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Old 12-20-16, 07:43 PM   #16
GoldenRivet
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I hope to see something constructive done about or with the affordable care act.

rates, for literally every single person i personally know both on "Obamacare" and with employer provided health care has increased anywhere from 3 to 6 times over the past few years.

The health insurance in my family is provided through my wife's employer offered health care plan, we have received letter after letter about rate changes over the past couple of years.

i can personally guarantee that the first 25-30% of each of her work month goes just toward covering premiums and the cost is ridiculous. especially where i am concerned because prior to ACA, i had NO health insurance, no premiums, i literally always either paid cash for what few medical treatments or doctor visits i needed or signed up on a payment plan to pay $100 a month (or some other amount) until the debt was paid.

admittedly that was easy to do in my 20s and early 30s, and as age creeps up on us both health will certainly decline and paying cash becomes unreasonable or outright impossible.

but, the bottom line is, the government does something like pass the ACA to "help you" and then they end up bleeding you dry by pulling money out of your check.

------

next up, congressional term limits, congressmen (and women for the sake of being pc ) get elected and then they end up keeping their seats for 40 and 50 years simply because it is human nature to resist change... well, the cornerstone of progress is change, get them in, let them innovate with fresh ideas for 4 or 6 years and then push em out!

------

remove the golden parachute

put all of the congressional leaders on social security, remove the lifetime income guarantee, and require all congressional leaders to be on the same health care plan as is offered by the government. period. remove the first class citizen status these idiots have
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Old 12-20-16, 08:16 PM   #17
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Originally Posted by GoldenRivet View Post
put all of the congressional leaders on social security, remove the lifetime income guarantee, and require all congressional leaders to be on the same health care plan as is offered by the government. period. remove the first class citizen status these idiots have
I take it that you are unaware that this already is in place.

1. Members of Congress have been paying into Social Security since 1984 (PL 98-21).

2. Members of Congress are in the same retirement pension plan as other federal employees. Members of Congress are eligible for a pension at the age of 62 if they have completed at least five years of service. Members are eligible for a pension at age 50 if they have completed 20 years of service, or at any age after completing 25 years of service. The amount of the pension depends on years of service and the average of the highest three years of salary. By law, the starting amount of a Member’s retirement annuity may not exceed 80% of his or her final salary.

3. Prior to 2014, members of congress were covered by the same health plan as other federal employees -- The Federal Employee's Health Benefits Program.But starting Jan. 1, 2014, House and Senate members, and their staffs, can only obtain employer-subsidized, private coverage through the exchanges established under the ACA. So actually members of Congress lost their health coverage through the FEHBP and now has to purchase private insurance through the ACA exchanges.

It keeps going around the Internets Tubes how congress is in a special class and are exempt from pretty much anything. Members of Congress are federal employees and their benefits are in the same class as for other federal employees. There are some minor differences but they are truly minor.
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Old 12-20-16, 08:32 PM   #18
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Originally Posted by GoldenRivet View Post
I hope to see something constructive done about or with the affordable care act.

rates, for literally every single person i personally know both on "Obamacare" and with employer provided health care has increased anywhere from 3 to 6 times over the past few years.

The health insurance in my family is provided through my wife's employer offered health care plan, we have received letter after letter about rate changes over the past couple of years.

i can personally guarantee that the first 25-30% of each of her work month goes just toward covering premiums and the cost is ridiculous. especially where i am concerned because prior to ACA, i had NO health insurance, no premiums, i literally always either paid cash for what few medical treatments or doctor visits i needed or signed up on a payment plan to pay $100 a month (or some other amount) until the debt was paid.

admittedly that was easy to do in my 20s and early 30s, and as age creeps up on us both health will certainly decline and paying cash becomes unreasonable or outright impossible.

but, the bottom line is, the government does something like pass the ACA to "help you" and then they end up bleeding you dry by pulling money out of your check.

------

next up, congressional term limits, congressmen (and women for the sake of being pc ) get elected and then they end up keeping their seats for 40 and 50 years simply because it is human nature to resist change... well, the cornerstone of progress is change, get them in, let them innovate with fresh ideas for 4 or 6 years and then push em out!

