Affordable Care Act

[Billo_Really]

That hasn't been proven. But let's even say it is true.

If the way in which the ACA has increased access to health care, is by increasing government borrowing and spending on health care programs..... then you basically are saying doing what Greece did, is a good thing.

Greece spent endless money to give the Greek public more and more services. How are they doing now? Not so good.

Is sacrificing the future, for the sake of more health care now, really worth it? Greece may never recover from what they are going through. If we do the same thing, because left wingers sacrificed the entire country for health care, that's not a win.

How does it increase government borrowing and spending?

And if you want to go there, nothing increases government borrowing and spending more than our obscene defense budget.

I am all for slimming down our defense budget where it is wise to do so. In general, the left cuts money where it is most harmful, and then we have to spend twice as much money replacing what we shouldn't have cut.

That said... you people make it out like 90% of the budget is all defense, and we want to advocate cutting tiny 5¢ programs.

The reality is the exact opposite. Military spending is only about 16% of the budget. The vast majority, more than half, is entitlements and social programs.

The truth is, the leftists are the ones trying to cut the 5¢ off the budget, while ignoring the multi-Trillion dollar elephant.

And that's just the direct budget expenses. You are missing the liabilities.

This right here, is what sinks entire nations.

According to most estimates, and you can look up Medicare / Medicaid Unfunded liabilities on google, there are dozens of sources about it.... The health care reform has INCREASED future unfunded liabilities.

That's a problem. The military, if we really get into a pinch, we can cut the military.

This problem here.... people change how they live, when they think the government is going to cover their health care. We are going to owe TRILLIONS. And that's going to play havoc, just like it has in Greece.

We need to cut the defense budget in half. We also need to end these bullshit wars we've been fighting for over a decade. And we also need to close these over a 1000 bases all over the world. If a country wants our base there, then they can pay for it. We'll send them a bill for all costs incurred.

Then we need to raise the tax rate on capital gains and dividends to 25%. Then we need to create a Financial Transactions Tax on all traded instruments and close the loop holes allowing corporations to offshore their profits. We also need to make derrivitives illegal again.

Keep the ACA, but add the "public option" to the bill. That'll drive medical costs down and the for-pay medical industry can't do a thing about it, except make their rates more competitive.

Don't touch Medicare and SS.

 

[Greenbeard]

Have you ever wondered why you go to an inner city hospital, and find people there from an hour away? I've worked in hospitals, and that always confused me. This is why. The smaller hospitals were transferring patients out of their hospital, to bigger hospitals that could cost-shift the lack of payment from Medicare.

But Obama Care has started phasing out those programs. Why? Again, it's too expensive. They had to make Obama Care seem as though it wouldn't break the Federal Budget. So they cut some of these programs, that kept those rural hospitals alive.

The fact that they need inflated payments to be "kept alive" should be a red flag that we're talking about an inefficient model. The organization of a health system will impact cost. As I already said, hospitals have high fixed costs. Having more just to have more--be it duplicating services in more populated areas or offering them in areas where it isn't cost effective to do so--doesn't axiomatically lower costs, it often increases them. If a community can't sustain the fixed costs of having its own inpatient facility, then if you want to keep costs in check you'll have to do exactly what you're saying: divert cases to places where those facilities can be sustained.

You bring up India, which illustrates this very principle.

India’s Secret to Low-Cost Health Care

In order to reach the masses of people in need of care, Indian hospitals create hubs in major metro areas and open smaller clinics in more rural areas which feed patients to the main hospital, similar to the way that regional air routes feed passengers into major airline hubs.

This tightly coordinated web cuts costs by concentrating the most expensive equipment and expertise in the hub, rather than duplicating it in every village. It also creates specialists at the hubs who, while performing high volumes of focused procedures, develop the skills that will improve quality. By contrast, hospitals in the U.S. are spread out and uncoordinated, duplicating care in many places without high enough volume in any of them to provide the critical mass to make the procedures affordable. Similarly, an MRI machine might be used four to five times a day in the U.S. but 15 to 20 times a day in the Indian hospitals. As one CEO told us, “We have to make the equipment sweat!”

You don't just tack on additional fixed cost after additional fixed cost in the hopes that competition (and if you don't think consumer cost-sharing is "so great" I don't know where you think provider price competition comes from anyway) somehow undoes it. Not here, not in India.

Now maybe there is some other part of the law, that I don't know about..... but.... based on what I read, CON laws cover every single bed in any hospital in the state of Ohio.

You don't need another part of law. The regulations you quote are very clearly, very explicitly about long-term care facilities, not acute care hospitals and certainly not emergency departments. I honestly don't know what the source of your confusion is.

Now as you can see, every time that Medicare and Medicaid pay out less and less for care, the hospitals cost-shift that to private patients in higher and higher mark ups.

Accepting that theory requires assuming that hospitals are not profit maximizers (that is, they can always command higher prices than they do but opt not to). Even for nonprofit hospitals, that's a tough one to swallow, since even if their margins aren't going to investors they're going back into the community or the hospital. Why leave money on the table? The literature on the cost shifting theory is ambiguous at best.

One could just as easily look at the figure and ask: what if, when Medicare signals through a policy change that a new era of cost containment is upon us, hospitals sit up and take note? It's arguably the most important payer in the country, it's not so hard to imagine that providers will respond to the signals it sends by changing behavior. If providers begin to better control their costs as Medicare payment growth declines, and if private insurers' prices continue on their same trajectory (since private insurers are generally locked into multi-year contracts) then of course their payment-to-cost ratios will rise since costs are falling on a relative basis.

Indeed, Chapin White pointed out in ""Slower Growth in Medicare Spending — Is This the New Normal?" just a few years ago that Medicare's switch under Reagan to prospective fee setting was extremely effective at getting hospitals to contain their costs.

There is a historical precedent for harsh, simple-minded cuts setting the stage for broad-based payment reform. Up until the early 1980s, Medicare reimbursed hospitals for costs incurred, subject to ceilings. The Tax Equity and Fiscal Responsibility Act of 1982 substantially tightened those limits, leaving hospitals with no upside — they could not earn a profit by reducing costs — and a growing downside for those whose costs exceeded the limits. The next year, legislation was passed, with the support of the hospital industry, replacing cost reimbursement with the inpatient prospective payment system (IPPS), with rates initially calibrated to leave Medicare outlays unchanged. Hospitals then had the opportunity to reduce costs per admission by shortening lengths of stay and to earn a positive margin in the process.

The IPPS is generally viewed as a major policy success: it encouraged hospitals to seek efficiencies, and when they found those efficiencies, it allowed the federal government to share in the savings. Should ACOs and other reforms prove effective, they will provide broader opportunities to increase the efficiency of delivery beyond shortening lengths of stay, such as managing chronic disease more effectively so as to keep beneficiaries out of the hospital in the first place. But our current challenge is more complex than the one faced in the early 1980s. Broadening the unit of payment will require reaching across different types of providers and helping to stitch together real delivery systems in places where now there are none.

All of this is to point out the regulation, and government intervention, is what has caused all of this. If every single patient, paid for their own care, we wouldn't be talking about this.

You've taken exception to rising patient cost-sharing so I'm not sure I follow. Patients are sharing in the costs and prices of their care more now than ever before. Price sensitivity is more prevalent now than ever.

But you can't tell me that reducing or eliminating regulation can't possibly result in lower cost, because we can look around the world, and see that hospitals that do not have the regulations we do, operate at a fraction of our cost.

I haven't argued that. What I've said is that an insurance market without structure (in which there are no particular prices for products, opacity is the seller's primary weapon, and the incentive to cost shift dominate the incentive to cost contain) won't work.

It didn't work for the past half century in the individual market and it won't work now.

They were doing that before the exchanges existed. That's actually part of the problem. Hospitals increase prices, to account for the negotiated discount. If a treatment costs $1,000, and the insurance companies have a 50% discount, how much does the hospital charge? $2,000.

This system harms the uninsured the most, because they have to pay the full, made up, price.

If "this system" refers to private contracts between private insurers and private providers, I don't know how you propose to abolish that. Indemnity plans used to dominate health insurance and spending and costs soared. The rise of managed care--that private insurer-provider negotiation over prices--led to the only period in the last half century (other than the last five years) in which cost growth was contained, the mid-1990s. This was a market innovation. In fact, most of the old state-based all-payer systems of the '70s and '80s were deregulated on the theory that private competition manifested in the negotiations behind those private contracts would better control costs than the heavy-handed government regulation that preceded them.

