Lurker wrote:You don't understand the overall package or know whats in it. You point to a couple deals in the Senate bill that didn't amount to the tiniest fraction of spending and are being removed, you complain about back room dealing even though major provisions were debated for years, you complain about the number of pages... but you don't actually know or understand the bill and you don't care to.
The bottom line is you are ideologically opposed to providing subsidies for people who can't afford coverage. That's the basis of your opposition.
Lets explore that for a moment... the devil is always in the details...
Should obese people pay a 10% premium on covnerage since they drive 10% of the costs? You and Partha have been very careful to avoid the question of lifestyle. We, as Americans, are fatter, more obese, have more high blood pressure, have more cholesterol... than our other European counterparts. This, is a lifesyle choice. And why should some of us be forced to subsidize the lifestyle choices of others? Why should we be forced to subsidize preventable disease?
Answer me that.
Correction Mr. President, I DID build this, and please give Lurker a hug, we wouldn't want to damage his self-esteem.
If you could actually prove the person's health is due to their own choices, but if a group is paying more due to their increased risk of medical costs, you'd be including many more groups of people than just the obese. Many people that choose to work in high stress jobs bring health issues upon themselves, and athletes risk injuries all the time, expensive ones - especially the so-called "weekend warriors". Businessmen would also be a good example of a group going into a high stress field who have a very high rate of hypertension. Pretty soon we all fit into some financially risky group that would incur a surcharge, so it's rather pointless.
I was not in favor of using it as a funding source for health reform. I was also opposed your idea of charging obese people higher insurance premiums if their lifestyle was the cause; an idea that was completely unworkable since most people get their insurance through their employer or through the Government. We don't want to give employers a disincentive to hiring someone because of their weight, and we don't want the Government tracking lifestyles so they can adjust Medicare deductions.
Harlowe highlights a much better solution if the goal is to help people lead healthier lives. That wasn't your goal, though. You wanted to set up an intrusive and complicated system of tracking and charging people based on lifestyle (odd for someone who doesn't even want his health records stored electronically) to fund reform just so you could avoid paying taxes you admit you aren't paying anyways.
If you're going to hike up rates for obese people because they make poor food choices, then how about a rate hike for people who engage in any risky (X-treme) sports of hobbies/activities.
higher rates for recreational drug users (we'll just test them periodically).
higher rates for those at higher risk for AIDS/HIV/HEPATITIS
higher rates for those at higher risk for pregnancy (and therefore abortions)
Or, do you really want Uncle Sam all up your tweeter about your private choices here?
Companies need to be able to deny care for a limited time (say a year or two) for pre-existing conditions if someone is first joining a program that covers that condition. If you don't do that then people will only buy insurance once the condition happens, which is a breaking deal for the companies (it would force them to have only one level of coverage). Yes, pregnancy is a pre-existing condition with an obvious 9-10 month waiting period for coverage of birth-related expenses.
I also think it's valid for a private company to offer discounted plans for people based on lifestyle choices and in exchange you agree to let them test you for keeping your end of the bargain.
Ddrak, the individual mandate with penalties will take the sting out of people trying to game the system, and it's a much better solution than allowing insurance companies to deny care for a year or two, or 9-10 months for a pregnancy.
I'm a bit surprised you made that last post. It seems rather cold-hearted and contrary to what you've written about health care in the past.
Lurker wrote:The bottom line is you are ideologically opposed to providing subsidies for people who can't afford coverage. That's the basis of your opposition.
This is really all it boils down to.
Fallakin Kuvari wrote:
Lurker wrote:
Fallakin wrote:It'd create more competition among insurers in every state (More Supply) which would drive down prices over time and more people would be insured (Less Demand).
Wouldn't more people being insured be more demand?
I understand it as more people being insured meaning less people looking to be insured, thus less demand.
"Demand" includes people who are already insured as they are still "demanding" (paying for) insurance.
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Lurker wrote:Ddrak, the individual mandate with penalties will take the sting out of people trying to game the system, and it's a much better solution than allowing insurance companies to deny care for a year or two, or 9-10 months for a pregnancy.
I'm a bit surprised you made that last post. It seems rather cold-hearted and contrary to what you've written about health care in the past.
No, it's perfectly rational. It just starts from the assumption that there should be a public supplier of medical care, in addition to for-profit insurance.
