OBAMA/TRUMPCARE MEGATHREAD

[Balta1701]

I'm sure the people seeing their health plans cancelled agree.

And I'm sure you'd have been quite happy paying higher hospital fees when they went to the hospital and found out that they had no coverage for such incidents, thus again leaving it to everyone else to cover it.

[Y2HH]

What will the boost to the economy be when millions of people have access to affordable health care services?

 

You keep calling it affordable and for most people, it's not affordable. Because AGAIN, they did nothing to control the cost sourcing. Doctors/Hospitals/Clinics can STILL charge whatever they want, whenever they want, because there is no ability to shop around or refuse an in-hospital 20 second doctor "visit" that tacks on another 200-400$ to your bill.

 

Prices will rise at the same rate they were rising BEFORE the law went into effect because nothing was done to control costs at the source.

[Balta1701]

I thought you were asking about a net effect, not whether any one particular individual will be adversely affected?

He's very used to expecting the entire economy to turn on the behavior of a very small group of individuals and treating them as the only ones who matter at all.

 

(/rimshot).

[southsider2k5]

And I'm sure you'd have been quite happy paying higher hospital fees when they went to the hospital and found out that they had no coverage for such incidents, thus again leaving it to everyone else to cover it.

 

Which is exactly what this plan is doing, on top of paying the government to hire a lot of new people to do it.

[southsider2k5]

You keep calling it affordable and for most people, it's not affordable. Because AGAIN, they did nothing to control the cost sourcing. Doctors/Hospitals/Clinics can STILL charge whatever they want, whenever they want, because there is no ability to shop around or refuse an in-hospital 20 second doctor "visit" that tacks on another 200-400$ to your bill.

 

Prices will rise at the same rate they were rising BEFORE the law went into effect because nothing was done to control costs at the source.

 

Bingo. There is literally no price pressure now.

[Balta1701]

You keep calling it affordable and for most people, it's not affordable. Because AGAIN, they did nothing to control the cost sourcing. Doctors/Hospitals/Clinics can STILL charge whatever they want, whenever they want, because there is no ability to shop around or refuse an in-hospital 20 second doctor "visit" that tacks on another 200-400$ to your bill.

 

Prices will rise at the same rate they were rising BEFORE the law went into effect because nothing was done to control costs at the source.

The Slowdown in Health Care Spending

[StrangeSox]

To most of lower rungs? Nothing. They weren't "paying" in the first place. They are the loss leaders you just referred to. You yourself said this is going to transfer money from the healthy to the hospitals and insurance companies.

 

That's not what a "loss leader" is, but many still paid substantial percentages of their income out-of-pocket, even if they couldn't pay the whole bill, or they simply went without, meaning they were less healthy and less productive. Plus you have some people who already had health insurance, but it was ridiculously expensive and they are seeing their premiums drop and may even be partially subsidized. Or they'll be covered by the Medicaid expansion.

[Jenksismyhero]

I can already read your "you shouldn't be eating at McDonalds 5 days a week" complaint when someone has a heart attack with no insurance and sticks the taxpayer with a $100k bill for the emergency room.

 

100k is not reasonable, but either way this happens now, whether that person is covered or not.

 

And again, how awful of me to expect that people will take care of themselves and be responsible for their own actions.

[southsider2k5]

That's not what a "loss leader" is, but many still paid substantial percentages of their income out-of-pocket, even if they couldn't pay the whole bill, or they simply went without, meaning they were less healthy and less productive. Plus you have some people who already had health insurance, but it was ridiculously expensive and they are seeing their premiums drop and may even be partially subsidized. Or they'll be covered by the Medicaid expansion.

 

And where are those subsidies coming from? Here's a hint, it isn't free money.

[Y2HH]

He's very used to expecting the entire economy to turn on the behavior of a very small group of individuals and treating them as the only ones who matter at all.

 

(/rimshot).

 

I don't think anyone here is arguing that it's a good thing to cover more people.

 

The issue was, and IS, that nothing was done to curb costs at the source. All we did was shift the burden around more evenly...but the bills are the same (or higher), and will continue to be the same or higher.

 

They needed to do both. They want to call this "comprehensive", but it's not. It's quite focused on insurance, and nothing more than insurance.