The relaxation of managed care by the payers at the end of the '90s was followed by the escalation in health care costs and prices of the 2000s. More aggressive network management to tackle prices and costs has returned now in a big way, particularly in the individual market, and lo and behold provider price growth has neared all time lows.

This is one of the reasons we don't have a transparent market. All of those costs on those bills are made up numbers, to account for the cost-shifting regulations, and the negotiated discounts. Again, if we had zero regulations..... all of that would go away.

If "regulations" go away, Aetna isn't going to try and negotiate the lowest prices it can from health care providers?

How do you claim, a market that has shrunk in size, is 'robust'? I just posted the raw numbers. The individual market has declined.

First of all, I'm talking about the market dynamics. Insurers are competing, price leaders are changing, and consumers are actively shopping. That is what's "robust" about it. It's working as an insurance market ought to.

Second, what you're saying is incorrect. Individual market enrollment was up about 50% (and growing) as of last year.

And no, the reason the law has come in under the budget, is because very few of the uninsured, got insurance. The budget was based on the idea that all 45 Million of the uninsured, would get insurance. That hasn't happened.

Insurance really is substantially cheaper than anticipated. Competition works, you should feel vindicated.

Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act, April 2014

The current projection of the average premium for the benchmark silver plan in 2016 of about $4,400 is 15 percent below the comparable estimate of $5,200 published by CBO in November 2009.

Updated Budget Projections: 2015 to 2025

Reduced Costs for Exchange Subsidies CBO and JCT now project that the government’s net costs for exchange subsidies and related spending and revenues over the 2016–2025 period will be $849 billion— $209 billion (or 20 percent) below the previous projection. That reduction is largely a result of projections of slower growth in premiums and, to a lesser extent, slightly lower exchange enrollment (as discussed above). Relative to CBO and JCT’s previous projection, the agencies now anticipate that, in most years, premiums in the exchanges will be roughly 10 percent lower and about 1 million fewer people will obtain health insurance through the exchanges.

That's why spending per enrollee (a number independent of actual enrollment) has fallen so much--about 24%--relative to pre-ACA projections.

Back in March 2010 it was supposed to cost $5,200 to insure someone through an exchange this year.

Yet in reality it's costing $3,960 per person. The coverage really is much cheaper than anticipated.

And I don't think price competition has been so great. The only reason prices have no gone up... is because benefits have declined. The base deductibles have increased dramatically.

Pretty easy to hold prices down, when you cut benefits by a ton.

Covered benefits have gone up, not down, where they've changed at all. If you mean the consumer has more cost-sharing for covered benefits in many cases--well, yes. That's been a goal of market reformers for decades. Make the consumer price-sensitive at the point of care and they'll introduce competition into the provider market.

 

[Andylusion]

That hasn't been proven. But let's even say it is true.

If the way in which the ACA has increased access to health care, is by increasing government borrowing and spending on health care programs..... then you basically are saying doing what Greece did, is a good thing.

Greece spent endless money to give the Greek public more and more services. How are they doing now? Not so good.

Is sacrificing the future, for the sake of more health care now, really worth it? Greece may never recover from what they are going through. If we do the same thing, because left wingers sacrificed the entire country for health care, that's not a win.

How does it increase government borrowing and spending?

And if you want to go there, nothing increases government borrowing and spending more than our obscene defense budget.

I am all for slimming down our defense budget where it is wise to do so. In general, the left cuts money where it is most harmful, and then we have to spend twice as much money replacing what we shouldn't have cut.

That said... you people make it out like 90% of the budget is all defense, and we want to advocate cutting tiny 5¢ programs.

The reality is the exact opposite. Military spending is only about 16% of the budget. The vast majority, more than half, is entitlements and social programs.

The truth is, the leftists are the ones trying to cut the 5¢ off the budget, while ignoring the multi-Trillion dollar elephant.

And that's just the direct budget expenses. You are missing the liabilities.

This right here, is what sinks entire nations.

According to most estimates, and you can look up Medicare / Medicaid Unfunded liabilities on google, there are dozens of sources about it.... The health care reform has INCREASED future unfunded liabilities.

That's a problem. The military, if we really get into a pinch, we can cut the military.

This problem here.... people change how they live, when they think the government is going to cover their health care. We are going to owe TRILLIONS. And that's going to play havoc, just like it has in Greece.

We need to cut the defense budget in half. We also need to end these bullshit wars we've been fighting for over a decade. And we also need to close these over a 1000 bases all over the world. If a country wants our base there, then they can pay for it. We'll send them a bill for all costs incurred.

Then we need to raise the tax rate on capital gains and dividends to 25%. Then we need to create a Financial Transactions Tax on all traded instruments and close the loop holes allowing corporations to offshore their profits. We also need to make derrivitives illegal again.

Keep the ACA, but add the "public option" to the bill. That'll drive medical costs down and the for-pay medical industry can't do a thing about it, except make their rates more competitive.

Don't touch Medicare and SS.

But here's the problem. For several years, if we had a defense budget of ZERO..... We still would have had a deficit.

Do you not see a problem there? If the Defense budget had been ZERO, there still would have been a deficit.

Greece has a defense budget that is a much smaller portion of their GDP, than ours is, and they still crashed.

Point being, if you think we should cut defense spending, I'm ok with that. Saying in half is garbage. You are crazy. But ok, maybe we should cut defense spending by some amount.... Ok. We can debate that.

But if you think cutting defense is going to solve the budget problem, you are nutz. Sorry, but that's crazy talk.

I just posted, that the unfunded liabilities of Medicare, Medicaid, and Social Security, are well over $100 Trillion. If you think slimming down the Defense budget by $300 Billion, is going to fix that, you either can't do math, or you need medication.

As for international bases, many of them are funded by international dollars, and the UN. Some, we have treaties with countries to maintain those bases. Others, we pay the full cost, but they are often important bases that we really need.

Take South Korea, for example. The only reason that war hasn't broken out, is because the North Koreans know that a full scale attack, would activate American troops, and the results would be devastating.

You really want us to pull out of that area, knowing that war would be the result, and we'd be sucked back in, only this time under heavy fighting? Bad plan.

Now if you want to eliminate the UN..... ok! I'm in favor of that myself. But you can't simultaneously say "I want the UN!" and at the same time "I don't want to fund military bases that the UN says we should have".... That doesn't work.

 

[Andylusion]

Have you ever wondered why you go to an inner city hospital, and find people there from an hour away? I've worked in hospitals, and that always confused me. This is why. The smaller hospitals were transferring patients out of their hospital, to bigger hospitals that could cost-shift the lack of payment from Medicare.

But Obama Care has started phasing out those programs. Why? Again, it's too expensive. They had to make Obama Care seem as though it wouldn't break the Federal Budget. So they cut some of these programs, that kept those rural hospitals alive.

The fact that they need inflated payments to be "kept alive" should be a red flag that we're talking about an inefficient model. The organization of a health system will impact cost. As I already said, hospitals have high fixed costs. Having more just to have more--be it duplicating services in more populated areas or offering them in areas where it isn't cost effective to do so--doesn't axiomatically lower costs, it often increases them. If a community can't sustain the fixed costs of having its own inpatient facility, then if you want to keep costs in check you'll have to do exactly what you're saying: divert cases to places where those facilities can be sustained.

You bring up India, which illustrates this very principle.

India’s Secret to Low-Cost Health Care

In order to reach the masses of people in need of care, Indian hospitals create hubs in major metro areas and open smaller clinics in more rural areas which feed patients to the main hospital, similar to the way that regional air routes feed passengers into major airline hubs.

This tightly coordinated web cuts costs by concentrating the most expensive equipment and expertise in the hub, rather than duplicating it in every village. It also creates specialists at the hubs who, while performing high volumes of focused procedures, develop the skills that will improve quality. By contrast, hospitals in the U.S. are spread out and uncoordinated, duplicating care in many places without high enough volume in any of them to provide the critical mass to make the procedures affordable. Similarly, an MRI machine might be used four to five times a day in the U.S. but 15 to 20 times a day in the Indian hospitals. As one CEO told us, “We have to make the equipment sweat!”

You don't just tack on additional fixed cost after additional fixed cost in the hopes that competition (and if you don't think consumer cost-sharing is "so great" I don't know where you think provider price competition comes from anyway) somehow undoes it. Not here, not in India.

Now maybe there is some other part of the law, that I don't know about..... but.... based on what I read, CON laws cover every single bed in any hospital in the state of Ohio.

You don't need another part of law. The regulations you quote are very clearly, very explicitly about long-term care facilities, not acute care hospitals and certainly not emergency departments. I honestly don't know what the source of your confusion is.

Now as you can see, every time that Medicare and Medicaid pay out less and less for care, the hospitals cost-shift that to private patients in higher and higher mark ups.

