Repeal of Obamacare

[Armistead]

Originally Posted by August

Well part of the problem is the redefinition of what constitutes "Middle class". It used to describe the owner of a construction company, not the guys who worked for him, skilled laborers or not.

Well, lower middle class, most make $11-$20 bucks per hour, plumbers, ect.. Today $20 an hour would barely give you a middle class living.

[tater]

What people "have" for a given "class" is so different than when we were kids.

People working hourly wage jobs have more "stuff" than I had as a kid, and my dad was president of a publishing company in NYC. People have better cars, better TVs, more everything, nicer kitchens, and new construction homes made for "working class" people are as big as houses in the CT suburbs built in the 1950s.

There has been major "inflation" in what constitutes a normal, middle, or lower middle class lifestyle.

[CaptainHaplo]

Originally Posted by mookiemookie

I did. Nice subtle jab at me, implying that I didn't, though. Don't do that. You're better than that.

Mookie,

It wasn't meant as a jab at you. Your a pretty sharp cookie. You quoted the blog that stated "The law authorized the creation of a government operated marine hospital service and mandated that privately employed sailors be required to purchase health care insurance." The title of the blog being about "socialized" medicine and its historical support - the blog itself argues that the government has history on its side.

The blog is incorrect, and I figured that in reading the relevant document you would have noticed that. The government had jurisdiction to require such payment (tax) because those involved specifically were defined as participating in international trade and the payment requirement applied to them only in this case. International trade actions are things the government has the right to regulate under the constitution and the subsequent "commerce clause". In fact - the blog does not even attempt to address that domestic shipping is excused - why is that do you think? Could it be that they have a point they want to make - regardless of its accuracy?

Either way, the limitation stands - domestic commerce could not be touched by this - so to claim that it is "socialized medicine" or an insurance mandate is plain wrong. To say that it gives the government precedence to mandate we all buy insurance is ludicrous. In fact, to further argue the point, note that it did not stipulate american seamen. ANY seaman - regardless of nationality - working on a boat that berthed in a us port - paid this - unless the ships master or owner paid it FOR them. Given the time frame, your talking English, French, Spanish, Portuguese, etc - paying for the care of sailors. Again - this speaks to regulation of (and on) international trade - not a socialized medicine mandate upon all US citizenry or even all US seamen.....

Where in the document as passed does it even have the word "insurance" (or equivelant term) at all? It doesn't. So to say it "mandated" sailors purchase insurance is pure bullocks.

No insult was intended. So lets debate the matter at hand, instead of getting side tracked. The issue is the blog is full of crap - there was no insurance mandate in 1798. Nor did it mandate EVERYONE had to pay it. If you want to say it does in fact contain such mandates, by all means make your argument.

[sharkbit]

I don't know if this adds anything to the discussion or not. To be frank, I don't understand the ins and outs of health insurance. All I really know is I have insurance thru my work and the cost has gone up every year. My employer has switched carriers three times in the last four years due to rising costs.

Anyways, in December, I went to the ER for numbness in my right arm, leg, and face and then had to spend the night in the hospital for a suspected stroke. Went thru quite a few tests, including an MRI and CT scans.

The copy of the bill came earlier this month, all itemized. $36000 total , including $6000 for the ER visit and $8000 for the MRI.
With the contractual agreement the hospital had with the insurance company, the hospital only billed the insurance company $2400 with my out of pocket being $240.
I got the Explanation of Benefits from the insurance company yesterday which pretty much backed up what the bill was.

So where does the hospital make up the difference between the $36000 and the $2400?

Another odd story-
My brother in law's girlfriend/fiance/significant other/crazy drunk bitch (long story) who doesn't have insurance and doesn't work(another long story) was admitted to the hospital for a couple days early last year. The bll was some outrageous amount.
My brother in-law went to the hospital, told them she couldn't pay. The hospital said they would set up a payment plan. He told them she couldn't even afford that. The hospital ended up eating the whole amount except for around $600. All of this dealing took place in the span of a couple of hours at the hospital.

All of this is pretty crazy and just mystifies me.

[gimpy117]

Originally Posted by sharkbit

Anyways, in December, I went to the ER for numbness in my right arm, leg, and face and then had to spend the night in the hospital for a suspected stroke. Went thru quite a few tests, including an MRI and CT scans.