 

It did nothing to curb the rising costs of care, and it did nothing to curb the rising costs of drugs.

 

IF and only if all of that was done, it would be fair to call this comprehensive reform.

[Balta1701]

100k is not reasonable, but either way this happens now, whether that person is covered or not.

 

And again, how awful of me to expect that people will take care of themselves and be responsible for their own actions.

So in other words...we can either keep the status quo where you pay the bills for those people, we can try to give them an option where they can actually have preventative care thus opening up both potential improvements in the health of the nation and cost savings, or we can stop covering them entirely and hope that their deaths are the appropriate lecture on personal responsibility.

[Jenksismyhero]

So you want to provide BCBS with your tax return every year so that they can adjust your policy costs appropriately every year? This would effectively eliminate the entire concept of group plans (i.e. what a majority of americans have). I'm struggling to understand what your envisioned policy here is and why it should be that way.

 

Your insurance company already knows, directly or indirectly, what range of salary you make. That's why people making more at a company pay more for their insurance than people that make less (at least they do in my plan). Why would that result in the end of group plans?

[Y2HH]

So in other words...we can either keep the status quo where you pay the bills for those people, we can try to give them an option where they can actually have preventative care thus opening up both potential improvements in the health of the nation and cost savings, or we can stop covering them entirely and hope that their deaths are the appropriate lecture on personal responsibility.

 

I think his basic point is, is that if they're being heavily subsidized to buy this insurance, we're still paying for their bills anyway.

 

Perhaps this is a better method of doing so, but in the end, it's still being paid by the taxpayer.

[Balta1701]

I don't think anyone here is arguing that it's a good thing to cover more people.

 

The issue was, and IS, that nothing was done to curb costs at the source. All we did was shift the burden around more evenly...but the bills are the same (or higher), and will continue to be the same or higher.

 

They needed to do both. They want to call this "comprehensive", but it's not. It's quite focused on insurance, and nothing more than insurance.

 

It did nothing to curb the rising costs of care, and it did nothing to curb the rising costs of drugs.

 

IF and only if all of that was done, it would be fair to call this comprehensive reform.

Who cares if the reform isn't "Comprehensive" enough when we've already seen some slowdown in cost growth and tens of millions of people will get access to better/cheaper care?

 

Ohhh darn, we have more work to do to make a better system...that was apparent from the start...in no small part a consequence of the rules of the Congress.

[StrangeSox]

You keep calling it affordable and for most people, it's not affordable. Because AGAIN, they did nothing to control the cost sourcing. Doctors/Hospitals/Clinics can STILL charge whatever they want, whenever they want, because there is no ability to shop around or refuse an in-hospital 20 second doctor "visit" that tacks on another 200-400$ to your bill.

 

Prices will rise at the same rate they were rising BEFORE the law went into effect because nothing was done to control costs at the source.

 

Well, I believe that healthcare is probably the worst possible place to rely on a pure consumer market precisely because it's a vital good (in the literal sense!) that often can't be delayed at all to shop around.

 

The ACA did contain some cost-control provisions, and they appear to be having at least somewhat of an effect already. Allowing Medicare to negotiate drug prices could help, but short of strict price controls, I'm not sure what you'd like to see in order to reduce costs from doctors/hospitals/clinics.

 

Part of the cost built-in is the ridiculous cost for medical school. One of my friends it finishing up his dentistry program and then wants to go into oral surgery. By the time he's done, he'll have over half a million in debt, and he's going to public schools.

[Y2HH]

Who cares if the reform isn't "Comprehensive" enough when we've already seen some slowdown in cost growth and tens of millions of people will get access to better/cheaper care?

 

Ohhh darn, we have more work to do to make a better system...that was apparent from the start...in no small part a consequence of the rules of the Congress.

 

We haven't seen a slowdown in cost growth. People keep claiming this, but it hasn't happened.

[Balta1701]

I think his basic point is, is that if they're being heavily subsidized to buy this insurance, we're still paying for their bills anyway.

 

Perhaps this is a better method of doing so, but in the end, it's still being paid by the taxpayer.

And my point to him is...if he wants to enforce "personal responsibility" in this case, he's going to have to come out and say that people should die to enforce it.