------

remove the golden parachute

put all of the congressional leaders on social security, remove the lifetime income guarantee, and require all congressional leaders to be on the same health care plan as is offered by the government. period. remove the first class citizen status these idiots have


I think quite simply they are going to gut Obamacare and not look to replace it for a while - that might take years even - - even though trump had mentioned a while back in passing he likes some parts, i cant imagine that he is going to really stick with that, when he flips on everything else and it is not even in line iwth the GOP who despise anything that isnt controlled by private interests looking for a profit and driven by some quite backward and disturbing ideologies sadly.

affordable quality health care is not impossible - most developed countries have it no problems - we have it in australia, where it is a mix of public and private and that works well, i think most australians are happy to pay the fraction they do into medicare.

All the ideology aside though there are inevitable problems - if the population is aging, getting sicker and needing more regular care, also if the overall health of a population declines - evident with the rise in junk food consumption and obesity levels in the western world in the recent decade, and also access to fresh food, clean air and clean water

-one thing i am very concerned for my US friends about is that Trump and the people he has gathered want to eliminate the EPA - this is madness really, - getting rid of regulatory bodies pretty much guarantees the further contamination of water supplies
- and this is already a big issue in the USA - not just Flint, but in many other cities where lead levels are even higher as it has been found now

and if you want to see what air quality looks like with no regulations on pollution just look at China now, where the air pollution is so bad that even flights are ground, and similarly in Delhi.

It is galling and beyond disturbing the kind of apocalyptic levels of insanity that are being harnessed to form the Trump admin - slipping into very dark dark places.
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Old 12-20-16, 08:42 PM   #19
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20-30%? What on Earth are you guys doing?

I don't pretend that our system is perfect but it certainly seems a lot simpler. You pay in a certain percentage of contribution each paycheck, which varies depending on your pay rate, and that is all sent to the National Insurance Fund which then helps fund the service so that it is free of charge at point of delivery.
The US health care system seems complex for no reason other than the sake of being complex. I just don't get it.
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Old 12-20-16, 09:53 PM   #20
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The GOP led destruction of the USA's programs like ACA, social security and its various regulatory bodies and institutions aside

trump himself is descending now well into running a far right fascism and knitting such deep system divisions into all parts of not just the government, but also the media and now the intelligence bodies -

here is another example of the despotic autocracy that is now powering up

http://www.salon.com/2016/12/20/dona...NESsg.facebook

I really am quite deadly serious about all this and am fearful for the lives of not just the american population but the whole globe.
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Old 12-20-16, 10:22 PM   #21
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Originally Posted by agathosdaimon View Post
here is another example of the despotic autocracy that is now powering up

http://www.salon.com/2016/12/20/dona...NESsg.facebook
Quoting Salon is like quoting the Democratic National Committee. Nothing but Liberal claptrap and it seems to have skewed your view of my country.
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Old 12-20-16, 10:32 PM   #22
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Quote:
Originally Posted by agathosdaimon View Post
The GOP led destruction of the USA's programs like ACA, social security and its various regulatory bodies and institutions aside

trump himself is descending now well into running a far right fascism and knitting such deep system divisions into all parts of not just the government, but also the media and now the intelligence bodies -

here is another example of the despotic autocracy that is now powering up

http://www.salon.com/2016/12/20/dona...NESsg.facebook

I really am quite deadly serious about all this and am fearful for the lives of not just the american population but the whole globe.

Aww, relax, we're going to have some grown-ups running the government for a change. Well, maybe not the President, but so far, his cabinet is solid. All proven leaders and successful people, not chosen because they make the cabinet look diverse.
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Old 12-20-16, 11:20 PM   #23
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Originally Posted by agathosdaimon View Post
I really am quite deadly serious about all this and am fearful for the lives of not just the american population but the whole globe.
Take a read through the election thread, have a look at the discussions there...and then think about the responses you expect to get to a statement like that in General Topics.
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Old 12-20-16, 11:51 PM   #24
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Originally Posted by Oberon View Post
20-30%? What on Earth are you guys doing?

