OBAMA/TRUMPCARE MEGATHREAD

[CrimsonWeltall]

Link? I'm interested to see how many people die from not receiving medical care in this country.

 

This study estimated it at 45,000/year. http://news.harvard.edu/gazette/story/2009...ealth-coverage/

[Jenksismyhero]

This study estimated it at 45,000/year. http://news.harvard.edu/gazette/story/2009...ealth-coverage/

 

http://www.politifact.com/truth-o-meter/ar...-year-because-/

 

The case against estimates like this

 

There are not many specific arguments against Grayson’s specific number -- 45,000.

 

But because that estimate is built off the work of earlier, lower estimates, we think previous criticisms are still germane.

 

The biggest? It’s impossible to know precisely how many people die from having no insurance. There’s no national data for it.

 

Richard Kronick, a University of California San Diego medical professor who now works for the Department of Health and Human Services, wrote in 2009 that estimates are "almost certainly incorrect."

 

His paper, published in August 2009 in HSR: Health Services Research, found that uninsured participants had no different risk of dying than those were covered by employer-sponsored group insurance. The finding was surprising coming from Kronick, who told PolitiFact then it was "not the answer I wanted."

 

Kronick, recently named director of the Agency for Healthcare Research and Quality, said he does not doubt the overall point that having no insurance takes a toll on a person’s health. (Kronick was out of the office as we worked on this fact-check and could not be reached.)

 

Health policy experts across the political spectrum told PolitiFact in 2009 that Kronick’s critique was credible. And John Goodman, president of the conservative National Center for Policy Analysis, testified before Congress that year that we "do not know how much morbidity and mortality is attributable to lack of health insurance."

 

Katherine Baicker, a Harvard University health economics professor, echoed that it’s hard to get good evidence for a connection between lacking insurance and dying. The uninsured often earn less money than those who have insurance, she said, and poverty is associated with worse health.

 

"So when you see that the uninsured have higher mortality, you don't know whether it is because they are uninsured or because they are lower income," Baicker said.

 

Henry Aaron, a senior fellow at the centrist-to-liberal Brookings Institution, told us in an interview that he, too, thinks the number of deaths is impossible to nail down. In addition to Kronick’s skepticism, he pointed to a study of Oregon’s Medicaid experiment (which Baicker co-authored and PolitiFact looked at here) that found no significant improvement in health outcomes, including conditions like blood pressure, cholesterol and blood sugar, between a group of new Medicaid enrollees and uninsured Oregonians who could not get on the Medicaid rolls.

 

"Like Kronick, I am a strong advocate of measures to achieve universal insurance coverage and would rather that Kronick’s study and the Oregon project provided evidence in support of my policy preference," he said. "But, as far as mortality is concerned, they just don’t."

 

Edited October 4, 2013 by Jenksismybitch

[StrangeSox]

Jenks, do you not believe that millions of Americans lack(ed) access to affordable health care? Would my statement be agreeable if I modified it to "Millions of us don't have any candy at all and we literally suffer and sometimes die because of it"?

Edited October 4, 2013 by StrangeSox

[Jake]

Lack of access to healthcare is a lifetime problem. Just because people w/o insurance can head to the emergency room when they are near death to prevent that death, this does not change the fact that they are systematically prevented from good health.

 

Go speak to some homeless people and see how many of them have developed physical disabilities. I have to wonder how many people become homeless because they were unable to treat conditions that prevented them from working.

[Jenksismyhero]

Jenks, do you not believe that millions of Americans lack(ed) access to affordable health care? Would my statement be agreeable if I modified it to "Millions of us don't have any candy at all and we literally suffer and sometimes die because of it"?

 

It was the "dying because of it" part I didn't necessarily agree with, and I was curious if there was an actual figure out there for how many people die as a direct result of not being insured.

 

From my experience working with clients of all backgrounds in personal injury, med mal and wrongful death cases, and being married to someone who works at RUSH and knows every program they have, I don't buy that the lack of health insurance means you go without care. There are plenty of cheap and/or free places to go. Are they John Hopkins quality? Nope. But neither are 99% of the other hospitals/clinics out there for people that do have insurance. And yes, long term diseases and long term care is more difficult, but i'm also aware of a variety of programs for people in those situations (various forms of cancer, HIV/AIDS, etc.) to obtain the long term care they need.

