Obamacare succeeding

[Monk Of Reason]

No, yours is the terrible opinion!
(There....how's that for a clever retort?)
There will always be some rationing of care, be it by systematic allocation, waiting time or price. And there will always be different opinions about just what "basic" health care is. I see no reason to limit anyone to what is provided by government, if they want to use their own resources to get something better. What you propose is enforcing a lowest common denominator. Two tier care rules!

A common misunderstanding is that the governmetn would not be providing the care. We would have the exact same doctors, the exact same hospitals, the exact same everything that we have now. However the difference is that instead of them being paid through an insurance company of some kind they are paid by the government through a single payer system. It is much like medicaid or medicare now. You get the same treatment but its cheaper on you. And the costs would be drastically reduced even if the healthcare costs themselves were not reduce. This is because the middle man that makes billions of dollars in profit, the insurance companies, would be more or less put out of business. Or they might move to dental or some such thing. I don't know if a single payer system would cover dental or chiropractic services.

 

[metis]

I spend a great deal of time in Canada since I live only a 20 minute drive away, and I have yet to run across a single Canadian that would trade their health-care system for ours.

A common misunderstanding is that the governmetn would not be providing the care. We would have the exact same doctors, the exact same hospitals, the exact same everything that we have now. However the difference is that instead of them being paid through an insurance company of some kind they are paid by the government through a single payer system. It is much like medicaid or medicare now. You get the same treatment but its cheaper on you. And the costs would be drastically reduced even if the healthcare costs themselves were not reduce. This is because the middle man that makes billions of dollars in profit, the insurance companies, would be more or less put out of business. Or they might move to dental or some such thing. I don't know if a single payer system would cover dental or chiropractic services.

Exactly, and the smart thing for us to do is to do what we didn't do, namely just expand the Medicare/Medicaid system to cover all. It is far more efficient that private insurance companies (3-6% overhead-- depending on what one counts as part of the system-- versus 29% overhead for private insurers-- these figures date back to 2009, and I have none that are more recent).

 

[Monk Of Reason]

I spend a great deal of time in Canada since I live only a 20 minute drive away, and I have yet to run across a single Canadian that would trade their health-care system for ours.

Exactly, and the smart thing for us to do is to do what we didn't do, namely just expand the Medicare/Medicaid system to cover all. It is far more efficient that private insurance companies (3-6% overhead-- depending on what one counts as part of the system-- versus 29% overhead for private insurers-- these figures date back to 2009, and I have none that are more recent).

I would imagine that the overhead for insurance companies has only gotten worse since the enactment of the ACA.

 

[metis]

I would imagine that the overhead for insurance companies has only gotten worse since the enactment of the ACA.

I can't answer that, but the rate of medical inflation went from a bit over 9% per year and was down to 1 & 1/2% either last year of the year before (I think it's more likely the latter-- at my age, the years tend to blend). Part of this decline has been due to increased competition to sign up millions of new applicants, and also there are changes in the payout system, which is now more based on outcomes. I'm sure there's more to the story that I'm not aware of, however.

 

[Monk Of Reason]

I can't answer that, but the rate of medical inflation went from a bit over 9% per year and was down to 1 & 1/2% either last year of the year before (I think it's more likely the latter-- at my age, the years tend to blend). Part of this decline has been due to increased competition to sign up millions of new applicants, and also there are changes in the payout system, which is now more based on outcomes. I'm sure there's more to the story that I'm not aware of, however.

With more people signing up there tends to be a higher amount of profit being made. The more people that sign up the higher the amount of overhead needed. Its a bit overly simplistic and even if the statistics themselves are not worse the total number will be worse.

 

[metis]

With more people signing up there tends to be a higher amount of profit being made. The more people that sign up the higher the amount of overhead needed. Its a bit overly simplistic and even if the statistics themselves are not worse the total number will be worse.

My understanding, although I don't know where I got this from, is that most of the overhead with private insurers is tied up with advertising. It seems that if one watches an hour of t.v. here, for example, you'll typically see at least one or two medical-type of advertisements, and buying that time is expensive.