I don't pretend that our system is perfect but it certainly seems a lot simpler. You pay in a certain percentage of contribution each paycheck, which varies depending on your pay rate, and that is all sent to the National Insurance Fund which then helps fund the service so that it is free of charge at point of delivery.
The US health care system seems complex for no reason other than the sake of being complex. I just don't get it.
it costs a lot to cover a family of four with medical, vision and dental.
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Old 12-20-16, 11:53 PM   #25
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Originally Posted by Platapus View Post
I take it that you are unaware that this already is in place.

1. Members of Congress have been paying into Social Security since 1984 (PL 98-21).

2. Members of Congress are in the same retirement pension plan as other federal employees. Members of Congress are eligible for a pension at the age of 62 if they have completed at least five years of service. Members are eligible for a pension at age 50 if they have completed 20 years of service, or at any age after completing 25 years of service. The amount of the pension depends on years of service and the average of the highest three years of salary. By law, the starting amount of a Member’s retirement annuity may not exceed 80% of his or her final salary.

3. Prior to 2014, members of congress were covered by the same health plan as other federal employees -- The Federal Employee's Health Benefits Program.But starting Jan. 1, 2014, House and Senate members, and their staffs, can only obtain employer-subsidized, private coverage through the exchanges established under the ACA. So actually members of Congress lost their health coverage through the FEHBP and now has to purchase private insurance through the ACA exchanges.

It keeps going around the Internets Tubes how congress is in a special class and are exempt from pretty much anything. Members of Congress are federal employees and their benefits are in the same class as for other federal employees. There are some minor differences but they are truly minor.
thank you for the info

I'll read up on it
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Old 12-21-16, 12:22 AM   #26
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Originally Posted by GoldenRivet View Post
it costs a lot to cover a family of four with medical, vision and dental.
Of course, I didn't take into consideration that it's not a state or local government defined rate. One thing I will concede in regards to our health service is that things like dental and vision are generally not covered by the National Insurance rate, so when I eventually go back to the dentist or opticians I will have to pay for this, and the rates are, not particularly low. There are options on the table for those on the social and that, but for the most part you do have to pay. So there's that. Obviously we have health insurance over here too which also (sometimes) can go towards those kinds of bills, and you do also have to pay a flat rate for prescription medicine unless you meet certain criteria, for example if you have a specified medical condition and have a valid medical exemption certificate, these conditions include diabetes, epilepsy, cancer and/or other physical conditions which prevent you from going outside without assistance. Also, if you reach pension age then prescriptions are free. The current flat rate is £8.40, which is about 10 dollars per item.
So, your family of four in the UK would have the adult workers pay in their National Insurance contribution, depending on your wage, if the kids are under 16 then the prescriptions are free, so the main thing you'd be paying for would be dental and optical treatments. You can get free eye tests in some places, but actually getting the lenses and frames, you're probably looking at anything up to and over £100 ($123 dollars), as for a dental check-up...off the top of my head, the last time I went (which was too long ago...really need to get back) was between £40-60 ($49-74) so outside of your National Insurance contribution you're looking at about $200 per person per appointment, and that's just basic stuff in regards to the dentist, the opticians would probably be lower for just check-ups, but in regards to lense replacement and that, you're looking at the higher end of the scale obviously.
Now National Insurance contribution rates vary wildly, I don't know what you bring in as a family, so I'll base it on the UK average income which is £26,500 per year ($32,111) which works out at around £2208 a month, which means that the contribution is 13.8% which is £305 approximately. So you're probably looking at around £400-500 per month expenses on medical coverage in the UK for yourself, which is around 20-25%. Of course, the two kids would not need to pay into the NI until they start work, so you can deduct that £305 each for them, but you'd still have to pay for dental and opticians as the need arose and when they get over 16 then you'll also need to pay prescription charges, although if it's long-term medication then you'll usually get enough to cover a months supply, so that's £8.40 per month, depending on the condition of course.