Accepting that theory requires assuming that hospitals are not profit maximizers (that is, they can always command higher prices than they do but opt not to). Even for nonprofit hospitals, that's a tough one to swallow, since even if their margins aren't going to investors they're going back into the community or the hospital. Why leave money on the table? The literature on the cost shifting theory is ambiguous at best.

One could just as easily look at the figure and ask: what if, when Medicare signals through a policy change that a new era of cost containment is upon us, hospitals sit up and take note? It's arguably the most important payer in the country, it's not so hard to imagine that providers will respond to the signals it sends by changing behavior. If providers begin to better control their costs as Medicare payment growth declines, and if private insurers' prices continue on their same trajectory (since private insurers are generally locked into multi-year contracts) then of course their payment-to-cost ratios will rise since costs are falling on a relative basis.

Indeed, Chapin White pointed out in ""Slower Growth in Medicare Spending — Is This the New Normal?" just a few years ago that Medicare's switch under Reagan to prospective fee setting was extremely effective at getting hospitals to contain their costs.

There is a historical precedent for harsh, simple-minded cuts setting the stage for broad-based payment reform. Up until the early 1980s, Medicare reimbursed hospitals for costs incurred, subject to ceilings. The Tax Equity and Fiscal Responsibility Act of 1982 substantially tightened those limits, leaving hospitals with no upside — they could not earn a profit by reducing costs — and a growing downside for those whose costs exceeded the limits. The next year, legislation was passed, with the support of the hospital industry, replacing cost reimbursement with the inpatient prospective payment system (IPPS), with rates initially calibrated to leave Medicare outlays unchanged. Hospitals then had the opportunity to reduce costs per admission by shortening lengths of stay and to earn a positive margin in the process.

The IPPS is generally viewed as a major policy success: it encouraged hospitals to seek efficiencies, and when they found those efficiencies, it allowed the federal government to share in the savings. Should ACOs and other reforms prove effective, they will provide broader opportunities to increase the efficiency of delivery beyond shortening lengths of stay, such as managing chronic disease more effectively so as to keep beneficiaries out of the hospital in the first place. But our current challenge is more complex than the one faced in the early 1980s. Broadening the unit of payment will require reaching across different types of providers and helping to stitch together real delivery systems in places where now there are none.

All of this is to point out the regulation, and government intervention, is what has caused all of this. If every single patient, paid for their own care, we wouldn't be talking about this.

You've taken exception to rising patient cost-sharing so I'm not sure I follow. Patients are sharing in the costs and prices of their care more now than ever before. Price sensitivity is more prevalent now than ever.

But you can't tell me that reducing or eliminating regulation can't possibly result in lower cost, because we can look around the world, and see that hospitals that do not have the regulations we do, operate at a fraction of our cost.

I haven't argued that. What I've said is that an insurance market without structure (in which there are no particular prices for products, opacity is the seller's primary weapon, and the incentive to cost shift dominate the incentive to cost contain) won't work.

It didn't work for the past half century in the individual market and it won't work now.

They were doing that before the exchanges existed. That's actually part of the problem. Hospitals increase prices, to account for the negotiated discount. If a treatment costs $1,000, and the insurance companies have a 50% discount, how much does the hospital charge? $2,000.

This system harms the uninsured the most, because they have to pay the full, made up, price.

If "this system" refers to private contracts between private insurers and private providers, I don't know how you propose to abolish that. Indemnity plans used to dominate health insurance and spending and costs soared. The rise of managed care--that private insurer-provider negotiation over prices--led to the only period in the last half century (other than the last five years) in which cost growth was contained, the mid-1990s. This was a market innovation. In fact, most of the old state-based all-payer systems of the '70s and '80s were deregulated on the theory that private competition manifested in the negotiations behind those private contracts would better control costs than the heavy-handed government regulation that preceded them.

The relaxation of managed care by the payers at the end of the '90s was followed by the escalation in health care costs and prices of the 2000s. More aggressive network management to tackle prices and costs has returned now in a big way, particularly in the individual market, and lo and behold provider price growth has neared all time lows.

This is one of the reasons we don't have a transparent market. All of those costs on those bills are made up numbers, to account for the cost-shifting regulations, and the negotiated discounts. Again, if we had zero regulations..... all of that would go away.

If "regulations" go away, Aetna isn't going to try and negotiate the lowest prices it can from health care providers?

How do you claim, a market that has shrunk in size, is 'robust'? I just posted the raw numbers. The individual market has declined.

First of all, I'm talking about the market dynamics. Insurers are competing, price leaders are changing, and consumers are actively shopping. That is what's "robust" about it. It's working as an insurance market ought to.

Second, what you're saying is incorrect. Individual market enrollment was up about 50% (and growing) as of last year.

And no, the reason the law has come in under the budget, is because very few of the uninsured, got insurance. The budget was based on the idea that all 45 Million of the uninsured, would get insurance. That hasn't happened.

Insurance really is substantially cheaper than anticipated. Competition works, you should feel vindicated.

Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act, April 2014

The current projection of the average premium for the benchmark silver plan in 2016 of about $4,400 is 15 percent below the comparable estimate of $5,200 published by CBO in November 2009.

Updated Budget Projections: 2015 to 2025

Reduced Costs for Exchange Subsidies CBO and JCT now project that the government’s net costs for exchange subsidies and related spending and revenues over the 2016–2025 period will be $849 billion— $209 billion (or 20 percent) below the previous projection. That reduction is largely a result of projections of slower growth in premiums and, to a lesser extent, slightly lower exchange enrollment (as discussed above). Relative to CBO and JCT’s previous projection, the agencies now anticipate that, in most years, premiums in the exchanges will be roughly 10 percent lower and about 1 million fewer people will obtain health insurance through the exchanges.

That's why spending per enrollee (a number independent of actual enrollment) has fallen so much--about 24%--relative to pre-ACA projections.

Back in March 2010 it was supposed to cost $5,200 to insure someone through an exchange this year.

Yet in reality it's costing $3,960 per person. The coverage really is much cheaper than anticipated.

And I don't think price competition has been so great. The only reason prices have no gone up... is because benefits have declined. The base deductibles have increased dramatically.

Pretty easy to hold prices down, when you cut benefits by a ton.

Covered benefits have gone up, not down, where they've changed at all. If you mean the consumer has more cost-sharing for covered benefits in many cases--well, yes. That's been a goal of market reformers for decades. Make the consumer price-sensitive at the point of care and they'll introduce competition into the provider market.

The fact that they need inflated payments to be "kept alive" should be a red flag that we're talking about an inefficient model.

Yes. The government mandate, regulate, and subsidize model. I just explained all that in detail, with evidence to support my statements.

You bring up India, which illustrates this very principle.
India’s Secret to Low-Cost Health Care

From your own link:

Task Shifting

The Indian hospitals transfer responsibility for routine tasks to lower-skilled workers, leaving expert doctors to handle only the most complicated procedures.
​

I just posted the law, which prevents US hospitals from doing that. You can't shift routine basic tasks, like say handing out Aspirin and water, to an intern. The law requires that Hospitals must only have an RN, or LPN, do that job. Which of course, costs tons of money.

And there are hundreds of such examples.

The regulations you quote are very clearly, very explicitly about long-term care facilities

And I very explicitly pointed out the specific law that defined what 'long-term care facilities' is. And the definition, according to the Ohio code, was any bed that had a nurse, or skilled nurse, assigned to it.

Are you telling me that acute care beds do not have a nurse or skilled nurse assigned to it? Do you have anything else to back up this claim? Anything at all?

Indeed, Chapin White pointed out in ""Slower Growth in Medicare Spending — Is This the New Normal?" just a few years ago that Medicare's switch under Reagan to prospective fee setting was extremely effective at getting hospitals to contain their costs.

Medicare's switch to fee setting did not get hospitals to contain their cost at all. The whole point of that graph is proof that they didn't contain costs.

Yeah, they contained medicare costs.... but cost-shifting to private patients. The cost to private patients went up, to pay for the treatment of government patients. Was that graph difficult to understand? Or are you simply ignoring evidence that doesn't fit your theory?

The only reason the growth in Medicare costs has slowed down, is because hospitals have shifted more costs onto private patients.

You are the only one thus far, that I have presented this evidence to, that hasn't been able to grasp it. I'm really confused by your nonsensical answer.

You've taken exception to rising patient cost-sharing so I'm not sure I follow.

Well yeah. That's the whole problem. Why do you think everyone is pissed off? Why do you think we're complaining about high prices?