 

[Monk Of Reason]

My understanding, although I don't know where I got this from, is that most of the overhead with private insurers is tied up with advertising. It seems that if one watches an hour of t.v. here, for example, you'll typically see at least one or two medical-type of advertisements, and buying that time is expensive.

The profit margin (usually between 4-8%), advertisements and administrative and legal fee's are all vastly more than what government programs require per person. And then on top of that the contracted rates with providers are far higher than with government based insurances. Providers don't usually like this but guaranteed payment is very good even if it is at a lower rate.

 

[Dirty Penguin]

Let's put it in perspective. Republicans actually do like many of the aspects of the ACA and why wouldn't they... It was actually an idea from them in the first place. A Massachusetts governor (Mitt Romney) actually lobbied for and signed the same type of structured healthcare into law years before the ACA. If you set them side by side you will notice they resemble each other in many ways...and why wouldn't they... Many of the same architects for ("RomneyCare") were instrumental in crafting ("ObamaCare"). Even Romney's running mate, Paul Ryan, likes the structure of the ACA. During the campaign and throughout he's been one of the voices calling for the dismantle of the ACA just not as loud as some others. But we actually have evidence that Paul Ryan likes the ACA structure because on his very own official website he lays his plan out as to how he sees Medicare and when you see it you begin to wonder why there's such a disdain for the ACA even though none of them ever sought to defund (RomneyCare). Yes. That's right. Even the current healthcare plan championed by then Governor Romney gets federal funding to sustain it. So here's Paul Ryan's CURRENT plan for medicare. It's been on his website since 2012/2013 and the only thing that has changed is the year to keep it current...

Medicare | U.S. Congressman Paul Ryan
"The Medicare reform envisioned in this budget resolution begins with a commitment to keep the promises made to those who now are in or near retirement. Consequently, for those who enter the program before 2024, the Medicare program and its benefits will remain as they are, without change.

For future retirees, the budget supports an approach known as “premium support.” Starting in 2024, seniors (those who first become eligible by turning 65 on or after January 1, 2024) would be given a choice of private plans competing alongside the traditional fee-for-service Medicare program on a newly created Medicare Exchange. Medicare would provide a premium-support payment either to pay for or offset the premium of the plan chosen by the senior, depending on the plan’s cost. For those who were 55 or older in 2013, they would remain in the traditional Medicare system.

The Medicare recipient of the future would choose, from a list of guaranteed-coverage options, a health plan that best suits his or her needs. This is not a voucher program. A Medicare premium-support payment would be paid, by Medicare, directly to the plan or the fee-for-service program to subsidize its cost. The program would operate in a manner similar to that of the Medicare prescription-drug benefit. The Medicare premium-support payment would be adjusted so that the sick would receive higher payments if their conditions worsened; lower-income seniors would receive additional assistance to help cover out-of-pocket costs; and wealthier seniors would assume responsibility for a greater share of their premiums.

This approach to strengthening the Medicare program — which is based on a long history of bipartisan reform plans — would ensure security and affordability for seniors now and into the future. In September 2013, the Congressional Budget Office analyzed illustrative options of a premium support system. They found that a program in which the premium-support payment was based on the average bid of participating plans would result in savings for affected beneficiaries as well as the federal government.

Moreover, it would set up a carefully monitored exchange for Medicare plans. Health plans that chose to participate in the Medicare Exchange would agree to offer insurance to all Medicare beneficiaries, to avoid cherry-picking, and to ensure that Medicare’s sickest and highest-cost beneficiaries receive coverage.

While there would be no disruptions in the current Medicare fee-for-service program for those currently enrolled or becoming eligible before 2024, all seniors would have the choice to opt in to the new Medicare program once it began in 2024. This budget envisions giving seniors the freedom to choose a plan best suited for them, guaranteeing health security throughout their retirement years.

These reforms also ensure affordability by fixing the currently broken subsidy system and letting market competition work as a real check on widespread waste and skyrocketing health-care costs. Putting patients in charge of how their health care dollars are spent will force providers to compete against each other on price and quality. That’s how markets work: The customer is the ultimate guarantor of value."