That's not the system we have. I assumed Ddrak was speaking to the system we have and not some hypothetical system we'd like to have.
Since there's no single payer system or public option, the best solution to the problem of people gaming the system and waiting till they get sick (or pregnant) to buy insurance is to have a mandate with penalties. Allowing insurance to simply not cover people for a couple years would be a great way to protect insurance company profits, and that's all. So no, it's not a rational solution to the problem.
If you have a mandate with penalties then it isn't an issue anyway. My point was only about people trying to get *new* insurance, not those with existing coverage (which a mandate would enforce).
And yes, having a public health care system that picks up those without private coverage makes the private system work much more smoothly by allowing them to not cover things for a time period knowing there's a backstop for people during that time.
I dont think health insurance shouldn't be a for profit venture, but I do think that the profits that are made should be put back into the people they cover. Too many people getting fat and requiring more medical care ? How about better programs to allow them to make better choices ? How about nutrition counseling, and weight loss programs and incentives ? How about rewarding people who are trying to make the right choices but have had very little direction in HOW to do so. It's easy to put someone in the hospital and say "Look, you're obese and now you have type 2 diabetes, you need to check your blood sugar and take insulin" but how about telling them they could have a chance at NOT having that condition if they do x, y and z and helping them to do those things. But then isn't type 2 diabetes a per-existing condition if they need to change insurances ? Isn't cancer thats in remission a pre-existing condition ? Pregnancy of course, c-sections that were done in an emergency situation ? There's too many what if's in the system, you can't possibly predict anything ! We can now test for cancer markers, if you turn up positive, even if you HAVE no cancer at that time then is it considered a pre-existing condition and you should be denied coverage based on the possibility of the chance ? I mean come on, even State Farm is offering a percentage of your car insurance premium back every 6 months as long as you remain accident free. If you lose 10% of your weight shouldn't you be rewarded ? I suppose good health is it's own reward, but i've seen way too many cases of people who thought they were fine, exercised, ate right and didn't have any problems, until they had a major problem.
The costs of healthcare coverage versus what is covered and what your out of pocket expenses are is phenomenal. Take Select, she's paying the premium, and paying out of pocket BUT at the cost of her insurance company actually being successful in dropping her knowing that her condition requires constant medical care. It's not as if Select made poor choices and now she's caught MS, it's not as if it's ever going to go away, but shouldn't the company be responsible enough to provide for a person with poor health instead of looking for the best reason to drop them ? I guess thats the governments concern, not the for profit agency's concern. I mean why should Select be given the best options possible to give her a BETTER life, instead of minimal options so she's simply doing ok.
As another example of healthcare costs (quality versus quantity of life) we had a patient come into the ER the other day, the guy had been 40 feet up in the air trimming the trees at his house, no harness, no nothing. He fell 40 feet and landed right on his head. He was missing chunks of his skull, most of his teeth were broken and he'd snapped his neck. 30 min of CPR and 5 hours later he went into surgery, he later died as a result of his injuries. The family came in while he was still in the ER< and his mother was crying because he had no insurance. His death will probably cost them 100's of thousands of dollar, they still have to pay for the surgery costs, the MRI's and cat scans, the paramedics, the medications and he died anyway. He was pretty much a lost cause when he came in. What could be done to improve his quality of life ? We're not talking Christopher Reeve with active brain activity, we're talking a guy who only had a pulse because he was being kept alive with medical intervention and zero brain activity.
Lets look at another example. Remember baby Leah born at 23 weeks gestation ? I dont know what id have done in that situation, but i'd have been inclined to believe if my child lived she'd have major challenges ahead of her in life, and what's worse in that situation ? What was Leah's medical costs for 6 months in NICU ? over $600,000. Rachel had medical insurance, they still paid over 30k, put it on credit cards because they had no other way to pay, they will literally be paying on her birth until they die. How is Leah now ? She's a beautiful one year old, smiling and laughing and crawling, but they still dont know how her brain development is and how challenged she'll be. Leah also "probably" shouldn't be alive however she wasn't born with her brain coming out of her skull, her heart was beating on it's own and required no resuscitation, she had brain activity and the only assistance she required in this aspect was help breathing, because her lungs literally couldn't do it on their own.If she had needed to be resuscitated then she wouldn't have been, but that wasn't ever a consideration, she never needed to be. She was given medical intervention but at what they considered to be the least possible amount. She wasn't given anything to stay alive, but was given drugs to assist in her development. Her insurance considers any future disabilities as pre-existing conditions due to the circumstances of her birth, so she's literally screwed from birth.