The copy of the bill came earlier this month, all itemized. $36000 total , including $6000 for the ER visit and $8000 for the MRI.
With the contractual agreement the hospital had with the insurance company, the hospital only billed the insurance company $2400 with my out of pocket being $240.
I got the Explanation of Benefits from the insurance company yesterday which pretty much backed up what the bill was.

So where does the hospital make up the difference between the $36000 and the $2400?

But where does the hospital get 36,000 dollars for one person getting one test and an overnight stay? Yes, hospital's are expensive and what not, but $36,000?! some Americans don't even make that in a year. Thats more than what I spend at college a year with full room and board and books plus booze money.

Originally Posted by Armistead

Well, lower middle class, most make $11-$20 bucks per hour, plumbers, ect.. Today $20 an hour would barely give you a middle class living.

yes, wages have stagnated but the CPI has marched upwards. Most of the growth in our GDP since the 80's has not gone to the middle or lower class.

[GoldenRivet]

Originally Posted by sharkbit

So where does the hospital make up the difference between the $36000 and the $2400?

the way i understand it, they have to bill out things 5 times higher than actual cost because if you or your insurance doesnt pay they will only get a percentage of it covered by uncle sam.



If you think that your employers are having to spend a lot of time and money shopping around for insurance now... just wait until Obamacare kicks in.

they will likely opt to provide their employees with NO insurance and simply pay the government fine as this is likely to be cheaper, leaving you out in the rain to fend for yourself against the insurance companies and the government both.

[Armistead]

Originally Posted by tater

Stop whining and go to med school, then work for free.

Nah, you'll just keep whining.

Government is the problem with our system to the extent there is a problem. 46+ % of US healthcare is already "government." The government care is why the rest is so FUBAR. The current expense of the US system is because those paying for insurance are also paying for the fact that the government systems pay too little. Fee for service, combined with artificial (and arbitrary) reimbursements means that there is incentive to "do more stuff" to the nearly 50% on charity care. That and CYA (defensive medicine).

Since no one is actually paying for the care themselves (insurance, gov care does), there is no incentive for shopping for cost, so there is no incentive to deliver savings. Look at cash-only medical practices, and you'll see that while they may keep their rates high, they always offer more and more for those rates. Better Lasik, more effective vasectomy reversal, etc. Lasik used to be really expensive. It's not any more. Why not? The government is not involved, that's why.

The current US system incentivizes all the wrong things, and almost entirely because of the government mucking around.

The reason 46% of care is already government funded is do to what, the corporate take over of healthcare making it unavailable to most. The question remains, which is worse, government of corporate? Most look at the past and track the history of how we got here...corporate control, political monopoly, regulation for mass profit over health...all pushed by the GOP, check to see all of these new members advisors...lobbyist for large firms.

Since the corporate takeover, business being business, it's not about health, it's about mass profits, all plans are related to profits. Like meds, we all know the goal of pharma is not to cure, it's to keep you as sick as possible, as long as possible on as many meds as possible. Because of Pharma's basic contol of the medical industry, that seems to be the goal. Americans prescription use is up 100% just in 10 years, including children. Course we see all the new diseases and pill commercials everyday.

Let's face it, we have a great way to fix a lot of this....preventive care, but you'll never see that thanks to corporations, not enough money in it.

What a crisis we're in today, a larger one is coming, the upcoming generation will see a mass increase of chronic life long disease due to being obese, lack of exercise, ect...Many already are. They say this will cost more than the baby boomers. 40% of kids today are just fat, compared to my generation, about 2%. Big Pharma is celebrating.

The biggest issue is health is something we all want, profit is what big business wants. Business will make profits at the expense of health. All the players in health want big profits, med profession, Insurance, Pharma, not to mention the lawyers that make billions off them all. When health fails, it overloads the system, so who pays for it...not the players, but the taxpayers.

Seems we have 3 choices, fix mass profit for health, taxpayers flip the bill or we just say what most in the GOP would prefer...Get sick, pay high cost until poverty and bankruptcy....then just die and go away, that is until a GOP member gets seriously ill without coverage.

They could fix it you know, but they won't...doesn't suit the special interest of either side.

[CaptainHaplo]

Fixing health care actually is really simple, but it requires us to fix some other things too.

If you need life saving care, your always going to get it - regardless. Ok I am fine with that. But when you go to the ER and there is a family of 8 people in there, none of which speaks english, because one of them has a stuffy nose - and they can't pay for service - the quality of care goes down - and your bill just went up - because the staff has to attend to them when they could be attending to other things and you have to bear the burden of some of the costs involved to serve them.