 

I'm all about making our health care cheaper. I'm all about making it easier for people to obtain health insurance. I don't know that making people insured really matters THAT much at the end of the day.

 

Edit: and as i've said before there are parts of this law I like - not being denied coverage for pre-existing conditions, college kids being kept on policies for longer, etc.

Edited October 4, 2013 by Jenksismybitch

[NorthSideSox72]

Yeah, I think that whole conversation was ridiculous. The ACA fixes the problem of the uninsured because of money and because of pre-existing conditions. Now make this work without cost controls, because socialism. Now make this as revenue neutral as possible.

Seriously? Of course it was. It was a joke. With some grains of truth to it.

 

[bmags]

Seriously? Of course it was. It was a joke. With some grains of truth to it.

 

I'm aware it was a joke. But it advances a number of consistent themes that I refuse to entertain.

[Y2HH]

Lack of access to healthcare is a lifetime problem. Just because people w/o insurance can head to the emergency room when they are near death to prevent that death, this does not change the fact that they are systematically prevented from good health.

 

Go speak to some homeless people and see how many of them have developed physical disabilities. I have to wonder how many people become homeless because they were unable to treat conditions that prevented them from working.

 

If only.

 

You can head to the ER if you have a sliver. Or a cold. Or a runny nose.

 

I see you've never been to a f***ing ER to have even said this ridiculous nonsense.

[Jake]

If only.

 

You can head to the ER if you have a sliver. Or a cold. Or a runny nose.

 

I see you've never been to a f***ing ER to have even said this ridiculous nonsense.

 

I have been and of course our system also makes people feel compelled to go to the emergency room for minor problems. Unfortunately, the horrible emergency room that you are thinking of also drives these people to ignore these things because it is so time-consuming and inconvenient to bother. I have volunteered at "The MED" in Memphis which is downtown and is pretty much the place people who don't have insurance go to. Let's just say I saw a guy walk in there with his dismembered penis in his hand. Some people might think sitting through that s*** is worth it to get some cough medicine, but many decide that it isn't worth it

[bmags]

That post really became great at the end.

[StrangeSox]

I don't buy that the lack of health insurance means you go without care.

 

Ok, but that doesn't change the reality that an awful lot of people actually do go without care, which leads to chronic illness, untreated illness or worse complications down the road.

 

Edit: and as i've said before there are parts of this law I like - not being denied coverage for pre-existing conditions, college kids being kept on policies for longer, etc.

 

how do you pay for these things without the mandate?

Edited October 4, 2013 by StrangeSox

[mr_genius]

I saw a guy walk in there with his dismembered penis in his hand.

 

 

...whoa

[Y2HH]

Ok, but that doesn't change the reality that an awful lot of people actually do go without care, which leads to chronic illness, untreated illness or worse complications down the road.

 

 

 

how do you pay for these things without the mandate?

 

You don't.

 

I think people need to give this time to play out a bit before declaring it a total failure or a total success.

 

I think, in time, it will emerge as something with good and bad ideas, and most of these issues can (and should) be fixed. I say, and should, because knowing our government, they'll find a way to fix the things that were working fine, and break the things that were broken even more...given enough time.

[Jake]

...whoa

 

You can find pictures of procedures like this on the internet, but I'm told that they "saved" it. What they do is attach it to a stable blood source (like your arm) until the groin area is ready for reattachment.

 

I have since decided that medicine is not really my thing

Edited October 4, 2013 by Jake

[bmags]

You think the NHS is capable of reattaching a penis to an arm, you socialists?

 

USA USA USA

[Jenksismyhero]

Ok, but that doesn't change the reality that an awful lot of people actually do go without care, which leads to chronic illness, untreated illness or worse complications down the road.

 

How do you know the rate isn't the same for insured people? I've been covered under my wife's plan for 4 years. I've never gone to the doctor. Our insurance premium at this point is just another deduction out of her paycheck, just like taxes. We don't really think twice about it (well, we didn't, until we had to change the plan to get a kid).

