Question for people who like the Obamacare mandate

[PLC1]

45,000 death annually due to lack of health insurance.

Nearly 45,000 annual deaths are
associated with lack of health insurance, according to a new study published
online today by the American Journal
of Public Health. That figure is about two and a half times higher than an
estimate from the Institute of Medicine (IOM) in 2002.

That is what we're getting for having the most expensive health care system on the planet.

 

[dogtowner]

Correct on the fact that anyone selling insurance in the state of California has to comply with California state regulations. Correct also that the "if only insurance companies could compete across state lines" mantra is a gimmick.

Now, let's see if there is a way we can solve this problem short of a " total federal takeover of the entire HC system in America." I'm pretty sure that we're in agreement that wouldn't work.

Let's issue everyone a medical care MasterCard. Only medical services could be charged on it, and the holder would be responsible for paying it. The bank issuing the card would be responsible for collections, and could charge interest just like on a current card. The bank, since they would be taking a risk issuing cards to people with questionable credit, would be allowed to attach wages and whatever other income the recipient might have, including welfare.

Once the holder had charged more than 8% of his annual income on the card in any given year, he/she could bill the federal government for the remainder.

No one would be forced to go into medical bankruptcy.
Everyone could choose whatever health care provider they wanted.
The individual would have the responsibility to shop around for prices.
No medical provider would have to have a billing department.
Overhead would be zero.
Everyone would have insurance.
Everyone would have to pay something.

I think costs would be a lot less under such a system. It would be much more efficient. The government wouldn't be running health care. It's a perfect partnership between the public and private sectors.

There it is, and it doesn't have to occupy 2,000 pages of text.

Costs would not go down but up. People would not care about the cost as anything above the line Uncle Daddy Sam picks up.

Perhaps there is a chance if only "catastrophic" costs were magically paid but then there is the question of is catastrophic (this can be played with and you know it will). And you lose all negotiation the ins cos do to manage costs. That will want people to demand that someone set what a given thing costs (the feds of course) and we've seen what a trainwreck that becomes.

But points for creativity.

 

[PLC1]

Costs would not go down but up. People would not care about the cost as anything above the line Uncle Daddy Sam picks up.

Perhaps there is a chance if only "catastrophic" costs were magically paid but then there is the question of is catastrophic (this can be played with and you know it will). And you lose all negotiation the ins cos do to manage costs. That will want people to demand that someone set what a given thing costs (the feds of course) and we've seen what a trainwreck that becomes.

But points for creativity.

Catastrophic costs would be different for different people.
There would be no insurance companies (therefore, such a plan would never pass, as their lobbyists would see to it that it didn't)
Everyone would have an incentive to know what medical care costs and control those costs. The individual could do a better job of it than an insurance company that can pass costs on to the customer, or the government.

"Uncle daddy Sam" wouldn't pick up anything but catastrophic costs.

but, it's just a pipe dream anyway. A workable UHC plan isn't going to be passed in this country, and we'll continue to pay more than anyone else and see 45 thousand needless deaths every year.

It's the American way.

 

[dogtowner]

Catastrophic costs would be different for different people.
There would be no insurance companies (therefore, such a plan would never pass, as their lobbyists would see to it that it didn't)

some animals are more easily prone ? No, I think you were better off with your X% concept. think there is no need for processing ? you're forgetting fraud and it does not pay to forget that.

Everyone would have an incentive to know what medical care costs and control those costs. The individual could do a better job of it than an insurance company that can pass costs on to the customer, or the government.

Under the plan you suggest, the same disincentive for the providere exists as today. SOMEBODY will pay up so why compete ? at least with the ins cos they can leverage their pool of enrollees as a means to negotiate lower costs. individuals cannot.

"Uncle daddy Sam" wouldn't pick up anything but catastrophic costs.

nope, you said north of 8%. for po folks that might be a birth or apendectomy, shoot maybe a sprained ankle. hardly catastrophic.

but, it's just a pipe dream anyway. A workable UHC plan isn't going to be passed in this country, and we'll continue to pay more than anyone else and see 45 thousand needless deaths every year.

It's the American way.

UHC is no answer IMO and all you would do is trade 45k for a different 45k (or more)

 

[PLC1]

some animals are more easily prone ? No, I think you were better off with your X% concept. think there is no need for processing ? you're forgetting fraud and it does not pay to forget that.

?? what does that have to do with what you quoted? I can't respond to that as I don't understand it.

Under the plan you suggest, the same disincentive for the providere exists as today. SOMEBODY will pay up so why compete ? at least with the ins cos they can leverage their pool of enrollees as a means to negotiate lower costs. individuals cannot.

Sure, and somebody will pay the grocer, too, but which grocer? Everyone has to eat, after all, so, according to that logic, there is no incentive to compete. Under the plan I've outlined, the patient can go wherever he wants, and has an incentive to find out costs in advance.

nope, you said north of 8%. for po folks that might be a birth or apendectomy, shoot maybe a sprained ankle. hardly catastrophic.