If its not life threatening and/or an emergency - you shouldn't be seen at an ER. Period.

Insurance. I am fine with the pre-existing condition clause - as long as it allows insurance companies to charge higher rates to those with them. This is common sense. What needs to happen with the insurance realm is that it needs to be unexempted from anti-trust legislation and it needs to have the across state lines boundaries removed. Those 2 alone would create huge positive impacts for consumers.

Tort Reform - doctors practicing defensive medicine has made costs skyrocket. Reduce their costs for insurance and your costs for tests and such you don't need, and your health care bills will lessen.

Medicaid - remove the "safety net" for those who are here illegally. This goes not just to health - but all welfare across the board. Without being able to use the ER's for non-emergency treatment and without using our tax dollars to go see a medicaid accepting doctor - illegals will have one less reason to be here.

[GoldenRivet]

Originally Posted by CaptainHaplo

If its not life threatening and/or an emergency - you shouldn't be seen at an ER. Period.

The problem with that statement is simple:

a minor persistent cough - while not life threatening - is a symptom of leukemia.

Stomach pain, with an elevation in temperature might just be a minor 24 hour stomach bug - but it could also be appendicitis.

a lot of life threatening ailments start out as minor little annoyances - and if you have an ER that simply dismisses a runny nose, or a fever or a cough as "not being serious enough because this is a hospital and we have better things to do" - you have a system where people go home and die from an undiagnosed problem.

[Armistead]

Originally Posted by CaptainHaplo

Fixing health care actually is really simple, but it requires us to fix some other things too.

If you need life saving care, your always going to get it - regardless. Ok I am fine with that. But when you go to the ER and there is a family of 8 people in there, none of which speaks english, because one of them has a stuffy nose - and they can't pay for service - the quality of care goes down - and your bill just went up - because the staff has to attend to them when they could be attending to other things and you have to bear the burden of some of the costs involved to serve them.

If its not life threatening and/or an emergency - you shouldn't be seen at an ER. Period.

Insurance. I am fine with the pre-existing condition clause - as long as it allows insurance companies to charge higher rates to those with them. This is common sense. What needs to happen with the insurance realm is that it needs to be unexempted from anti-trust legislation and it needs to have the across state lines boundaries removed. Those 2 alone would create huge positive impacts for consumers.

Tort Reform - doctors practicing defensive medicine has made costs skyrocket. Reduce their costs for insurance and your costs for tests and such you don't need, and your health care bills will lessen.

Medicaid - remove the "safety net" for those who are here illegally. This goes not just to health - but all welfare across the board. Without being able to use the ER's for non-emergency treatment and without using our tax dollars to go see a medicaid accepting doctor - illegals will have one less reason to be here.

The issue with those that have preexisting conditions, they are allowed to raise premiums, up to 30%. If you have to buy it on your own, the cost way exceed what most could afford, so they wouldn't buy it. So they would live with it until it got worse or life threatening, go to the ER and cost sky rocket.

The state line deal is crap. All studies show they would all still charge the same, basically agree on high cost.

I agree on tort reform to a degree, but it's also dangerous. Today Doctor's kill a lot of people. The bigger issue is Doctor's often don't dx many chronic illnesses. I live with a nerve disease that took me 5 years and over 30 different Doctors, finally figured it out at Mayo. Doctors did do numerous test and couldn't figure it out. Finally Doctors started calling me a nut or that symptoms were in my head. The lead Neuro at Mayo guessed it in one visit, follow up test proved it.. My fear is many with severe or rare diseases would get passed over as Doctors refuse to find a dx or do test. Go to any nerve disease forum and you'll find many that had to Doctor shop over and over.

We spend 1 out of every 4 health dollars in end of life care. I know that's a hard issue, but with treatment and meds this high cost of extending life for a few months to a year is breaking medicare. ...60 trillion in debt now.

[UnderseaLcpl]

Originally Posted by Armistead

The reason 46% of care is already government funded is do to what, the corporate take over of healthcare making it unavailable to most. The question remains, which is worse, government of corporate? Most look at the past and track the history of how we got here...corporate control, political monopoly, regulation for mass profit over health...all pushed by the GOP, check to see all of these new members advisors...lobbyist for large firms.