I worked at this company a few years back, and there was this 300 lbs girl, who drank constantly, and was always in the hospital. We tried to get her to cut back on the booze, and she didn't care. We tried to have a company "health wellness" thing, and she didn't care. She was in and out of the hospital so much, she had the hospital and doctors saved on her cell phone.

The company was only 20 people, yet our company health care premiums doubled two years in a row. Why? That alcoholic obese chick was driving up health care costs on everyone in the entire company.

This is cost sharing at it's finest. Cost sharing is one of the primary reasons costs are going up.

When you go medical tourism, to an Indian hospital, you are not cost sharing at all. That's why the prices are lower. You are not paying for that other guy in the bed next to you. You are not paying for the other people in your companies 'group plan'. You are not paying for the Medicare Patient down the hall.

You are just paying for one person's care. YOURS. Shockingly... the price is lower. Why is that surprising?

If "this system" refers to private contracts between private insurers and private providers, I don't know how you propose to abolish that

I already explained that. The reason that system exists, is because of government regulations. Eliminate the regulations, and those contract will disappear too.

If there were 50 competing hospitals in the Columbus Ohio area, there is no possible way, that an insurer could form contracts with all fifty of them. But when the regulations and mandates, and controls, and CON Laws (you still haven't made your case), prevent entry into the market..... so that there are only 3 major health service providers, then it's easy for insurance companies to make three contracts, and lock down the market.

Get rid of the regulations, and competition will open up. More competition, and those contracts will disappear.

Individual market enrollment wasup about 50% (and growing) as of last year.

If it is, then that is somewhat positive. I have a feeling that's not as true as you think it is. I wager most of that is subsidized, or due to quality plans being unaffordable now.

Insurance really is substantially cheaper than anticipated. Competition works, you should feel vindicated.

Not true. Just simply not true.

Obamacare sends health premiums skyrocketing by as much as 78 percent - Washington Times

I don't even know how you can even pretend that's an honest statement to claim insurance is cheaper... unless you anticipated it being hideously more expensive, and only got horribly more expensive. The only way you think it's cheaper, is if you expected a 200% rise in costs, and it was only 100% rise in costs.

My personal experience mirrors what the reports are. Back in the mid 2000s, I got a policy for only $67 dollars, that had a $2,000 deductible. I'm now looking at a policy for the same amount, that has a $7,500 deductible.

The price may not have changed, but coverage is a ton lower.

It's interesting that you quote the CBO.... I don't give a crap if the cost to the government is lower than they expected. How the heck does that help me? So ACA was cheaper for government, while my bills double? How is that a 'vindication' of anything? I suppose it vindicated my belief that the Affordable Care Act would make Care Un-affordable.

Covered benefits have gone up, not down, where they've changed at all.

Well that certainly isn't the reality that I face, or anyone I know has faced, or what the numbers show.

 

[Billo_Really]

But here's the problem. For several years, if we had a defense budget of ZERO..... We still would have had a deficit.

Do you not see a problem there? If the Defense budget had been ZERO, there still would have been a deficit.

You said that. Twice. We might still have a deficit, but we'd be able to pay it down a little more.

Greece has a defense budget that is a much smaller portion of their GDP, than ours is, and they still crashed.

That's another thing we need to do, break up the big banks into little banks. That way when they fail, they don't affect the global economy.

Point being, if you think we should cut defense spending, I'm ok with that. Saying in half is garbage. You are crazy. But ok, maybe we should cut defense spending by some amount.... Ok. We can debate that.

Maybe more than half. We have enough nuclear weapons to kill the population of the planet 37 times. I think we're safe.

But if you think cutting defense is going to solve the budget problem, you are nutz. Sorry, but that's crazy talk.

I didn't say that.

I just posted, that the unfunded liabilities of Medicare, Medicaid, and Social Security, are well over $100 Trillion. If you think slimming down the Defense budget by $300 Billion, is going to fix that, you either can't do math, or you need medication.

At least with Medicare and SS, we get something in return.

What did we get in return for the over 6$ trillion we paid out for the Afghanistan and Iraq wars? Nothing. We got nothing in return for that investment. We spent all that money and the average American got no direct benefit as a result.

As for international bases, many of them are funded by international dollars, and the UN. Some, we have treaties with countries to maintain those bases. Others, we pay the full cost, but they are often important bases that we really need.

How does our military protect this country, when they are not physically in the country they're defending?

Take South Korea, for example. The only reason that war hasn't broken out, is because the North Koreans know that a full scale attack, would activate American troops, and the results would be devastating.

So. We let South Vietnam go, we're all still here.

You really want us to pull out of that area, knowing that war would be the result, and we'd be sucked back in, only this time under heavy fighting? Bad plan.

Why would we be sucked back in? That's on the other side of the planet, who gives a fuck?

Now if you want to eliminate the UN..... ok! I'm in favor of that myself. But you can't simultaneously say "I want the UN!" and at the same time "I don't want to fund military bases that the UN says we should have".... That doesn't work.

We should keep the UN. But we need to stop protecting Israel with our veto in the UNSC.

 

[Andylusion]

But here's the problem. For several years, if we had a defense budget of ZERO..... We still would have had a deficit.

Do you not see a problem there? If the Defense budget had been ZERO, there still would have been a deficit.

You said that. Twice. We might still have a deficit, but we'd be able to pay it down a little more.

Greece has a defense budget that is a much smaller portion of their GDP, than ours is, and they still crashed.

That's another thing we need to do, break up the big banks into little banks. That way when they fail, they don't affect the global economy.

Point being, if you think we should cut defense spending, I'm ok with that. Saying in half is garbage. You are crazy. But ok, maybe we should cut defense spending by some amount.... Ok. We can debate that.

Maybe more than half. We have enough nuclear weapons to kill the population of the planet 37 times. I think we're safe.

But if you think cutting defense is going to solve the budget problem, you are nutz. Sorry, but that's crazy talk.

I didn't say that.

I just posted, that the unfunded liabilities of Medicare, Medicaid, and Social Security, are well over $100 Trillion. If you think slimming down the Defense budget by $300 Billion, is going to fix that, you either can't do math, or you need medication.

At least with Medicare and SS, we get something in return.

What did we get in return for the over 6$ trillion we paid out for the Afghanistan and Iraq wars? Nothing. We got nothing in return for that investment. We spent all that money and the average American got no direct benefit as a result.

As for international bases, many of them are funded by international dollars, and the UN. Some, we have treaties with countries to maintain those bases. Others, we pay the full cost, but they are often important bases that we really need.

How does our military protect this country, when they are not physically in the country they're defending?

Take South Korea, for example. The only reason that war hasn't broken out, is because the North Koreans know that a full scale attack, would activate American troops, and the results would be devastating.

So. We let South Vietnam go, we're all still here.

You really want us to pull out of that area, knowing that war would be the result, and we'd be sucked back in, only this time under heavy fighting? Bad plan.

Why would we be sucked back in? That's on the other side of the planet, who gives a fuck?

Now if you want to eliminate the UN..... ok! I'm in favor of that myself. But you can't simultaneously say "I want the UN!" and at the same time "I don't want to fund military bases that the UN says we should have".... That doesn't work.

We should keep the UN. But we need to stop protecting Israel with our veto in the UNSC.

You missed the point. If you can completely eliminate the defense budget, and still have a deficit, by definition, you can't "pay it down a little". That's not logical. Unless you think somehow we can cut the defense budget to a negative amount, so that it is cut so much it brings in money, there is no possible way to cut it enough to have positive revenue.

There are over $100 Trillion dollars in unfunded liabilities in Social Security and Medicare. There is no amount of cutting to any other, or ALL other aspects of the Federal Budget that is going to fix that problem.

Breaking up the banks will cause there to be a bigger problem, not a smaller problem.

Most of the banks that failed during the 2008 sub-prime crash, were banks that only dealt in mortgages. In fact, the way the government 'fixed' the problem was to merge banks together.

How is doing the opposite of what the government did to fix the problem... going to fix the problem?

The solution isn't to break up the banks. The solution is to allow the banks to fail. It's worked before. It worked in Estonia. It worked in Iceland. It worked in England. It will work here to.

Breaking up the banks will only make them even more susceptible to failure.

Yes we have a bunch of nukes.... so what?

First, you shouldn't assume we're safe. There are some regimes in the world, that honestly do not believe we'll use them. I am not even sure we would use them.

A weapon no one thinks we'll ever use, is a weapon that might as well not exist. Under Reagan, it was a deterrent. Because people thought that if push came to shove, Reagan would do whatever he thought he must.

Under Obama, no one is worried we'll drop a nuke. If Russia began an invasion, we wouldn't drop a nuke.