 

I feel like people forget that insurance coverage doesn't necessarily mean healthier people. The majority of people DON'T get medical treatment despite being covered. That's how insurance companies stay in business.

 

 

How do you pay for these things without the mandate?

 

Raising the age doesn't cost anything extra. You're still getting the premiums for those kids, just a little longer. People 20-30 are the healthiest around anyway, so it's not like they'd be using up the system.

 

Pre-existing conditions, yeah, that might be costly, but design a system that insurance has to be more reasonable in the amount it'll cover but not to the point that the government has to be the surety on healthcare bills.

[mr_genius]

You think the NHS is capable of reattaching a penis to an arm, you socialists?

 

it would have to get cleared by the death panel first, probably.

 

 

 

[StrangeSox]

How do you know the rate isn't the same for insured people? I've been covered under my wife's plan for 4 years. I've never gone to the doctor. Our insurance premium at this point is just another deduction out of her paycheck, just like taxes. We don't really think twice about it (well, we didn't, until we had to change the plan to get a kid).

 

I feel like people forget that insurance coverage doesn't necessarily mean healthier people. The majority of people DON'T get medical treatment despite being covered. That's how insurance companies stay in business.

 

You are literally arguing now that insurance isn't actually useful and that people without insurance aren't forgoing medical care because they probably wouldn't have to go even if they did have insurance. This is completely absurd.

 

 

 

 

Pre-existing conditions, yeah, that might be costly, but design a system that insurance has to be more reasonable in the amount it'll cover but not to the point that the government has to be the surety on healthcare bills.

 

Without a mandate and with guaranteed coverage, everyone can just wait until they are ill and then get insurance. The system can't function that way.

 

There are systems where health care is much more reasonable and affordable. They're socialized.

 

[ptatc]

Of course, you could also give money to people.

 

As far as all that goes though, it was much, much cheaper for me to go to Harvard than UIUC. My parents made almost double the median income of the USA and that was the case. I didn't end up going to Harvard since an undergrad education there is a borderline scam, but the LAC that I ended up attending was always much cheaper.

 

I also love how I had earned a Robert C. Byrd Honors Scholarship from the federal government...then Robert C. Byrd died and it was mere months before that was defunded. Thanks, I'm glad we can build some more tanks now

This is a common theme. Private schools have a great deal more money to spend on aid than state schools. I lose a number of highly qualified applicants, particular underrepresented groups, to private schools because in the end it's cheaper. Our tuition is 30% of Northwestern. However, because of the aid they provide it is cheaper for the student to go there.

[ptatc]

There are plenty of doctors, but our current system discourages people from becoming primary care physicians. It is well known that fixing our immigration system and the way the medical industry looks at foreign medical training would easily fix this, as there are lots of doctors from across the world that want to be primary care physicians in the USA. We generally treat all foreign medical training as null and void, requiring any doctor that can manage to immigrate here to then go to school for several years to receive American certification.

 

Part of the reason nobody in the USA wants to become a primary care physician is because we don't help people go to college, so they must choose their specialty based almost solely on the most lucrative thing they could possibly be allowed to do since they are forced to take on an ungodly amount of debt to perform such an essential service.

This is only true because of the accreditation and quality management in the US. Most other countries producing the health professionals (MD and PT from my experience) do not monitor the quality of these educational programs. I have many physician's from countries such as India and Egypt where this takes place, who cannot apply to our program because they are not qualified.

For example all of their basic sciences that we would accept here (bio, chem physics) are taken at the undergrad level for entry into the DPT or MD program. In these countries the same courses are accepted from high school. These are not equvilent to US standards. Medical schools in these countries are basically trade schools and I don't want them treating my grandmother.

[cabiness42]

This is a common theme. Private schools have a great deal more money to spend on aid than state schools. I lose a number of highly qualified applicants, particular underrepresented groups, to private schools because in the end it's cheaper. Our tuition is 30% of Northwestern. However, because of the aid they provide it is cheaper for the student to go there.

