Politics Obamacare

redux - You dont privatize Medicare. You privatize everything, so people at age 65 retain the insurance they always had.
bodkin, that's exactly right. All definitions are arbitrary, of course, but that's what all insurance is -- if you have homeowners insurance they don't pay for normal wear and tear but they will pay for water damage in a flood. Car insurance won't pay for your gas and oil changes but will pay for an accident or theft. All I'm proposing is that health insurance should be real insurance, for major medical problems, and not a system for getting other people to pay your bills for you.

 

I HAVE JUST AS MUCH RIGHT TO LIVE AS YOU DO MOTHER FUCKER, I AM SICK AND TIRED OF THE PAST YEAR HAVING TO DEFEND MY RIGHT TO LIVE SO FUCK OFF!!!!!!

AND NO I DON'T KNOW A GOD DAMNED THING ABOUT YOUR LIFE OTHER THAN YOU WOULD WANT ME DEAD TO PROVE A FUCKING POINT... GO FUCK YOURSELF. I AIN'T DYING, MUCH TO YOUR OBVIOUS DISMAY.

See I can play with font sizes and bold and italics and even underline also.

THE ONLY THING I FUCKING WANT IS TO LIVE A LIFE....... IS THAT SO "EVIL" AND FUCKING UP YOUR LIFE THAT MUCH? REALLY? I'VE DEALT WITH ASSHOLES LIKE YOU FOR OVER A FUCKING YEAR TELLING ME TO DIE LITERALLY, IF YOU WANT I'LL BE MORE THAN HAPPY TO FORWARD YOU THE SAME SHIT I FORWARDED FACEBOOK WHO SAID THEY CAN'T DO ANYTHING, BUT I COULD BLOCK THE PEOPLE... SO I BLOCKED THE PEOPLE AND THEY WOULD JUST CHANGE NAMES AND THEN BITCH THAT I BLOCKED THEM AND CALLED ME NAMES FOR BLOCKING THEM BECAUSE THEY WERE TELLING ME TO DIE. AGAIN, FACEBOOK REFUSED TO DO ANYTHING (I'D CALL IT BULLYING BUT I GUESS FACEBOOK DOESN'T).

I AM SO SICK OF THE 'I GOT MINE FUCK YOU IF YOU CAN'T GET YOURS' ATTITUDE THAT IS AMERICA THESE DAYS THAT IN JUNE I DOWNED A BUNCH OF AMBIAN AND TRAZADONE TO KILL MYSELF BECAUSE OF PEOPLE LIKE YOU AND THAT ATTITUDE. GIVEN WHAT YOU HAVE POSTED I AM QUITE SURE YOU ARE UPSET THAT DIDN'T WORK AND IT WAS MORE MONEY YOUR TAX DOLLARS WERE SPENT ON....

Now that we got the yelling and screaming out of the way, your attitude would be the same as mine would be (back when I WORKED and had insurance), if I said, fuck your son, he needs long term care and because of that my premiums are high, let your son die. Same attitude just phrased differently. It's a pathetic way of thinking and living that one would rather someone else die in this land of "prosperity" and built upon "Christian virtues". So much for compassion for fellow man being a "Christian virtue", or any kind of civility for that matter.

Let me cover this again for your idiocy, and yes telling someone that you'd rather they die so YOU CAN HAVE YOURS is idiocy and selfish beyond belief.

Medicaid and federal law only covered my life or death situation, they would NOT cover the needed hospital stay or necessary follow ups because no doctor could say I would "die" without them, just that I would relapse. So my case, thanks to Obama care, was given to a private insurance company that covered the follow ups and hospital stays, so long as I do not have a job or make under basically $10,000 to which I would have to buy my own insurance.... and who's going to cover someone with a history of stroke and brain surgeries, for a price someone who makes minimum wage at a part time job can afford. (The job market here is kind of depressed and part time minimum wage is about the extent of employment.)

Now, I have child support I HAVE to pay and they refuse to grant ANY leniency they want their money...ok, I have no problem with that. I had to wait and am still waiting for disability to say ok 4 brain surgeries, a stroke, a suicide attempt.... yeah you maybe disabled. I even closed period the disability so my chances would go up. But can I work? Maybe, but I would lose all medical benefits the second I made over 10,000. I need my medicines that I cannot afford otherwise.

This country is so full of blowhards that "have theirs so fuck off anyone that needs anything that might help them live a dignified life" that it's laughable when I hear how this nation was founded on "Christian beliefs" and thus we cannot have abortion, we cannot have gay marriage, we cannot have ANYTHING that so called Christians would frown upon..... but people can DIE and we WANT them to because we have ours and fuck them.

So, in conclusion, Loquiter, by wishing my death... don't be upset when I wish the same upon your son. Maybe then you'll know some, some of my pain. But then again, wtf does it matter it's only your son... not like it is you. Just remember I am someone's son and father and brother. But in your mind and your words I should die. Mazel tov.