If you think we're going to isolate ourselves, and let the rest of the world burn.... I don't think so. Not going to happen. We need conventional forces to defend our allies. Nukes are not useful for that purpose.

Yes, we let millions of people die in Vietnam, our ally.

That strikes me as an incredible injustice, and a terrible level of selfish arrogance. That might be the attitude of the self absorbed, "me-first-and-only" American mentality. But that's sick and twisted.

We used to be better as a people than that.

Why would we be sucked back in? That's on the other side of the planet, who gives a fuck?

A: Because we were not always selfish spoiled brats.
B: Because being an ally of the US used to mean something.
C: Because the reputation of America as a people who stand by their word as a nation, involves us actually standing up for what we say we'll do if an ally is attacked.

I get it. That honor and dignity, isn't something that applies to you. But some of us, it does. Hopefully there are more like us, than like you.

How does our military protect this country, when they are not physically in the country they're defending?

One spark in the wrong place at the wrong time, can send half of California up in flames.

Similarly, one fight in the wrong place, at the wrong time, can prevent the world from going up in flames.

You are constantly running on the basis that the US will never be sucked into an international war. They most certainly will. No doubt at all.

Our troop being a bulwark against the sparks, is preventing World War 3 from starting.

And again, I'm not completely against us having a discussion on cutting back military wise.

But I still remember having a thread on a proposal to shut down the last remaining tank plant in the US. Fire all the employees. Get rid of all the engineers and designers. The plant would be closed, retooled for domestic production, and used for who knows what.

It wasn't the following year after that discussion, Russia confiscates Crimea, and rolls heavy units into Ukraine, and Putin says he's doing it for the benefit of the Russians in Ukraine..... Exactly the same rational for Hitler taking over the Sudetenland. A move the ultimately led to Germany sparking world war 2.

All of a sudden, we need heavy armor vehicles.

If we had followed the belief system of those like you, back during that Tank plant closure debate, we would be spending billions of dollars opening a new plant, new engineers, new retooling, new everything.

The cost to replace a manufacturing plant is tens of billions, compared to a few million to keep one we already have running.

 

[Greenbeard]

And I very explicitly pointed out the specific law that defined what 'long-term care facilities' is. And the definition, according to the Ohio code, was any bed that had a nurse, or skilled nurse, assigned to it.

You need to go back and read the definition again (not your attempt to paraphrase it, the actual words used). An emergency department is not a long-term care facility. If your read of a definition has an outpatient unit somehow having long-term care beds, that's a good sign you need to go back and try again. This is getting absurd. Your world view doesn't need to collapse upon the realization that CON laws aren't why you don't have more ERs.

Medicare's switch to fee setting did not get hospitals to contain their cost at all. The whole point of that graph is proof that they didn't contain costs.

The figure shows a ratio. Knowing a ratio went up tells you one of three things: 1) the denominator decreased (in this case, hospital costs), 2) the numerator increased (commercial reimbursements rose), or 3) some combination of the two.

You can make as plausible a case for (1) as for (2). In reality, I suspect the answer lies in (3).

I worked at this company a few years back, and there was this 300 lbs girl, who drank constantly, and was always in the hospital. We tried to get her to cut back on the booze, and she didn't care. We tried to have a company "health wellness" thing, and she didn't care. She was in and out of the hospital so much, she had the hospital and doctors saved on her cell phone.

The company was only 20 people, yet our company health care premiums doubled two years in a row. Why? That alcoholic obese chick was driving up health care costs on everyone in the entire company.

This is cost sharing at it's finest. Cost sharing is one of the primary reasons costs are going up.

To be clear, cost-sharing refers to the amount the individual has to pay for their care the point of service (deductibles, copays, coinsurance, self-pay, whatever). More cost-sharing means you pay less for other people, and they pay less for you. Not the other way around.

Higher deductibles and cost-sharing mean the woman in your example is responsible for more of her costs and you're responsible for less of them. Which is why I'm trying to figure out your opposition to cost-sharing.

The concept behind moving to high deductible plans (including those that can be paired with an HSA to cover the increased cost-sharing) is that it makes the individual more price sensitive between competing provider services and more responsible for the services they consume.

If there were 50 competing hospitals in the Columbus Ohio area, there is no possible way, that an insurer could form contracts with all fifty of them.

Of course they could. The analog here is just solo practitioners or very small group practices today. In a given area of the state, there will be hundreds or more of such folks. Each is contracted with some group of insurers. But since they have zero market clout, they essentially get a boilerplate contract from the insurer that they have to sign if they want to be in network and have access to that patient pool (and it presumably goes without saying that they accept the rates and fee schedule offered them by the insurer). Larger hospitals--and particularly systems--on the other hand have clout to push back, which is why their contracts are more complex and actively negotiated. Including prices.

In the world you imagine where that's been taken away, a bunch of solo hospitals are still going to have contracts. They'll just be more tilted toward the insurer.

But when the regulations and mandates, and controls, and CON Laws (you still haven't made your case), prevent entry into the market..... so that there are only 3 major health service providers, then it's easy for insurance companies to make three contracts, and lock down the market.

As I just mentioned, you've actually got it backwards. In a world where providers have no clout relative to the insurer, the insurer can draw up a single boilerplate contract that all providers sign. It's only when you have providers with the clout to negotiate back that things get harder for the insurer and more varied or complex contracts begin to enter the picture.

I don't even know how you can even pretend that's an honest statement to claim insurance is cheaper... unless you anticipated it being hideously more expensive, and only got horribly more expensive. The only way you think it's cheaper, is if you expected a 200% rise in costs, and it was only 100% rise in costs.

We don't really need to guess what was anticipated in the budgeting, we have that answer: An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act (2009). Before the law passed, premiums for the coming open enrollment were expected to average about $5,200 (about $433/month) for single silver coverage. The actual numbers for next year actually look like they'll average more like $300-$350 per month. Significantly below budget. And below what comparable benefit packages cost in the employer space.

My personal experience mirrors what the reports are. Back in the mid 2000s, I got a policy for only $67 dollars, that had a $2,000 deductible. I'm now looking at a policy for the same amount, that has a $7,500 deductible.

A family plan for $67 would've been unusual a decade ago; today it's virtually unheard of. Congrats.

It's interesting that you quote the CBO....

Who else would I quote? I said it came in under budget. They're the ones who budgeted it and are tracking actual spending so that's where you have to go to check in. Like I said, it's coming in hundreds of billions under budget and the slowdown in health spending growth (including premiums far lower than anticipated) is a big reason.

Well that certainly isn't the reality that I face, or anyone I know has faced, or what the numbers show.

What covered benefit does your plan (which apparently has the same premium it did a decade ago!) no longer have that it use to?

 

[Andylusion]

And I very explicitly pointed out the specific law that defined what 'long-term care facilities' is. And the definition, according to the Ohio code, was any bed that had a nurse, or skilled nurse, assigned to it.

You need to go back and read the definition again (not your attempt to paraphrase it, the actual words used). An emergency department is not a long-term care facility. If your read of a definition has an outpatient unit somehow having long-term care beds, that's a good sign you need to go back and try again. This is getting absurd. Your world view doesn't need to collapse upon the realization that CON laws aren't why you don't have more ERs.

Medicare's switch to fee setting did not get hospitals to contain their cost at all. The whole point of that graph is proof that they didn't contain costs.

The figure shows a ratio. Knowing a ratio went up tells you one of three things: 1) the denominator decreased (in this case, hospital costs), 2) the numerator increased (commercial reimbursements rose), or 3) some combination of the two.

You can make as plausible a case for (1) as for (2). In reality, I suspect the answer lies in (3).

I worked at this company a few years back, and there was this 300 lbs girl, who drank constantly, and was always in the hospital. We tried to get her to cut back on the booze, and she didn't care. We tried to have a company "health wellness" thing, and she didn't care. She was in and out of the hospital so much, she had the hospital and doctors saved on her cell phone.

The company was only 20 people, yet our company health care premiums doubled two years in a row. Why? That alcoholic obese chick was driving up health care costs on everyone in the entire company.

This is cost sharing at it's finest. Cost sharing is one of the primary reasons costs are going up.

To be clear, cost-sharing refers to the amount the individual has to pay for their care the point of service (deductibles, copays, coinsurance, self-pay, whatever). More cost-sharing means you pay less for other people, and they pay less for you. Not the other way around.

Higher deductibles and cost-sharing mean the woman in your example is responsible for more of her costs and you're responsible for less of them. Which is why I'm trying to figure out your opposition to cost-sharing.

