the methodology used by WHO.  It was posted.  I've read it.  I've got the PDF on my computer.   Have you?


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## Andylusion (Sep 1, 2015)

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Every single time a socialized system fails, people start blame shifting.   It's fraud and abuse.

Ok, so what's the problem with Cuba's system?   Venezuela's system?  The UK system?

And the fundamentals of economics are universal.  They don't magically change because "this isn't Greece".   The people of Greece were saying the same thing.  "This isn't the Soviet Union.  Our system won't fail...."

Oops... it failed.  There's a book called "This time is different".  Very boring book, but it details how every time a country went into default, there were people in that country saying "This time is different!  We're not like all those others".... but amazingly if you do the same actions, you end up with the same results, and they all ended up in default.

There is nothing economically special about the United States.  If we follow the same bad policies, the same unsupportable pensions, the same unsustainable health care... we will end up with the same economic crash.   It will happen.


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## Andylusion (Sep 1, 2015)

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Price controls fail to improve poor people's access to medicines in India, IMS report says

Price controls fail to improve access.

"The report also noted that earlier efforts by Beijing in this area as well as countries such as the Philippines and South Korea "consistently failed" to improve overall access to medicines."

Try again.

How many times are you going to promote a failed concept, before you figure out the concept itself is bad?

Look, try and put yourself in the place.   I have no idea what you do for a living, but let's say that you produce three products.... and you have 8 hours a day to work on any of those three products.

Then the government comes in and says, it's unfair for you to make a good living off of a product because other people are poor.   So the government says you can only earn a $20,000 a year profit off of that product.

Now, you can choose which product to spend your 8-hours a day on.  Which is it going to be?   The product where no matter how hard you work, or how much product you make, you can only make $20K a year on it?  Or one of the others?


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## Andylusion (Sep 1, 2015)

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It's called "fiscal responsibility".

You want what happened to Detroit, to happen at the state level?

For Many American States, It's Like the Recession Never Ended

Most states are facing budget short falls.

Pretty easy for Obama, and arrogant people on a forum, to claim states should have just increased Medicaid and Medicare spending, when you don't have to cough up the money for it.


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## Andylusion (Sep 1, 2015)

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By all means, donate all your own money to the cause.  I donate money for charity care.  Do you?

But I don't FORCE people to support others at the end of a gun.  That's not charity, that's tyranny.


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## David_42 (Sep 1, 2015)

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Universal healthcare is tyranny and done with the end of a gun? R/shitamericanssay


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## dblack (Sep 1, 2015)

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Try it without.


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## Andylusion (Sep 2, 2015)

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Of course it is.

Look.....  If I refuse to pay the money in taxes, that go to supply others with services...... what happens?  People with guns show up, and cart me away.

When I donate money to charity, or don't donate to charity, what happens?   Nothing.   Why?  Because it's actually "charity".

Have you ever met the people that your "charity" money helps?   I have.  You know what they display?   Gratitude.

Have you met the people on government programs?   I have.  You know what they display?  Entitlement.  "I"m OWED this".   They act like they 'deserve it'.   That I should get up, and go to work at 4 AM, and be glad I have the privilege of having my money stolen from my pay check, to pay for their free stuff.

It's tyrannical.      In fact, just the attitude of the left-wingers on this forum, shows tyranny.   You people treat those of us who work our butts off, like we should be happy to lose 1/4th of our pay checks to your wasteful programs.   And anyone who dares to complain..... well they must be greedy.

That's the attitude of a tyrant.   Stalin, Hitler, Chavez, Mao, all of them and more, had the exact same attitude.


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## David_42 (Sep 2, 2015)

Andylusion said:


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LOL.Shit Americans Say • /r/ShitAmericansSay


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## Andylusion (Sep 2, 2015)

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I noticed you couldn't deny anything I said.


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## David_42 (Sep 2, 2015)

Andylusion said:


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Because it's all anecdotal bullshit. Doesn't help you compare Europe to Stalin. LOOOL.


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## Andylusion (Sep 4, 2015)

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Really?   So if I refuse to fund 'universal healthcare' that I don't believe in, people with guns don't show up?   Try it, and find out which of us is right.

“To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical.” - Thomas Jefferson

I'm on his side.  Which side are you?


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