 

yeah, you're real righteous, Pan. Giving all sorts of reasons why to serve your interests, every single person in the whole damn country has to have their medical care tampered with. You never did think through what you're saying other than to say "gimme, I hurt." Well, other people hurt, too. You're not the most improtant person on earth other than to yourself, your mother and maybe one or two other people. Go figure out a way to pay for your care without screwing up millions of other people.

And thanks for wishing death on my son. This must be the famous lefty compassion I keep hearing about. And if you had bothered to read what I wrote, I didn't wish you dead, i just told you to fuck off because you obviously don't give a shit about anyone but yourself.

 

or the disabled.
--- merged: Mar 29, 2012 at 5:40 PM ---

Then we agree to disagree. I just want to live a life, I paid my taxes, I served my country and I am not asking for anything anyone else would not ask for.... the right to live with dignity and not be harassed by people who think they have theirs so everyone else should.

I would appreciate it if you do not address me any longer... nor will I you. You and I have reached a true impasse that neither I believe will back down from.

I just wished upon your son what you wished upon me.

 

actually, for most disabled people one of two things is true: they were born disabled or became disabled. If they were born disabled they should be on their parents' family plan and have that carry across, and if they become disabled they should have the plan they started with. This is actually a variant of the chronic conditions issue. But fundamentally, these questions go to implementation, not to concept. Obviously something I put up in two paragraphs in a blog post isn't going to be a comprehensive health insurance plan. It's just a concept. Deatils will obviously have to be worked out.

The reason I think this is the way to go is the level of price and service in two unregulated medical markets. Specifically, cosmetic surgery and veterinary medicine. Obviously, neither is completely comparable to normal medical care, but they are similar enough to be informative. And neither has seen the huge spikes in cost that we have seen in medical care the past twenty or so years just havent' happened, without any deterioration of service levels. On the contrary, the technology keeps getting better. So I think giving it a try for normal people is certainly worth a shot.

 

It should go without saying that the personal attacks here, big letters are unacceptable. It stops here. This is the only warning.

 

It seems to me the system is currently gamed so that people with insurance are required to pay an amount that is reasonable enough to keep them from rising up against it or using it for unneeded procedures. The insurance company pays the rest, usually an amount that is padded by the healthcare system. The insurance company doesn't care, they just raise the insured people's rates to cover it, plus a good profit. Everything is in balance and both the insurance companies and the healthcare systems make healthy profits.

Everything is hunky dory unless you can't get insurance. Whether you are unemployed or a part time employee with no benefits. Then you have to pay the whole nut. They can't charge you a cheaper rate because you aren't insured because the insurance companies would go nuts even though they could charge you half the price and still make a profit.

So what are these people to do? Don't tell me, "They should get a full time job". There are a finite amount of full time jobs with benefits. There are always going to be part time employed people. Don't tell me, "They can buy private insurance". The cost would be more that most part time workers make. Most of these people are a couple of paychecks away from bankruptcy. A huge medical bill can send them right over that falls. I know, I've seen it happen firsthand.

Don't get me wrong, I'm a freedom loving, money grubbing capitalist, but what is the answer for these people. Most of the part time employed people I know don't want to have to take a handout, but at some point, what is the alternative?

 

The problem lies in "if Medicare/Medicaid pays this amount then we'll charge what they will pay." Insurance companies get a break by demanding higher co-pays and deductibles. When my stepdad retired last year his and my mother's deductible went from $500/year to $1500 per year, for medications because of my mother's psych meds they were maxed out and trust me some psych meds are extremely expensive (he was 64 when he retired so he was ineligible for full Medicare), this year he can get full medicare and then have the supplemental private insurance.

There are also reports that doctors are closer to bankruptcy due to rising malpractice insurance rates and student loans and patients turning their deductibles over to creditors and just not paying.

This is all due to an unregulated healthcare system built NOT TO HELP PEOPLE but to get as much profit as possible. That's why you see hospitals dumping people off so they don't have to treat them.

 

An estimated 50 - 125 million Americans have pre-existing conditions (diabetes - more than 25 million alone, arthritis, heart disease, high blood pressure, asthma, etc.) These are also chronic conditions and the most costly.

Comparisons to cosmetic surgery and veterinary medicine is not similar or informative at all.

 

The thing the private market enthusiasts miss with the discussion over healthcare is that a truly private system would only be able to work if the insurance companies were given complete free reign to get information on patients. Think of the new GPS equipment car insurance companies are beginning to install, only for your health. Something that would make 1984 seems like child's play.

 

Plus, the combination of nonstandardized tracking methods, trade secrets, and health care information complexity would prohibit consumers from being "informed" enough for a private system to run efficiently.

 

The loss of freedom is coming, it's just a question of how do you want it? Would you rather have the private profit driven asshats tell you what you can or cannot do, what you can or cannot eat, where you can go, who you can sleep with, every aspect of your life so as to keep their liabilities low and your premiums high?

OR would you rather have government just heavily tax everything known to create obesity, heart issues, diabetes, etc. and put that money towards a healthcare system where EVERYONE who needs treatment can get it (whether or not life or death, sometimes preventative visits end up costing far less than waiting for an illness to become out of control).