The concept behind moving to high deductible plans (including those that can be paired with an HSA to cover the increased cost-sharing) is that it makes the individual more price sensitive between competing provider services and more responsible for the services they consume.

If there were 50 competing hospitals in the Columbus Ohio area, there is no possible way, that an insurer could form contracts with all fifty of them.

Of course they could. The analog here is just solo practitioners or very small group practices today. In a given area of the state, there will be hundreds or more of such folks. Each is contracted with some group of insurers. But since they have zero market clout, they essentially get a boilerplate contract from the insurer that they have to sign if they want to be in network and have access to that patient pool (and it presumably goes without saying that they accept the rates and fee schedule offered them by the insurer). Larger hospitals--and particularly systems--on the other hand have clout to push back, which is why their contracts are more complex and actively negotiated. Including prices.

In the world you imagine where that's been taken away, a bunch of solo hospitals are still going to have contracts. They'll just be more tilted toward the insurer.

But when the regulations and mandates, and controls, and CON Laws (you still haven't made your case), prevent entry into the market..... so that there are only 3 major health service providers, then it's easy for insurance companies to make three contracts, and lock down the market.

As I just mentioned, you've actually got it backwards. In a world where providers have no clout relative to the insurer, the insurer can draw up a single boilerplate contract that all providers sign. It's only when you have providers with the clout to negotiate back that things get harder for the insurer and more varied or complex contracts begin to enter the picture.

I don't even know how you can even pretend that's an honest statement to claim insurance is cheaper... unless you anticipated it being hideously more expensive, and only got horribly more expensive. The only way you think it's cheaper, is if you expected a 200% rise in costs, and it was only 100% rise in costs.

We don't really need to guess what was anticipated in the budgeting, we have that answer: An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act (2009). Before the law passed, premiums for the coming open enrollment were expected to average about $5,200 (about $433/month) for single silver coverage. The actual numbers for next year actually look like they'll average more like $300-$350 per month. Significantly below budget. And below what comparable benefit packages cost in the employer space.

My personal experience mirrors what the reports are. Back in the mid 2000s, I got a policy for only $67 dollars, that had a $2,000 deductible. I'm now looking at a policy for the same amount, that has a $7,500 deductible.

A family plan for $67 would've been unusual a decade ago; today it's virtually unheard of. Congrats.

It's interesting that you quote the CBO....

Who else would I quote? I said it came in under budget. They're the ones who budgeted it and are tracking actual spending so that's where you have to go to check in. Like I said, it's coming in hundreds of billions under budget and the slowdown in health spending growth (including premiums far lower than anticipated) is a big reason.

Well that certainly isn't the reality that I face, or anyone I know has faced, or what the numbers show.

What covered benefit does your plan (which apparently has the same premium it did a decade ago!) no longer have that it use to?

I didn't say an Emergency department. You are shifting terms. But again, Emergency departments fit under a different set of laws, that still have negative effects. Yeah, anyone could open an ER. But.... you can't turn anyone away from the ER. Which is great if you don't want to pay, and have a cough. You walk in with a sore throat, and they can't turn you away.

Baton Rouge General Mid City ER is now closed, OLOL prepares for new patients

Notice the date... Long after Obama care came into effect, they are closing their ER. Why?

Again, the obvious...

Hospital officials said closing the Mid City ER was due to the influx of uninsured patients who had previously been treated at the Earl K. Long charity hospital in north Baton Rouge.
Officials said they were losing around $2 million a month and were projected to lose nearly $25 million this year if they kept the Mid City ER from shuttering its doors.​

Why don't they simply turn away people who refuse to pay? Can't. Don't have a choice. So what do you suggest?

Here you were talking about how "Obama Care doesn't cost as much", and yet this right here is why. They cut funding for hospitals, and yet the people refused to pay for even heavily subsidized Medicaid, and now hospitals are closing their ERs.

See, no matter what part of the hospital you want to talk about, I can cite government laws and regulations, that jack up costs.

I'll give you another example... US ERs have on staff emergency trauma care doctors 24 hours a day, 7 days a week. In the UK, they do not.

England trauma services 'not good enough'

Vice president of the College of Emergency Medicine Don MacKechnie said: "Currently only a minority of emergency departments have adequate consultant numbers to achieve a consultant presence beyond much more than 'normal office hours'.​

In other words, they don't keep the skilled staff on hand past 'normal office hours'. Why? That costs money. See people keep saying we can cut costs, and pay less like in the UK. And we can..... just send the expensive skilled staff home at 5, and if you break a leg, or have a crash... well... SOL dude. Saved money though. At least you didn't have a big medical bill right?

Of course they could. The analog here is just solo practitioners or very small group practices today. In a given area of the state, there will be hundreds or more of such folks.

We'll just have to agree to disagree. I don't think so.

Ironically, my doctor before hand had no contracts with any insurance companies at all. Just recently, he became a contract doctor with Grant Medical care, which really really ticked me off, because I hate Grant. Always have. They are the cheapest, and are subsidized by the government, but as is typical of government funded institutions, they are complete and total jerks.

So I asked him, why the heck he signed on with Grant. He said very openly, the Obama Care law drove up his prices, and he couldn't practice as an independent office anymore. Him and his 3 other doctors, all made the decision to sell to a medical provider, and now they are part of Mega-Corp Health.

Like have said many times before, all regulations benefit the mega-corporations. Want to make the poor, poorer, and rich richer? That's how you do it.

A family plan for $67 would've been unusual a decade ago; today it's virtually unheard of. Congrats.

Not a chance. I'm single for life. I never meant to try and mislead anyone into thinking you can get a family plan for $67. Crazy.

Now my co-worker at work, he was doing contract work before he got the job he has there, and he was able to find a family plan for just $130 a month. That's him, wife, and two kids. High deductible of course. But otherwise, great coverage. 20/80, $5 Million lifetime.

Which is still pretty darn good honestly. Of course, all those plans are gone. Both me, and him, have been hunting around for alternative plans, because the employer plan had a 50% jump in premiums again.

Who else would I quote? I said it came in under budget.

Because again, I don't give a crap if it came in under budget for the government. How does that help me? My premiums double, and you sit there and say "Yeah but it's saving money",.... bull crap! It's not saving any money! "Yeah but it's holding down costs!" Bull CRAP! I can see my bill.... it's not lower... it's higher... but a TON!

And I just pointed out, ERs are closing, and the primary reason is that they cut funding. Yeah, it came in under budget, and now people are dying in the streets because all the ERs closed? That's a win?

What covered benefit does your plan (which apparently has the same premium it did a decade ago!) no longer have that it use to?

Wow.... ok..... I'm not trying to be sarcastic..... but you do grasp the idea that if the deductible goes from $2,000 to $7,000.... that's a loss of benefit? Do you get that concept? Because I posted how much the deductible was higher. It wasn't 'hidden' somehow... so I'm confused by your question.

premiums for the coming open enrollment were expected to average about $5,200 (about $433/month) for single silver coverage. The actual numbers for next year actually look like they'll average more like $300-$350 per month. Significantly below budget

How does that change anything I posted? Are premiums for the vast majority of the public, higher, or lower, than now? Have the premiums for the vast majority of the public increased more under Obama Care, or less under Obama Care?

I don't care what they thought their whatever plan was going to cost. Only a tiny fraction of the public is buying that stuff. Most of us are in the real world out here. What has Obama Care done to *US*? Not them. I don't care about them. I have my own bills to pay. That's what I'm concerned about.

 

[Billo_Really]

You missed the point. If you can completely eliminate the defense budget, and still have a deficit, by definition, you can't "pay it down a little". That's not logical. Unless you think somehow we can cut the defense budget to a negative amount, so that it is cut so much it brings in money, there is no possible way to cut it enough to have positive revenue.

I didn't say defense budget cuts would pay off the deficit, I said it would contribute to paying it down. If the defense budget was $900 billion and you cut that in half, that leaves you with $450 billion to go to paying off the deficit.

There are over $100 Trillion dollars in unfunded liabilities in Social Security and Medicare. There is no amount of cutting to any other, or ALL other aspects of the Federal Budget that is going to fix that problem.

A Financial Transactions Tax would bring in the necessary revenue to not only pay off the deficit, but provide healthcare to every citizen in the country.

Most of the banks that failed during the 2008 sub-prime crash, were banks that only dealt in mortgages. In fact, the way the government 'fixed' the problem was to merge banks together.

How is doing the opposite of what the government did to fix the problem... going to fix the problem?

The solution isn't to break up the banks. The solution is to allow the banks to fail. It's worked before. It worked in Estonia. It worked in Iceland. It worked in England. It will work here to.

Breaking up the banks will only make them even more susceptible to failure.