And this is exactly what you get when you allow companies to co-opt the government. It's just giving them an easy way to game the system. Healthcare costs are so high because we have a combination of the government making it extremely expensive, time-consuming, and risk-heavy to develop drugs or practice and large companies shutting out competition with legislation.

Since the corporate takeover, business being business, it's not about health, it's about mass profits, all plans are related to profits. Like meds, we all know the goal of pharma is not to cure, it's to keep you as sick as possible, as long as possible on as many meds as possible.

I'm not trying to be mean here, but that's an irresponsible claim on every count.

Firstly, you're assuming that medical and pharmacological professionals are unethical, which is not true. Medical and insurance firms do sometimes make harsh decisions involving care, and sometimes those decisions are wrong, but look at it from their perspective; people swindle them all the time, both intentionally and because so many people have a tendency to believe that anything that doesn't feel right is a disease. Plus, they get sued all the time for providing care, and for not providing care, and for providing the wrong care in a field that any doctor will tell you is difficult to make proper diagnoses in.

Secondly, while people like to think that medical firms try to keep them sick or convince them they have problems they don't have, that's not true, either. Insurance companies have a profit motive to get you healthy as quickly as possible, and few doctors would ever be so evil. There are the occasional quacks and profiteers, but they're never around for long. Any person or company in a private system that relies extensvely upon peer review and competition makes it difficult for them to operate for any perid of time.

Because of Pharma's basic contol of the medical industry, that seems to be the goal. Americans prescription use is up 100% just in 10 years, including children. Course we see all the new diseases and pill commercials everyday.

And thirdly, you're ignoring the actual state of the medical field today, a state which largely exists because of private innovation and development.

Yes, we see commercials for new pills and the like all the time, but there are two very good reasons for that:
1) Companies have to focus on marketing to recoup the huge losses they incurred while trying to get the drug through the FDA and
2) Medical nand pharmeceutical technologies are allowing us to address problems that were without remedy before.

Granted, I think a lot of people end up taking these drugs or getting procedures performed without needing them, but that's not the industry's fault, it's their own fault. I don't know why they do it exactly, but there are a lot of psychological reasons for people to want to believe that they are sick or that they have a condition. I could outline them in general, but I'd probably get it wrong. I'd ask Skybird if you want to know. Actually, I may ask him myself because now I'm curious.

Let's face it, we have a great way to fix a lot of this....preventive care, but you'll never see that thanks to corporations, not enough money in it.

Yeah, people like to think that, but again, not true. Ignoring the existence of entire industries based upon things like proper nutrition and other healthy lifestyle habits, and ignoring the shift that companies in general have taken towards making more healthy products, have you ever had a doctor who told you to do something unhealthy, or an insurance company that rewarded high-risk behaviours with lower premiums?

What would you have them do? Provide free checkups? Regulate your diet? Take a more active role in monitoring your health? There's a point at which such things are not economically viable, even for governments, and moreover, there's a point at which people have to take responsibility for themselves. I'm not assuming that you don't know this, I'm just putting it out there for people who like to blame everyone else for their own lack of responsibility.

What a crisis we're in today, a larger one is coming, the upcoming generation will see a mass increase of chronic life long disease due to being obese, lack of exercise, ect...Many already are. They say this will cost more than the baby boomers. 40% of kids today are just fat, compared to my generation, about 2%. Big Pharma is celebrating.

Hardly. Big Pharma has to pay for that, you know, and most of the obese population is lower-class, so it is unlikely that they'll be paying for it. Ultimately, when people can't pay their expenses, the state ends up absorbing the costs, and that spells taxation to business, big and small.

The biggest issue is health is something we all want, profit is what big business wants. Business will make profits at the expense of health. All the players in health want big profits, med profession, Insurance, Pharma, not to mention the lawyers that make billions off them all. When health fails, it overloads the system, so who pays for it...not the players, but the taxpayers.

Well, we're agreed upon the lawyers. I hate them, partly because they take so much and produce nothing, but the point is invalid. Why do you assume that profits and proper service are mutually exclusive?

Everyone wants food as well, and big business provides it because they want a profit. Every variety imaginable, and in every price range imaginable. If one is a fatass it's because one has chosen poorly from a vast selection. Where business can't provide in essential goods because consumers can't afford their product, they often opt to just give it away. Charitably-available food and healthcare is present almost everywhere and on a regular basis, not because the government made it so but because private firms with this terrible profit motive are not so heartless as you believe. And they get good PR.