 

Once upon a time, I almost went to grad school at UIUC.

 

[Jenksismyhero]

You are literally arguing now that insurance isn't actually useful and that people without insurance aren't forgoing medical care because they probably wouldn't have to go even if they did have insurance. This is completely absurd.

 

There are systems where health care is much more reasonable and affordable. They're socialized.

 

Go back and read what I wrote. I'm saying that no insurance =/= death. 30 million uninsured doesn't mean 30 million are dead tomorrow. Obviously if you have better access to healthcare, and cheap healthcare, you're going to be, on average, healthier than someone who doesn't. But it doesn't mean that if you don't have insurance you can't get healthcare so you die, just like it's not true that if you do have insurance you're going be the healthiest because you're going to use it to the fullest.

 

I'm trying to temper your "we don't have candy and we die" comment.

 

Without a mandate and with guaranteed coverage, everyone can just wait until they are ill and then get insurance. The system can't function that way.

 

Make an escalating scale or something for how much your out of pocket would be based on how long you've been signed up versus how long you've had the problem. Design a system that way. Cover everyone and let everyone else pay didn't have to be the answer.

[StrangeSox]

Go back and read what I wrote. I'm saying that no insurance =/= death. 30 million uninsured doesn't mean 30 million are dead tomorrow.

 

Coincidentally, neither was anyone else, beyond some silly one-liner inserted into NSS's purposefully silly story.

 

I'm trying to temper your "we don't have candy and we die" comment.

 

I already tempered it myself. I'm not accepting your claim that there aren't millions of people that go without adequate health care in this country because they lack health insurance, though.

 

You're aware of some free programs and clinics in a major metropolitan area. Great. Are there no people in the Chicagoland area that would like medical care but have to go without? I am doubtful. I am even more doubtful that your limited knowledge of some programs in a major urban center are applicable to millions of people who don't live in these areas. We see what happens when Doctors Without Borders hold one of their yearly free clinics in Appalachia.

 

Make an escalating scale or something for how much your out of pocket would be based on how long you've been signed up versus how long you've had the problem. Design a system that way. Cover everyone and let everyone else pay didn't have to be the answer.

 

That means sick people will be paying hugely expensive premiums. If you're already sick, then the insurance company knows exactly what it's going to cost them. The entire point of insurance is that everyone else who is healthy subsidies those who are sick.

 

Essentially, if you want to guarantee coverage, you can either have an individual mandate if you insist on a private for-profit insurance model or you can have a single-payer system if you want it to be a public service. I suppose you could enact significant taxes elsewhere and use those funds to subsidize these expensive pre-existing condition plans, but that inserts a pretty unnecessary step.

[cabiness42]

I like analogies. I’ve seen some recently for the shutdown. I was thinking about ObamaCare this morning, and here’s how I’d describe it. Kind of falls under the old saying: the Democrats are the party of bad ideas, and the Republicans are the party of no ideas. Just imagine that health care… is candy…

 

Americans (US): We don’t like the candy we pay for and get right now. Not good candy. We’d like more, better candy.

Democrats (DEM): No problem! We’ll give you the best candy you’ve ever seen, and for cheap too!

US: *skeptical look* Yeah, OK. Just try to make it better, alright?

Republicans (GOP): Tort reform for lawsuits against candy companies! Problem solved!

US: Well, I guess that’s OK. But I’m not sure that…

DEM & GOP: Great, we’re going to go solve your problem now! *go into closed office*

DEM & GOP: *much arguing is heard through the door*

DEM: Alright, we’ve solved your problem. Here you go! *drops 2000+ page ACA bill on table*

US: Wow. That is one big pile of s***. With some… candy stuck in it.

GOP: Yeah, that is one big pile of s***! Nice going, Dems.

DEM: Yeah OK you have to pick it out, but look at that fabulous candy!

US: um…

GOP: Wait a second, you can’t just put a pile of s*** on this table, that’s illegal!

DEM: Nuh uh!

GOP: Yeah huh!

DEM: Too bad, you passed it.

GOP: I’m taking you to court!