We need to bring back Glass-Steagall.

First, you shouldn't assume we're safe. There are some regimes in the world, that honestly do not believe we'll use them. I am not even sure we would use them.

A weapon no one thinks we'll ever use, is a weapon that might as well not exist. Under Reagan, it was a deterrent. Because people thought that if push came to shove, Reagan would do whatever he thought he must.

Under Obama, no one is worried we'll drop a nuke. If Russia began an invasion, we wouldn't drop a nuke.

If you think we're going to isolate ourselves, and let the rest of the world burn.... I don't think so. Not going to happen. We need conventional forces to defend our allies. Nukes are not useful for that purpose.

Except when we're the ones running around the world making up bullshit reasons to attack sovereign nations.

That strikes me as an incredible injustice, and a terrible level of selfish arrogance. That might be the attitude of the self absorbed, "me-first-and-only" American mentality. But that's sick and twisted.

We used to be better as a people than that.

Used to be, but then we elected Reagan.

A: Because we were not always selfish spoiled brats.
B: Because being an ally of the US used to mean something.
C: Because the reputation of America as a people who stand by their word as a nation, involves us actually standing up for what we say we'll do if an ally is attacked.

I get it. That honor and dignity, isn't something that applies to you. But some of us, it does. Hopefully there are more like us, than like you.

We used to be the bastion of democracy, now were the bastion of hypocrisy.

We gave our word that "a man is presumed innocent, until proven guilty" and that everyone receives "due process of law". Now the government can pluck anyone off the street and indefinitely detain them without charges for the rest of their life.

One spark in the wrong place at the wrong time, can send half of California up in flames.

Similarly, one fight in the wrong place, at the wrong time, can prevent the world from going up in flames.

You are constantly running on the basis that the US will never be sucked into an international war. They most certainly will. No doubt at all.

Our troop being a bulwark against the sparks, is preventing World War 3 from starting.

And again, I'm not completely against us having a discussion on cutting back military wise.

But I still remember having a thread on a proposal to shut down the last remaining tank plant in the US. Fire all the employees. Get rid of all the engineers and designers. The plant would be closed, retooled for domestic production, and used for who knows what.

It wasn't the following year after that discussion, Russia confiscates Crimea, and rolls heavy units into Ukraine, and Putin says he's doing it for the benefit of the Russians in Ukraine..... Exactly the same rational for Hitler taking over the Sudetenland. A move the ultimately led to Germany sparking world war 2.

Funny you mentioning Hitler and the Ukraine, since we're providing material support to the Nazis in Kiev.

All of a sudden, we need heavy armor vehicles.

If we had followed the belief system of those like you, back during that Tank plant closure debate, we would be spending billions of dollars opening a new plant, new engineers, new retooling, new everything.

The cost to replace a manufacturing plant is tens of billions, compared to a few million to keep one we already have running.

Did you know all the helmuts the military wears, are exclusively made from prison labor? 100% of them.

The manufacturing plant can re-tool for commercial use.

 

[Greenbeard]

I didn't say an Emergency department. You are shifting terms. But again, Emergency departments fit under a different set of laws, that still have negative effects. Yeah, anyone could open an ER.

This is actually specifically why we're talking about CON laws. You said ERs are subject to CON laws in Ohio (they aren't) and that's why there aren't more. Before "anyone could open an ER" it was "If you and I got together, pooled our money, got some investors, and tried to open an Emergency Room service.... we couldn't do it."

There are only about a half dozen Emergency rooms in Columbus Ohio. Of those, there are actually only four total providers. Riverside Methodist, Mount Carmel, Grant, and OSU University Hospital (which is terrible gov-care).

In an area of 2 Million people, why are there only a whooping four Emergency Health care providers?

Because government controls that market. If you and I got together, pooled our money, got some investors, and tried to open an Emergency Room service.... we couldn't do it. The government prevents outsiders from competing. It's called 'certificate of need'. Its a method to have a "structured market". You can't just let anyone into the market! That would be chaos!

But it sounds like we're done talking about that so that's great. Let's move on.

But.... you can't turn anyone away from the ER. Which is great if you don't want to pay, and have a cough. You walk in with a sore throat, and they can't turn you away.

They have to stabilize individuals with emergency medical conditions (if they want to be eligible for Medicare reimbursement, which they generally do). They don't have to be your primary care doctor because you have the sniffles. They might choose to be, but they're under no requirement to be.

See people keep saying we can cut costs, and pay less like in the UK. And we can..... just send the expensive skilled staff home at 5, and if you break a leg, or have a crash... well... SOL dude. Saved money though. At least you didn't have a big medical bill right?

It sounds like you're ridiculing the idea of relaxing requirements on ERs in the name of saving money. And yet I thought everything you're saying is in service of the idea that we need to relax requirements on medical facilities to save money. So I'm really not sure what you're saying or what your point is.

Not a chance. I'm single for life. I never meant to try and mislead anyone into thinking you can get a family plan for $67. Crazy.

Odd. A deductible can't be higher than the total out-of-pocket maximum for a plan (obviously), and yet the legal OOP max for ACA-compliant single coverage this year is $6,600. So it isn't really possible to have a deductible as high as the one you quoted for an individual plan. Unless of course you're in a grandfathered plan that isn't even subject to the ACA, in which case I don't know why it's even entered into this conversation.

How does that help me? My premiums double, and you sit there and say "Yeah but it's saving money",

You said your premiums are the same as they were ten years ago. You said they're $67. Doesn't particularly sound to me like you need help.

And I just pointed out, ERs are closing, and the primary reason is that they cut funding. Yeah, it came in under budget, and now people are dying in the streets because all the ERs closed? That's a win?

"People are dying in the streets because all the ERs closed"? Get a grip.

Wow.... ok..... I'm not trying to be sarcastic..... but you do grasp the idea that if the deductible goes from $2,000 to $7,000.... that's a loss of benefit? Do you get that concept? Because I posted how much the deductible was higher. It wasn't 'hidden' somehow... so I'm confused by your question.

It sounds like you haven't lost any benefits (i.e., services covered by your insurance), you just have to pay more of the costs of those services when you access them. For someone complaining about the health habits of co-workers (they should pay their own costs!), I'm failing to see why you view this as a bad thing. Particularly when it's been effective at freezing your premiums for the last decade.

How does that change anything I posted? Are premiums for the vast majority of the public, higher, or lower, than now? Have the premiums for the vast majority of the public increased more under Obama Care, or less under Obama Care?

For the vast majority, they've increased less than the historical average.

Premiums for job-based insurance rose modestly for the third consecutive year, reflecting slowed spending, even as key elements of the federal health care law went into effect.

Family premiums rose 3 percent in 2014, one of the lowest increases tracked since the Kaiser Family Foundation and the Health Research & Educational Trust began surveying employers in 1999.

 

[playtime]

Yup and everyone will be paying more for their benefits.

My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?

Your costs went up because the insurance companies still want to make a profit off of your health, or lack of.

 

[Andylusion]

You missed the point. If you can completely eliminate the defense budget, and still have a deficit, by definition, you can't "pay it down a little". That's not logical. Unless you think somehow we can cut the defense budget to a negative amount, so that it is cut so much it brings in money, there is no possible way to cut it enough to have positive revenue.

I didn't say defense budget cuts would pay off the deficit, I said it would contribute to paying it down. If the defense budget was $900 billion and you cut that in half, that leaves you with $450 billion to go to paying off the deficit.

There are over $100 Trillion dollars in unfunded liabilities in Social Security and Medicare. There is no amount of cutting to any other, or ALL other aspects of the Federal Budget that is going to fix that problem.

A Financial Transactions Tax would bring in the necessary revenue to not only pay off the deficit, but provide healthcare to every citizen in the country.

Most of the banks that failed during the 2008 sub-prime crash, were banks that only dealt in mortgages. In fact, the way the government 'fixed' the problem was to merge banks together.

How is doing the opposite of what the government did to fix the problem... going to fix the problem?

The solution isn't to break up the banks. The solution is to allow the banks to fail. It's worked before. It worked in Estonia. It worked in Iceland. It worked in England. It will work here to.

Breaking up the banks will only make them even more susceptible to failure.

We need to bring back Glass-Steagall.

First, you shouldn't assume we're safe. There are some regimes in the world, that honestly do not believe we'll use them. I am not even sure we would use them.

A weapon no one thinks we'll ever use, is a weapon that might as well not exist. Under Reagan, it was a deterrent. Because people thought that if push came to shove, Reagan would do whatever he thought he must.

Under Obama, no one is worried we'll drop a nuke. If Russia began an invasion, we wouldn't drop a nuke.