So, at the end of all that rabbit, there's some parity there in our two systems, but there are also some differences, and I must admit I still can't get my head around the American healthcare system, especially when I see some of the hospital bills, and some of the really stupid stuff that people get charged for, but that's something that you tend to only see negative examples of, so that does present a skewed image somewhat.
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Old 12-21-16, 12:55 AM   #27
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I will just say though, before clocking off for now, that our system is by no means perfect, and I really cannot stress that enough. We Brits may have a bit of a gloat about it, but at the end of the day there are some pretty big problems facing it at the moment, and a lot of it is down to mismanagement and funding shortages...not to mention the potential for staff shortages post-Brexit (depending on what particular flavour Brexit we get).
That being said, I think that it is a part of the British national identity and if anyone made an overt attempt to privatize it, or attempt to implement some form of fee at the point of service there would be a large uproar over it.
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Old 12-21-16, 03:37 AM   #28
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@ Oberon

As you may or may not be aware, this year my step daughter went to the ER due to complaints of crippling back pain. as it turned out she was passing a kidney stone. She was sent home with pain management medication and antibiotics and advised to return if the pain worsened or persisted.

fast forward two days, the pain returned and was worse than the first go. She was taken back to the ER as directed and an MRI conducted. The doctors discovered that one of the kidney stones had become jammed in her left ureter just long enough to cause urine to back up into the kidney, this, combined with the irritation from the stone passage caused a kidney infection. she was admitted to the hospital here in our home town for a couple of days to manage the condition.

the stone passed, but the infection refused to relent and caused the kidney to abscess. She was transferred to a Children's Hospital about 2 hours drive from home and admitted where she remained for the next 22 days. During that time doctors determined that the offending organism was Klebsiella Bacteria and worked to save the kidney. Ultimately she needed a drain tube inserted through her abdomen into the kidney to allow the abscess fluid to exit the body (Nephrostomy) and we were advised that only a handful of antibiotics would actually work against Klebsiella Bacteria. Eventually she was sent home with a PICC line inserted into the left arm which was meant to feed the antibiotics directly into the circulatory system. This was something we were taught to do here on our own, but for the first few treatments she had a visiting nurse.

I cant complain about our insurance plan too much, we have a better plan than most, but we do pay exorbitantly for it. the final tally on her medical bills rested in the $115,000 range, of which we will be responsible for about $7,000 out of pocket.

Without putting too much of our business our there, my wife realistically only makes about $1,900 a month, her employer offered health care plan is what i would call a "Cadillac" policy. It offers a great many options and coverages. conversely, i out earn my wife many times over, but the employer offered health care plan through my employer is garbage ergo we elect to use her coverage instead of mine... which is why it gobbles up so much of her income.

My in-laws are another example. While self sufficient and proud people, they would be considered "low income" and since they are both "self employed" Obamacare was the only realistic option for them at the time of their enrollment. They couldn't go without insurance, and they certainly couldn't afford to pay the state mandated penalty for going uninsured.

Unfortunately for them, their ACA premiums have increased considerably since their initial enrollment and have expressed disappointment with the coverage compared to the cost. Im certain they are not the only folks in that boat.

I almost lean toward scrapping the ACA altogether and letting free market capitalism run with the ball, when insurers are tripping over their own asses competing for customers the premiums will invariably be reduced. besides... anyone with nary a single dime to spare cannot be turned away from medical treatment - hospitals already receive a ton of tax incentives for treatment of those who are unable to pay as is.

the bottom line is; there's only one big rock, and everyone has to get a piece of the rock. My favored politician is quite simply the one who a. gives me the most access to the rock and b. leaves my piece of the rock most unmolested.
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Old 12-21-16, 07:22 AM   #29
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We just got the numbers for next year's health care costs from my company. Our premiums have gone down and my contribution has gone down but the plan stayed the same.

ACA works for some people at least.
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Old 12-21-16, 09:01 AM   #30
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Originally Posted by GoldenRivet View Post
@ Oberon

...