At today's costs, an appendectomy would be catastrophic for most middle class families without insurance. Surgery and a couple of days in the hospital would cost in the tens of thousands. It doesn't have to be that way.

UHC is no answer IMO and all you would do is trade 45k for a different 45k (or more)

and yet, every nation that has it pays less than we do, every last one. We could do better, don't you think?
How do you think we should address this problem?

 

[dogtowner]

?? what does that have to do with what you quoted? I can't respond to that as I don't understand it.

my point was that any sort of sliding scale of catastrophic was bound to become a political football leading us to more vote buying.

Sure, and somebody will pay the grocer, too, but which grocer? Everyone has to eat, after all, so, according to that logic, there is no incentive to compete. Under the plan I've outlined, the patient can go wherever he wants, and has an incentive to find out costs in advance.

Why would grocers compete when they don't have to ? If Uncle is going to pick it up no questions asked, there will be zero incentive for the provider. There is already a lack of providers so its not nlike anyone has to try. I know it sounds right on paper but it wont work.

At today's costs, an appendectomy would be catastrophic for most middle class families without insurance. Surgery and a couple of days in the hospital would cost in the tens of thousands. It doesn't have to be that way.

No it doesn't but as long as there is a sugar daddy picking up the tab there can be no change. The figures you mention are bad, not catestrophic. People gladly pay as much for cars.

and yet, every nation that has it pays less than we do, every last one. We could do better, don't you think?
How do you think we should address this problem?

The question is how they supposedly do better and as has been documented here, that is narrowing as those countries are increasingly seeing the lifestyle / health related issues we have there.

I believe I laid my thoughts out above somewhere. In essence, govt has to get out of the medical biz

 

[PLC1]

my point was that any sort of sliding scale of catastrophic was bound to become a political football leading us to more vote buying.



Why would grocers compete when they don't have to ? If Uncle is going to pick it up no questions asked, there will be zero incentive for the provider. There is already a lack of providers so its not nlike anyone has to try. I know it sounds right on paper but it wont work.



No it doesn't but as long as there is a sugar daddy picking up the tab there can be no change. The figures you mention are bad, not catestrophic. People gladly pay as much for cars.




The question is how they supposedly do better and as has been documented here, that is narrowing as those countries are increasingly seeing the lifestyle / health related issues we have there.

I believe I laid my thoughts out above somewhere. In essence, govt has to get out of the medical biz

OK, so the government gets out of the medical biz. Totally out? No regulations about who can and can't practice medicine, no requirements that treatment be based on sound science, no curbs on deceptive advertising, nothing?

and as for those who don't have the bucks for an expensive treatment, do we just stand aside and let them die?

 

[dogtowner]

OK, so the government gets out of the medical biz. Totally out? No regulations about who can and can't practice medicine, no requirements that treatment be based on sound science, no curbs on deceptive advertising, nothing?

and as for those who don't have the bucks for an expensive treatment, do we just stand aside and let them die?

certification isn't exactly the healthcare biz
the government does not currently establish treatment protocols
deceptive advertising ? they do that now ? : )
believe it or not, people got treated without regard to ability to pay before the government came along

 

[dogtowner]

its THE root cause, but to the query...

the path out starts with getting the government out of ther medical management biz and back to being a purchaser of health insurance (I want insurance gone as well but there is no realistic one fell swoop).

So Uncle Sam sits down with the insurance providers and negotiates what coverage there will be for the dollars available (yes, they have to decide just what that is and its two parallel operations for medicare and Medicaid). And get ready, its not going to be what exists today. Not going to say whether it will be better or worse but it will be different.

Now the next step comes as a result of the public furor which is to say people questioning why insurance in NY costs so much more than Montana and getting better uniformity of required coverages to effectively match what the people want in juxtaposition to what they want to pay.

Now we start re-applying market forces to the market. The health care biz will be up in arms as they will have to compete and Lord but they don't want that. Oddly enough that will be the toughest hurdle to clear. Even tougher than the government giving up "control".

Anyhoo thats a rough plan for a way out.

here's the start out of where we're at again.

 

[GenSeneca]

Correct on the fact that anyone selling insurance in the state of California has to comply with California state regulations. Correct also that the "if only insurance companies could compete across state lines" mantra is a gimmick.

If you, as a resident of California, could purchase an insurance policy from another state where the regulatory requirements on insurance companies operating in that state allowed for the sale of cheaper policies than those sold in the state of California, purchasing the out of state policy would save you money on HC costs. That would also create actual competition between states, helping to drive the costs down even further. You acknowledge this, you understand this, yet you insist on claiming that it's a gimmick which won't actually bring down HC costs for anyone...

Now, let's see if there is a way we can solve this problem short of a " total federal takeover of the entire HC system in America." I'm pretty sure that we're in agreement that wouldn't work.

Are we in agreement on that? Youv'e stated several times that countries with socialized medicine have cheaper HC costs, that we should at least consider doing the same things they've done, and made fun of opposition to such plans as being knee-jerk reactions to the bogeyman of socialism.