Healthcare is no different from any other industry in that respect. It would be cheaper and we'd have more choices if the government didn't insist upon getting so heavily involved. Consider that it takes anywhere from five to twenty years to get a new drug approved by the FDA, and during that time everything you invested in the development is money that is not doing anything for anybody. It could have been used to invest, or pay employees, or for charity, or for development of a product with a more immediate return, but instead, it just sits there. Given that, I'm amazed anyone bothers to develop anything at all, and not surprised that only big companies can afford it. And then there are the liability requirements, and the licensures, and the restrictions, and the fact that all of the aforementioned have basically reduced the competitors to a handful of large firms.

Seems we have 3 choices, fix mass profit for health, taxpayers flip the bill or we just say what most in the GOP would prefer...Get sick, pay high cost until poverty and bankruptcy....then just die and go away, that is until a GOP member gets seriously ill without coverage.

I doubt that would ever happen that way. Members of Congress in both parties have their own healthcare plan, which is very expensive, but not suitable for the peons.

What they have for us is government healthcare, which, given the numerous examples of failure of government healthcare and the fact that a third of our considerable budget is devoted to government healthcare that nobody is happy with, is something which I do not expect to work. It's not a matter of politics or parties, it's a matter of logic. Without the profit incentive, work is just work, which is to say that it sucks, unless you're one of those enviable types who sees work as its own reward or you have a job you're really happy with.

Clearly, government workers are generally devoid of this incentive, and doubly so because they must maintain strict EEOC standards that require them to hire a workforce reflective of the population, regardless of aptitude. Furthermore, their workforce size is preset, so they can't shuffle bad workers into do-nothing positions and replace them good workers. The idea behind their system is very nice, but it doesn't work. That's just one of the handful of problems that plague every government agency with inefficiency, waste, and inefficacy.

What you want is a healthcare system that does the right thing because it is the right thing to do as dictated by consensus. What you'll get is a healthcare system that does the wrong thing because it is based upon the assumption that people are somehow different when they work for the government, or that Democracy is a valid type of government.

They could fix it you know, but they won't...doesn't suit the special interest of either side.

True enough.

In conclusion, I'd like to apologize for the tone of this post. I can see how it would be abrasive to some degree, but I was trying to keep it succinct by not putting a disclaimer in front of everything. I don't really disagree with your ideals, Armistead. I just don't think they are practicable without some changes to the equation.

[Armistead]

Try studying up on insurance corps like Unum. It was found their stated policy was always first to deny all but critical claims, deny first over 90% of all claims, then after red tape try again. They have been sued by most states as fraudulant, sued billions by lawyers.....why no changes, reports show they still make much more money doing fraud over what they pay out in lawsuits.

If you think big Pharma is ethical, well, let's agree to disagree....you should no better. There's a reason they have 20 lobbiest for every congressman and senator.

[mookiemookie]

Originally Posted by CaptainHaplo

Tort Reform - doctors practicing defensive medicine has made costs skyrocket.

No it hasn't. And protecting bad doctors is not the answer to our health care problems.

[GoldenRivet]

i'd say different mookie.

Doctors do practice medicine - constantly in "CYOA" mode.

[mookiemookie]

Originally Posted by GoldenRivet

i'd say different mookie.

Doctors do practice medicine - constantly in "CYOA" mode.

According to the actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs.

...

“It’s really just a distraction,” said Tom Baker, a professor at the University of Pennsylvania Law School and author of “The Medical Malpractice Myth.” “If you were to eliminate medical malpractice liability, even forgetting the negative consequences that would have for safety, accountability, and responsiveness, maybe we’d be talking about 1.5 percent of health care costs. So we’re not talking about real money. It’s small relative to the out-of-control cost of health care.”

Insurance costs about $50-$60 billion a year, Baker estimates. As for what’s often called “defensive medicine,” “there’s really no good study that’s been able to put a number on that,” said Baker.

...

A 1996 study in Florida found defensive medicine costs could be as high as 5 to 7 percent. But when the same authors went back a few years later, they found that managed care had brought it down to 2.5 to 3.5 percent of the total.

http://washingtonindependent.com/555...lth-care-costs

http://prescriptions.blogs.nytimes.c...th-care-costs/

I prefer to deal with data and facts.

Limiting the relief that people can seek from bad doctors is bad policy. The only tool we have to weed out bad doctors and hold them accountable is bringing malpractice charges against them.