So there you have it. He's in favor of the Exchanges, the subsidies, private plans competing for customers, the ability to opt in or out. To me this sounds very similar to the structure of RomneyCare and ObamaCare...why...because it IS very similar given that what he's proposing these two have done already and that they're all cut from the same cloth. We bicker, argue and debate the ACA not realizing that it is in fact their idea and it's how they originally saw the direction of healthcare. So why is it when Obama takes their idea and implements it they now have a problem. You can debate that all you like. All I see is a bunch of hypocrites wanting to undo something that is actually from their playbook.

 

[Shadow Wolf]

A lowest common...? Please.

What you are suggesting is not a two-tier system. It's a ramp system in which the more money you personally have, the more options you have. To be clear, care would not necessarily be provided by the government. It would only be payed for by the government. It is possible to have a win-win for everyone. Why not extend the ability to choose to everyone? I'm fine with making cosmetic care that is not associated with acute trauma an out-of-pocket expense. But why restrict access based on ability to pay?

If out-of-pocket expenses weren't an option, I could have went a few months at most with a torn ligament and cartilage, rather than a few years. And it's not like getting a stable knee back with some cushioning between the bones is an elective thing.
I just do not understand why anyone would have ever decided you should have to afford health care in order to get it, especially since traditionally that is not how it worked.

 

[gerobbins]

As a Canadian, I will try and put things in perspective:

1) Is our health care free? No, we do pay for it through our taxes; sales tax, income tax etc... The difference is, we don't feel it. Our taxes are what they are; we are still able to travel, live a good lifestyle, send out kids to school, buy a couple of cars and basically live the same dream as our American friends do.

2) I read some healthcare insurance can cost as much as $350.00 a month for Americans. So someone who has the same salary as a Canadian is more out of pocket with that monthly expense. (This does not include out of pocket expenses which their provider does not provide.
Question: Is there a deductible on your health plans?

3) As a Canadian, we can never, ever be turned down because of some pre-existing condition as well we do not have to seek approval for a insurance company to get health care. If we need to see a specialist then we see a specialist. Specialist are not just for the rich in Canada, they are for everyone.

3) Wait times? Yes we do have them, but only for elective surgery only. Anything life threatening is treated right away without having to wait. (Despite what another poster says or thinks about this)

4) We can choose our own Doctors (This is a common misconception)

5) Bottom line is this: Health care cost are not an issue for us, we go to the hospital or see our doctor and we do not give it a second thought when it comes to costs. We will never lose our homes, or go broke because of health care.

While our system is not perfect, it is perfect for us.

 

[Revoltingest]

A common misunderstanding is that the governmetn would not be providing the care. We would have the exact same doctors, the exact same hospitals, the exact same everything that we have now. However the difference is that instead of them being paid through an insurance company of some kind they are paid by the government through a single payer system. It is much like medicaid or medicare now. You get the same treatment but its cheaper on you. And the costs would be drastically reduced even if the healthcare costs themselves were not reduce. This is because the middle man that makes billions of dollars in profit, the insurance companies, would be more or less put out of business. Or they might move to dental or some such thing. I don't know if a single payer system would cover dental or chiropractic services.

When I referred to government providing care, I was talking about footing the bill, not whatever structure they'd have in place. But for the optional system, I'd expect it to be 100% private.
I'm skeptical that outrageous health care costs can be attributed to profit. Other industries put out cost effective products while making profits, so this points to inefficiencies & market distortions being at work.

 

[Revoltingest]

As a Canadian, I will try and put things in perspective:

1) Is our health care free? No, we do pay for it through our taxes; sales tax, income tax etc... The difference is, we don't feel it. Our taxes are what they are; we are still able to travel, live a good lifestyle, send out kids to school, buy a couple of cars and basically live the same dream as our American friends do.

2) I read some healthcare insurance can cost as much as $350.00 a month for Americans. So someone who has the same salary as a Canadian is more out of pocket with that monthly expense. (This does not include out of pocket expenses which their provider does not provide.
Question: Is there a deductible on your health plans?

3) As a Canadian, we can never, ever be turned down because of some pre-existing condition as well we do not have to seek approval for a insurance company to get health care. If we need to see a specialist then we see a specialist. Specialist are not just for the rich in Canada, they are for everyone.