I almost lean toward scrapping the ACA altogether and letting free market capitalism run with the ball, when insurers are tripping over their own asses competing for customers the premiums will invariably be reduced. besides... anyone with nary a single dime to spare cannot be turned away from medical treatment - hospitals already receive a ton of tax incentives for treatment of those who are unable to pay as is.

...
There are a few problems with that idea. There was, for the most part, a very much free market capitalism situation in terms of health insurance and health care. The result had been the excesses of the insurance industry, and by extension, the hospital and pharmaceutical industries; the result of letting them have their own lead was ever-increasing and skyrocketing medical care and medicine prices and the exclusion of a very sizable percentage of the population due to the insurance industry's cherry-picking of clients they would accept and the restrictions placed upon those who were accepted in terms of type of care and and the extent to which the industry would cover their clients. Remember, the calls for health care reform were the result of the pretty much unfettered free market capitalism insurance/health care industry, not just a mere political whim. The medical care horror stories heard prior to the ACA were as bad, and maybe even worse, than post ACA. Also remember, taxpayers were already paying for the care of those under-insured or uninsured; many of those people could not afford preventative care and went to ERs usually when their conditions were so far advanced as to require far more extensive, and expensive, care, at taxpayer cost, than if they had been able to seek preventative care. And, speaking of ERs, the ACA has provisions penalizing ERs and hospitals who engage in a sort of "put a band-aid on gunshot wound" sort of care where they do just enough to get the patient out the door, dealing with symptoms rather than causes, resulting in the same patients having to make repeated visits to the ERs, again at a repeated cost to taxpayers. Now ERs who show excessive return visits are required to justify their decisions and are fined if it is shown they take the "easy way out" when dealing with ER patients. As someone who has made a few ER visits in recent years, I can say the thoroughness of treatment post-ACA is noticeable; the 'here's a couple of aspirin, go walk it off' attitude is fading; also, the formerly packed to the gills ER waiting rooms have thinned out very noticeably. Even the Free Clinic in my neighborhood is handling a lot less traffic. The indications are that if you deal with a health problem properly when it is relatively small and relatively inexpensive, the less likely it will have to be dealt with when it is major and very expensive...

The upper management of health care is also an issue; gone are he days when hospitals decisions were made by capable medical practitioners who had at least some empathy for the patients; now, decisions are are made by corporate bean counters who have very, very little to no concern for individual patient care and are more concerned about optimizing profits for shareholders of their corporations and in meeting targets to trigger their own bonuses and perks...

California voters, years ago, in response to skyrocketing insurance rates and hikes, gave the state insurance commissioner the authority to set ceilings for insurance rates and rate hikes for automobile insurance; insurance companies had to justify the need for rates and hikes by presenting all the evidence to justify their increases. When the law passed, the insurers stormed and bellowed, threatening to pull out of CA and never sell policies in the state again. The law went into effect and, lo and behold, the rates not only stabilized, most of them actually went down and there were even rebates. Most of this was due to the greater transparency in the rate setting process, and a lot of it was also due to something the free market didn't provide: competition. While the major companies bellowed and cursed, smaller companies were able to compete as they filled the voids left by the larger companies. Consumers had far more choices and the big companies began to relent: California is a huge consumer market and the majors could not afford to lose their shares. The experience with the auto insurance industry has led to attempts to put healthcare insurance under the same requirements, but has so far been unsuccessful; the major companies, with their lobbying clout, have thus far been able to dodge and/or suppress any effort to make them as responsible for their actions as are the auto insurers. Maybe it will change soon; the November 2016 ballot had a measure putting e-cigarettes under some of the same law as regular cigarettes and the tobacco industry spent a whopping US $71+ million dollars to defeat the measure and lost by a a result of 64% in favor of the taxation of e-cigs against 36% against; more and more it seems big money is having less and less influence, at least in some states; how this will change, now that Daddy Warbucks is in charge, remains to be seen, but he has already indicated he wants to allow some facets of the ACA to remain intact, and not just minor aspects...



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