US: Hello? Over here. I have some questions about how to approach this…

SCOTUS: Taxes are legal. Taxes are s***. Therefore, by the transitive theory, s*** is legal. *gavel strike*

GOP: WHAT?!?!?!

DEM: AAAAAAAAAAHAHAHAHAHAHA

GOP: This fight isn’t over yet! Watch this…

US: Why is it not over?

GOP: *votes 35 times to defund ObamaCare, fails each time*

DEM: Really with this?

GOP: That’s it, we’re going nuclear.

DEM: Oh here we go…

US: Wait, what is happening here?

GOP: No more candy or chips or anything else for anyone until we end ObamaCare. Shut it all down!

DEM: Hey look – the Republicans shut down the government!

GOP: Nuh uh!

DEM: Yeah huh!

US: Are you guys even aware we’re still here?

DEM: What alternative do you suggest? What changes would you make to the candy?

*crickets*

GOP: *picks nose*

GOP: s*** sucks! Candy sucks!

US: *sigh*

 

I substituted 'p****' for 'candy' and found it to be a much more entertaining read.

[Y2HH]

Coincidentally, neither was anyone else, beyond some silly one-liner inserted into NSS's purposefully silly story.

 

 

 

I already tempered it myself. I'm not accepting your claim that there aren't millions of people that go without adequate health care in this country because they lack health insurance, though.

 

You're aware of some free programs and clinics in a major metropolitan area. Great. Are there no people in the Chicagoland area that would like medical care but have to go without? I am doubtful. I am even more doubtful that your limited knowledge of some programs in a major urban center are applicable to millions of people who don't live in these areas. We see what happens when Doctors Without Borders hold one of their yearly free clinics in Appalachia.

 

 

 

That means sick people will be paying hugely expensive premiums. If you're already sick, then the insurance company knows exactly what it's going to cost them. The entire point of insurance is that everyone else who is healthy subsidies those who are sick.

 

Essentially, if you want to guarantee coverage, you can either have an individual mandate if you insist on a private for-profit insurance model or you can have a single-payer system if you want it to be a public service. I suppose you could enact significant taxes elsewhere and use those funds to subsidize these expensive pre-existing condition plans, but that inserts a pretty unnecessary step.

 

Insurance, insurance, insurance. They're the bad guys.

 

When will you people wake up and realize the insurance companies aren't the ones writing out and sending the bills?

 

When will you finally ask the right questions, such as, why does an an American hospital charge 5,000$ for a procedure that costs 300$ in Canada, or elsewhere, instead?

 

I know, attacking the big bad insurance companies is convenient to a bad argument...but it doesn't, and DIDN'T solve the problem, which I called way back when this all started.

 

All that happened here was premiums skyrocketed for some, namely younger people regardless of income, and dropped for older people, again, regardless of income.

 

The goalposts were moved right along with the line of scrimmage.

 

...and nothing actually changed.

 

The same doctors, hospitals and pharmacies are still charging the same amount of money as they were before, only now they have more guaranteed business. And we did what we ALWAYS do in this country, we shifted the burden to the younger, less rich, less experienced section of the populous.

 

This is the same as giving the elderly 80% discounts at National Parks, and charging younger people full price. Let's think about that a second and ask a rather simple question...who has more money, the elderly who had a lifetime to work and save, or a youngster that just graduated college and is struggling to build a productive life and a family? Exactly. So, let's give the senior a discount and f*** the younger guy...he has time!

 

Rinse, repeat.

 

I'm like a broken record now, I said this at the very start, and I'm still saying it now. The problem isn't your insurance premiums. Ohhhh, I'm sure they have a hand in this racket, just like the rest of them, but they're not the ones setting the prices. They aren't the ones charging 5000$ for a procedure that took 3 minutes, done by a machine that's been paid for for over a decade, by a person making 18$ an hour, and a doctor that glanced at the image for all of 3 seconds who makes 300k+ a year.

 

They were in the right arena...they simply attacked the wrong enemy. This is like tackling the refs in an football game, because they're there, but letting the RB skate through, who makes 90x what the refs make...and then blaming the refs for the prices of everything in the arena.

Edited October 5, 2013 by Y2HH