My job offers health insurance. to a full time employee with a family it runs appx 60 bucks a month, to a part time employee for self only it's over 200 bucks a month. I dont understand why it costs MORE the LESS money you're making ! I dont have secondary health insurance to supplement and even if i did then how much would i be paying for the 2 insurances ? If something serious were to happen to me I'd be screwed, i'd be paying the bills for the rest of my life, or filing bankruptcy in an effort to have the bills taken away. I have no problems paying my employer for health insurance, but the cost is imbalanced. If i were paying for their health insurance it would be 1/3 of my take home pay (after i also pay my employer for my daycare) at the rate they pay me for the hours i work. It's slightly better now as my department has created a second part time position specifically for me. It's one they needed but it's not an "actual" position. If i were to lose my job they wouldn't hire for the other 2 days a week i work. It also works nicely for them because i can fill in for other people and they still dont pay me overtime, i'm still considered part time and my health insurance costs won't lower. It's also handy that open enrollment is over and i can't get coverage for another year. I wont be having a baby, i wont be adding to my family, i wont be getting married or divorced and i wont be losing my other health insurance, so i will have no qualifying events to be able to pick up the insurance. The problem is there's always a loop hole. If i get injured at work then my employer will cover the costs, if i'm in a car accident thats someone elses fault their insurance will cover the costs.
Im just rambling at this point, but health insurance is a pretty touchy subject for me. I guess i'm at a loss as to why other countrys in the world provide for their citizens, but here in America we have the kinds of health care situation we have, and the problems we deal with. I'm a firm believer in Socialized Healthcare, and Im sure someone can point out all the problems of it to me, but from where Im sitting it's looking like a pretty damn good deal for everyone.
I think you'll get a lot of tl;dr on that one, but this surprised me:
Her insurance considers any future disabilities as pre-existing conditions due to the circumstances of her birth, so she's literally screwed from birth.
Damn... I'm really surprised at that, and surprised someone hasn't fought it. At least with the bill that passed they'll have to cover her.
Oh - my daughter was 21 days in special care (a step down from NICU) from being 4 weeks premature and probably cost my insurance between $20k and $40k (never saw the total, but I know it was at least $1k/day from the nurses talking about it). I didn't pay a cent out of pocket. Much as I want to bitch about my premiums rising from $220/mo to $240/mo, I know things could be a lot worse: I could have been in the US.
I really hope for you guys that the idiot state AGs get their asses handed to them by the USSC, and the GOP gets their asses kicked to the curb for their idiocy since the bill's passage. Sure, the bill isn't perfect and there's a lot of things that could be done better in the long term, but it's a good step above where you were.
It's a fucked up way of putting it Ddrak, but if she develops autism, or CP or anything else they'll claim it was from lack of oxygen during critical development, or due to the drugs she WAS given where CP is a known possible side effect. So anything she comes down with can likely be attributed to her birth and the circumstances surrounding it.
Yeah i ended up rambling and i'm sure i'll pay the price for my tangent, but im a firm believer that health care should be available to everyone, at a price they can afford. If you want everyone to have health care then it needs to be provided for people without the problems and stigma that are attached to government provided assistance. Medical Assistance is welfare, but isn't it better to have welfare health coverage then none at all ?
I really hope for you guys that the idiot state AGs get their asses handed to them by the USSC
You mean the same court that gave us Bush v. Gore and Citizens United? More than likely, they'll throw out the health care bill and require a Medal of Freedom for the AG's.
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Fobbon Lazyfoot wrote:The system is broken. I don't really know anybody that thinks otherwise. I'm impressed that healthcare reform opponents have done as much to keep the issue from progressing as they have.
This is pretty much how I feel too. I'm baffled by people like Embar who think our system is A+ as it stands when it's pretty clearly not working out for a lot of people.
You misunderstand my position Tax. I'm not against healthcare reform, in fact I think our system is broken. But how they are going about it won't fix it. The insurance industry needs reform, but to put it in an analogy... what started as an operation on healthcare has resulted in Frankenstein. You guys dont see that yet, but you will.
i agree with you embar. i have my own horror stories regarding healthcare and now have none. who the hell can offord it??