3) Wait times? Yes we do have them, but only for elective surgery only. Anything life threatening is treated right away without having to wait. (Despite what another poster says or thinks about this)

4) We can choose our own Doctors (This is a common misconception)

5) Bottom line is this: Health care cost are not an issue for us, we go to the hospital or see our doctor and we do not give it a second thought when it comes to costs. We will never lose our homes, or go broke because of health care.

While our system is not perfect, it is perfect for us.

But you lazy & selfish Canuckistanians spend your tax money on yourselves, instead of meeting your obligation to continually bomb 3rd world countries.....into the....uh.....wait.....perhaps that isn't an obligation.
But another factor is that you have a freer (more capitalistic) economy than we do.

 

[Whiterain]

It caused a huge monopoly, it really didn't fix anything. The only thing I learned is a bit about how monopoly and stock exchange works.

UHS Stock Quote - Universal Health Services Inc. Cl B Stock Price Today (UHS:NYSE) - MarketWatch

Go ahead and watch UHS from '93-'15, made a lot of bureaucrats filthy rich, this is monopoly.

Then look at the costs of your most bogus health care providers.

 

[Monk Of Reason]

When I referred to government providing care, I was talking about footing the bill, not whatever structure they'd have in place. But for the optional system, I'd expect it to be 100% private.
I'm skeptical that outrageous health care costs can be attributed to profit. Other industries put out cost effective products while making profits, so this points to inefficiencies & market distortions being at work.

I think we've already discussed this to some extent about inelastic demand and an interwoven structure in healthcare where between the providers and health insurance there isn't much option to get far cheaper care.

 

[Dirty Penguin]

It caused a huge monopoly, it really didn't fix anything. The only thing I learned is a bit about how monopoly and stock exchange works.

UHS Stock Quote - Universal Health Services Inc. Cl B Stock Price Today (UHS:NYSE) - MarketWatch

Go ahead and watch UHS from '93-'15, made a lot of bureaucrats filthy rich, this is monopoly.

Then look at the costs of your most bogus health care providers.

The ACA isn't the best solution but it is better than what we had. Personally we should have universal healthcare considering how much the US currently pays for its healthcare (prior to the ACA and now during the ACA). Even under the ACA and while cost have come down we're still paying more than other industrialized countries for our healthcare and outcomes. So then it begs the question...If the previous system was horrible, opponents want to abolish the ACA and said proponents are against universal healthcare...then what is a viable solution?

 

[Monk Of Reason]

The ACA isn't the best solution but it is better than what we had. Personally we should have universal healthcare considering how much the US currently pays for its healthcare (prior to the ACA and now during the ACA). Even under the ACA and while cost have come down we're still paying more than other industrialized countries for our healthcare and outcomes. So then it begs the question...If the previous system was horrible, opponents want to abolish the ACA and said proponents are against universal healthcare...then what is a viable solution?

I believe the term they used was survival of the richest.

 

[gerobbins]

But you lazy & selfish Canuckistanians spend your tax money on yourselves, instead of meeting your obligation to continually bomb 3rd world countries.....into the....uh.....wait.....perhaps that isn't an obligation.
But another factor is that you have a freer (more capitalistic) economy than we do.

Give us our beer, hockey and 3 down football and we are happy eh..

 

[Shadow Wolf]

But another factor is that you have a freer (more capitalistic) economy than we do.

How is it freer when they pay their taxes and have far more social support? A very common argument from Libertarians is that taxes for social programs is the government getting to decide what to do with your money, which is such a grievous offense that it reduces your liberties in life. They also have many food regulations we don't, such as a ban on rBGH and a few food additives.

 

[Revoltingest]

How is it freer when they pay their taxes and have far more social support? A very common argument from Libertarians is that taxes for social programs is the government getting to decide what to do with your money, which is such a grievous offense that it reduces your liberties in life. They also have many food regulations we don't, such as a ban on rBGH and a few food additives.

I wasn't addressing any Libertarian arguments.....just noting that Canuckistan has risen above Americastan in one measure of economic freedom....
Country Rankings: World & Global Economy Rankings on Economic Freedom
Consider what this means......
They're arguably more capitalistic than we, & yet the provide a better social welfare system.
Interesting, eh?

 

[Shadow Wolf]

I wasn't addressing any Libertarian arguments.

You wasn't, but I was asking it.