Once the holder had charged more than 8% of his annual income on the card in any given year, he/she could bill the federal government for the remainder.

Predictably, such an effort would ultimately fail because it is based on an immoral principle that some individuals are entitled to the fruits of labor from other individuals.

 

[dogtowner]

If you, as a resident of California, could purchase an insurance policy from another state where the regulatory requirements on insurance companies operating in that state allowed for the sale of cheaper policies than those sold in the state of California, purchasing the out of state policy would save you money on HC costs. That would also create actual competition between states, helping to drive the costs down even further. You acknowledge this, you understand this, yet you insist on claiming that it's a gimmick which won't actually bring down HC costs for anyone...

that first word is the crux of the matter as you cannot and to do so would breech state sovereignty so it won't ever happen without a fight.

a minor point is that it does nothing to alter health care costs, only health insurance costs. the problem we have is the cost of health care, insurance is only a reflection of the provider costs. all it changes is that riders covering some things would not be in the policy. that could make care costs more for those needing such care.

Are we in agreement on that? Youv'e stated several times that countries with socialized medicine have cheaper HC costs, that we should at least consider doing the same things they've done, and made fun of opposition to such plans as being knee-jerk reactions to the bogeyman of socialism.

did such places have the situation we have regarding state v national in terms of health matters ? If so they would have to have striped the states first. I suspect states elsewhere would care less about such things.

I have heard it said that they spend less on health care, not that health care costs less. Not exactly the same thing.

Predictably, such an effort would ultimately fail because it is based on an immoral principle that some individuals are entitled to the fruits of labor from other individuals.

but everyone loves a sugardaddy except the non-consenting sugardaddies.

 

[Dr.Who]

I have to have Car insurance...I have to have homeowners insruance...and no one can say . well I just don't get sick...there is no way that you are not part of the market.

You dont need to have homeowners insurance. If you rather than the bank owns your home then you don't need insurance.

You don't need to insure the value of your care and you dont need to insure yourself in your car.
There are state laws that you need insurance in case you hit someone else. But I am unaware of any federal law as that would be unconstiutional. It is worth discussing if those state laws violate the state constitutions.

And there are ways not to be part of the insurance market. There are even ways to be out of the health care market. But even if we pretend that everyone is a part of both the health care market and the insurance market that is still not an excuse to force them to buy a particular product.

 

[Dr.Who]

Suppose that Obamacare is upheld by the Supreme Court, including the mandate, as constitutional.
Sometime in the future, Republicans are voted into supermajorities in both the House and the Senate, and into the Presidency.

Congress then passes a law, and the President signs it, requiring everyone to purchase a gasoline-powered electrical generator capable of keeping every electrical appliance, tool, and light in their residence, running. (Including air conditioning, stove, clothes dryer, and everything else that uses electricity.) In case of power failure. Sooner or later you'll likely need one, and it can be a lifesaver in certain circumstances.

You don't like it, generators that size cost thousands of dollars, and you don't mind sitting in the dark for a few hours and using flashlights. And you can't afford a generator like that, it will put a huge financial burden on your family, that you can't handle at present. So you sue in court to have the law thrown out, similar to what a number of people are doing against Obamacare today.

But Obamacare was passed years ago and upheld by the Supreme Court as constitutional, way back in 2012.

When you go up before the Federal judge to tell him why the generator-mandate should be thrown out, you'll have to tell him what law forbids the government from forcing you to spend thousands buy a generator. The Obamacare opponents cited the 10th amendment in 2012, but that challenge was ruled inapplicable in court.

Which law(s) will you cite?

The cost of the generator will be amortized over years so the actual cost is not that high. It is not at all unreasonable for the gov to force us all to have one. Those whl rent will just have it included in their rent.

I would cite the constitutional right to own property and to dispose of that property as I see fit. But if the mandate is called a tax then I have no ground to stand on. If it is not a tax then the court already decided that obamacare is legitimate so I also have no ground to stand on.

Soon every powerful interest group with a product will get their very own mandates.

 

[PLC1]

that first word is the crux of the matter as you cannot and to do so would breech state sovereignty so it won't ever happen without a fight.

a minor point is that it does nothing to alter health care costs, only health insurance costs. the problem we have is the cost of health care, insurance is only a reflection of the provider costs. all it changes is that riders covering some things would not be in the policy. that could make care costs more for those needing such care.

I'm not so sure that is a minor point. It seems like a major one to me, given the urgent need to rein in health care costs.

And you're right on about state sovereignty.

 

[PLC1]

Are we in agreement on that? Youv'e stated several times that countries with socialized medicine have cheaper HC costs, that we should at least consider doing the same things they've done, and made fun of opposition to such plans as being knee-jerk reactions to the bogeyman of socialism.

Countries with socialized medicine, for example, Spain, do have lower health care costs. Countries with universal health care, but not socialized medicine, also have lower costs. The US, in fact, has the highest costs in the world.