Me? I'd take the taxed situation. You want McDonald's then you pay this much tax. You want a Slim Jim, you pay this much tax, a bag of chip and soda.... and so on.

This way the GOP cannot say that "having to buy insurance for companies will bankrupt them, and in fact workers could possibly make more since companies won't have to supply benefits out of the worker's paychecks.

It's a rudimentary idea BUT I think it is coming far more than the whole "private insurance" idea I hypothesized before it. This election will give us the answer, a GOP president the insurance companies win and the people will lose, Obama re-elected, the government version, where yeah the taxes sound bad however, the added pay to workers and the less stress of getting ill plus the added freedom of companies that have that money freed up far outweigh the added taxes. It worked with cigarettes, now communities and states that taxed them too high and counted on that money don't have as much flowing in and eventually the market will determine what tax prices are acceptable by the income it generates.

 

That, and that the US has the highest costs for healthcare per capita in the West and relatively poor outcomes (below average life expectancy and child mortality)

 

How is Obamacare tampering with your health insurance, loquiter? I'm assuming it's offered through your employer and you pay a portion of the premium. ACA will not make it mandatory for you or your employer to do anything differently, though conservatives have certainly put that fallacy out there. If anything, the individual mandate to purchase a health insurance policy, if not offered through an employer, should eventually lower your premiums (If the insurance companies can be trusted).

I don't offer this in defense of Obamacare as I believe it to be a giveaway to the insurance companies. A larger pool of insured will enable them to lower premiums and absorb those with pre-existing conditions but honestly, I give them 5 years before they'll slowly start to increase premiums and find loopholes for eligibility. It's their way. I trust the government over private entities who look only at the bottom line. It would be nice if everyone would live a healthier lifestyle, or not get sick and need a prescription for a simple antibiotic and if they never needed to see a physician until that catastrophic or chronic condition presented itself. But the truth is, a simple visit to a physician can cost a couple of hundred dollars. For those who have children, regular visits are necessary. It tots up. A basic level of affordable medical insurance, in the absence of a single payer option and employer sponsored coverage, should be mandatory and welcomed. Everyone wins.

 

The law also requires insurance plans to spend at least 80 percent of premiums on direct patient care and related medical quality improvement; not more than 20 percent on insurance company administrative costs, salaries and profits (85/15 for largest employer plans). Insurance companies that did not meet the standard starting last year were required to pay rebates to customers. More than $300 million in rebates were assessed in 2011.

Starting this year, all consumers will be receiving detailed information on how much of their premiums were spend on medical care.

Yeah, the insurance companies will find loopholes, but it is still an improvement.

 

The government is going to try to manage health insurance companies with a one size fits all approach - this is going to be a problem. On the surface this simple 80% regulation sounds great.

Dig deeper and we get to potential problems easily.

We know a health insurance company sets rates, markets and sells to collect premiums. Out of those premiums they pay direct claims costs (the 80%), they pay marketing and administrative costs (20%) and they earn investment income. We can have a structure of, out of $100 of premiums collected - $80 for direct claims costs (which needs to be carefully defined), $20 for sales and admin costs, $5 investment income - with a net profit of $5. The insurance company has incentives to lower costs or increase investment returns to maximize profits. With this regulation, the insurance company no longer has any real incentive to control the biggest cost component, the $80 direct claims costs. In fact given the time value of reserves held for direct claims payments, the larger the pool the higher investment returns will be - improving profitability. So, an insurance company would rather charge $200 in premiums, pay $160 in direct claims costs, squeeze marketing and admin cost to $30, generate $10 in investment returns - leading to $20 in profits. Wow, that is a 4x increase on a 2x increase in premiums.

And I am not even an expert and can figure this out.

Here is another.

Insurance companies are statutorily obligated to maintain reserves for future and catastrophic losses. So, in year one the 80% rule may work fine, perhaps in year 2...9. But what happens when there is a catastrophic or shock loss. Should the 80% rule apply to a one year period or a 10 year period, perhaps to 20 year period. In some cases the costs of a reported claim in year one, will have to be projected into the future. This projection can be done conservatively or aggressively. For example a person is diagnosed with congestive heart disease. How does the government want the insurance company to reserve for those costs and project those costs into the future? In the free market companies that do these things well and accurately thrive, those that don't fail. Now the government is going to try to manage this??? Good luck.

An improvement? We will see.

 

I respect everyone's opinion and I'm glad we can have differing views. But you can tell me Obamacare will never work and cite facts and figures all day, but in the end it's about what will work. Someone give me an idea that is better than this and will not make a portion of the population choose between no care and bankruptcy.

 

The medical loss ratio is not a new or shocking concept -- that a signicant percentage of the money that I and other consumers (and our employers) pay in premiums should be spent on us and our medical care rather than salaries and admin costs of the insurance company.

If insurance companies cant pay their admin costs and generate revenue from 20 percent of total premiums, those companies need to improve internal efficiencies (and lower the mute-million dollar contracts of CEOs)

A recent CBO study suggests it is already working.