[StrangeSox]

100k is not reasonable, but either way this happens now, whether that person is covered or not.

 

And again, how awful of me to expect that people will take care of themselves and be responsible for their own actions.

 

I have to point out, again, that this is a pretty odd view of why people frequently need health care. It's not irresponsibility or moral failures that make you predisposed to getting cancer or catching the flu or just needing routine health care.

[Balta1701]

We haven't seen a slowdown in cost growth. People keep claiming this, but it hasn't happened.

The slowdown in health care cost growth has been sufficiently broad and persistent to persuade us to make significant downward revisions to our projections of federal health care spending.

-Congressional Budget office in August explaining why the 20-year Medicaid cost estimates were reduced by about a trillion dollars.

[Y2HH]

Well, I believe that healthcare is probably the worst possible place to rely on a pure consumer market precisely because it's a vital good (in the literal sense!) that often can't be delayed at all to shop around.

 

The ACA did contain some cost-control provisions, and they appear to be having at least somewhat of an effect already. Allowing Medicare to negotiate drug prices could help, but short of strict price controls, I'm not sure what you'd like to see in order to reduce costs from doctors/hospitals/clinics.

 

Part of the cost built-in is the ridiculous cost for medical school. One of my friends it finishing up his dentistry program and then wants to go into oral surgery. By the time he's done, he'll have over half a million in debt, and he's going to public schools.

 

These cost controls are only benefiting those on Medicare, which while good, doesn't help anyone else, as they simply shift the cost down. If Medicare patients pay less for Drug X, you and I make up the difference by paying that much more for Drug X.

 

These cost savings haven't materialized like people keep saying.

[StrangeSox]

And where are those subsidies coming from? Here's a hint, it isn't free money.

 

Various places (cadillac plan taxes, medical device taxes, etc.), definitely not directly from premium increases, which is what you were talking about.

[southsider2k5]

Various places (cadillac plan taxes, medical device taxes, etc.), definitely not directly from premium increases, which is what you were talking about.

 

Taxes = free money and no impact on the economy.

[Y2HH]

-Congressional Budget office in August explaining why the 20-year Medicaid cost estimates were reduced by about a trillion dollars.

 

And merely shifted elsewhere.

 

These reports are smoke and mirrors.

 

The same amount of money is going into that sector, whether less is coming from Medicare and more is coming from elsewhere, it doesn't matter.

[StrangeSox]

Your insurance company already knows, directly or indirectly, what range of salary you make. That's why people making more at a company pay more for their insurance than people that make less (at least they do in my plan). Why would that result in the end of group plans?

 

I work for one of the largest employers in the world. Our group health plan does not depend on how much you make. I've honestly never heard of that anywhere.

 

You are, oddly, arguing in favor of socialism here. You're arguing for progressive pricing for the same service based on your income level.

[Jenksismyhero]

Jenks, is it fair to say (based on your previous posts) that you don't even really believe that there's a significant number of people out there who lack access to affordable health care? You seem to be arguing that we should do something to address that problem, even if you don't know exactly what that would be*, but my impression in the past has been that you don't accept that it's even actually a problem.

 

*you don't need to have some fully developed substitute or anything in order to criticize existing systems and structures, I hope that was phrased neutrally enough.

 

I think it's a problem, I don't think it's a LARGE problem that was worth the cost of what we're going to spend and what we've spent already. At the end of the day you're still talking about a small minority of people that will get a great benefit from this (going from unaffordable coverage to more affordable coverage). Yet directly or indirectly, everyone else has to pay more for that.

 

I also question the claims that this will actually curb costs. I don't think there's been an adequate prediction of how these people who never had insurance (or adequate insurance), but now have coverage at incredibly cheap rates, can now go to more expensive hospitals and get all ranges of treatment. Yes, there will be a benefit of screenings and routine check ups and all that to prevent future health issues, but will that really curb the cost of someone going to the ER for a cold because they don't have to worry about the cost?

 

But really, my main issue with Obamacare (and I've voiced this repeatedly) was that we should have been focusing on the economy instead of this half fix (if you want to even call it that). Blame that on the GOP if you wish, but Obama could have put that on the back burner and he chose to make it his signature piece of legislation during his presidency at a time when the country was hurting.