If you think we're going to isolate ourselves, and let the rest of the world burn.... I don't think so. Not going to happen. We need conventional forces to defend our allies. Nukes are not useful for that purpose.

Except when we're the ones running around the world making up bullshit reasons to attack sovereign nations.

That strikes me as an incredible injustice, and a terrible level of selfish arrogance. That might be the attitude of the self absorbed, "me-first-and-only" American mentality. But that's sick and twisted.

We used to be better as a people than that.

Used to be, but then we elected Reagan.

A: Because we were not always selfish spoiled brats.
B: Because being an ally of the US used to mean something.
C: Because the reputation of America as a people who stand by their word as a nation, involves us actually standing up for what we say we'll do if an ally is attacked.

I get it. That honor and dignity, isn't something that applies to you. But some of us, it does. Hopefully there are more like us, than like you.

We used to be the bastion of democracy, now were the bastion of hypocrisy.

We gave our word that "a man is presumed innocent, until proven guilty" and that everyone receives "due process of law". Now the government can pluck anyone off the street and indefinitely detain them without charges for the rest of their life.

One spark in the wrong place at the wrong time, can send half of California up in flames.

Similarly, one fight in the wrong place, at the wrong time, can prevent the world from going up in flames.

You are constantly running on the basis that the US will never be sucked into an international war. They most certainly will. No doubt at all.

Our troop being a bulwark against the sparks, is preventing World War 3 from starting.

And again, I'm not completely against us having a discussion on cutting back military wise.

But I still remember having a thread on a proposal to shut down the last remaining tank plant in the US. Fire all the employees. Get rid of all the engineers and designers. The plant would be closed, retooled for domestic production, and used for who knows what.

It wasn't the following year after that discussion, Russia confiscates Crimea, and rolls heavy units into Ukraine, and Putin says he's doing it for the benefit of the Russians in Ukraine..... Exactly the same rational for Hitler taking over the Sudetenland. A move the ultimately led to Germany sparking world war 2.

Funny you mentioning Hitler and the Ukraine, since we're providing material support to the Nazis in Kiev.

All of a sudden, we need heavy armor vehicles.

If we had followed the belief system of those like you, back during that Tank plant closure debate, we would be spending billions of dollars opening a new plant, new engineers, new retooling, new everything.

The cost to replace a manufacturing plant is tens of billions, compared to a few million to keep one we already have running.

Did you know all the helmuts the military wears, are exclusively made from prison labor? 100% of them.

The manufacturing plant can re-tool for commercial use.

Well first off, the Defense Budget isn't even close to $900 Billion. It's more like $670 Billion.

If you cut that in half, that's $335 Billion, and the current deficit is over $400 Billion, and is projected to increase to $800 billion in the next decade based on the social programs and expenses the government has committed to pay in the future.

In other words, cutting defense spending in half, isn't going to eliminate the deficit or pay down the debt at all period. The math is not on your side.

A Financial Transactions Tax would bring in the necessary revenue to not only pay off the deficit, but provide healthcare to every citizen in the country.

Nice theory. It's wrong theory, but it's a nice theory. When they jacked up taxes on Yachts, rich people stopped buying yachts. The yachting industry went in a free fall. Revenue was a tiny fraction of what they claimed it would be.

The failure in your theory is that you assume that financial transactions would continue as they do now without the tax. That's wrong. When you tax something, people change their behavior to avoid the tax. Just like major companies move their operations outside the US, to avoid Corporate Taxes.

No, the financial tax will not bring in all the revenue in the world to pay for all your little programs.

We need to bring back Glass-Steagall.

Why? Glass-Steagall would have done nothing to prevent the crash of 2008. Glass-Steagall would have prevented the government from fixing the crash of 2008. No other country has ever had a Glass-Steagall act, and yet the problem started here in the US.

It will do nothing solve anything. So.... why?

Used to be, but then we elected Reagan.

So in your world, completely abandoning our ally to be overthrown, proving to the world we couldn't be trusted, resulting in a brutal, and insane dictator who is developing nuclear weapons, with the intent and purpose of attacking another of our ally.....

that to you is "honorable". But Reagan standing up to the Soviet Union, and helping the Germany people escape socialistic hell.... that's dishonorable.

You are a moron if you think that.

We used to be the bastion of democracy, now were the bastion of hypocrisy.

No, we were never supposed to be a democracy. You clearly haven't read the Federalist papers and what the founding fathers said of democracy. As for being a hypocrite.... you would be in the know.

Funny you mentioning Hitler and the Ukraine, since we're providing material support to the Nazis in Kiev.

Only if you are a Russian media plant. The BBC did a documentary about the whole thing. Are there Nazis in Kiev? Yes. Are there Nazis in the Russian Rebels? Yeah, actually most of them are. Why the heck do you think they believe Ukraine is rightfully part of mother Russia. It's a national socialist belief system.

We gave our word that "a man is presumed innocent, until proven guilty" and that everyone receives "due process of law". Now the government can pluck anyone off the street and indefinitely detain them without charges for the rest of their life.

So that needs to end, assuming it's true. Great. What's it go to do with the topic at hand?

 

[Andylusion]

I didn't say an Emergency department. You are shifting terms. But again, Emergency departments fit under a different set of laws, that still have negative effects. Yeah, anyone could open an ER.

This is actually specifically why we're talking about CON laws. You said ERs are subject to CON laws in Ohio (they aren't) and that's why there aren't more. Before "anyone could open an ER" it was "If you and I got together, pooled our money, got some investors, and tried to open an Emergency Room service.... we couldn't do it."

There are only about a half dozen Emergency rooms in Columbus Ohio. Of those, there are actually only four total providers. Riverside Methodist, Mount Carmel, Grant, and OSU University Hospital (which is terrible gov-care).

In an area of 2 Million people, why are there only a whooping four Emergency Health care providers?

Because government controls that market. If you and I got together, pooled our money, got some investors, and tried to open an Emergency Room service.... we couldn't do it. The government prevents outsiders from competing. It's called 'certificate of need'. Its a method to have a "structured market". You can't just let anyone into the market! That would be chaos!

But it sounds like we're done talking about that so that's great. Let's move on.

But.... you can't turn anyone away from the ER. Which is great if you don't want to pay, and have a cough. You walk in with a sore throat, and they can't turn you away.

They have to stabilize individuals with emergency medical conditions (if they want to be eligible for Medicare reimbursement, which they generally do). They don't have to be your primary care doctor because you have the sniffles. They might choose to be, but they're under no requirement to be.

See people keep saying we can cut costs, and pay less like in the UK. And we can..... just send the expensive skilled staff home at 5, and if you break a leg, or have a crash... well... SOL dude. Saved money though. At least you didn't have a big medical bill right?

It sounds like you're ridiculing the idea of relaxing requirements on ERs in the name of saving money. And yet I thought everything you're saying is in service of the idea that we need to relax requirements on medical facilities to save money. So I'm really not sure what you're saying or what your point is.

Not a chance. I'm single for life. I never meant to try and mislead anyone into thinking you can get a family plan for $67. Crazy.

Odd. A deductible can't be higher than the total out-of-pocket maximum for a plan (obviously), and yet the legal OOP max for ACA-compliant single coverage this year is $6,600. So it isn't really possible to have a deductible as high as the one you quoted for an individual plan. Unless of course you're in a grandfathered plan that isn't even subject to the ACA, in which case I don't know why it's even entered into this conversation.

How does that help me? My premiums double, and you sit there and say "Yeah but it's saving money",

You said your premiums are the same as they were ten years ago. You said they're $67. Doesn't particularly sound to me like you need help.

And I just pointed out, ERs are closing, and the primary reason is that they cut funding. Yeah, it came in under budget, and now people are dying in the streets because all the ERs closed? That's a win?

"People are dying in the streets because all the ERs closed"? Get a grip.

Wow.... ok..... I'm not trying to be sarcastic..... but you do grasp the idea that if the deductible goes from $2,000 to $7,000.... that's a loss of benefit? Do you get that concept? Because I posted how much the deductible was higher. It wasn't 'hidden' somehow... so I'm confused by your question.

It sounds like you haven't lost any benefits (i.e., services covered by your insurance), you just have to pay more of the costs of those services when you access them. For someone complaining about the health habits of co-workers (they should pay their own costs!), I'm failing to see why you view this as a bad thing. Particularly when it's been effective at freezing your premiums for the last decade.

How does that change anything I posted? Are premiums for the vast majority of the public, higher, or lower, than now? Have the premiums for the vast majority of the public increased more under Obama Care, or less under Obama Care?

For the vast majority, they've increased less than the historical average.

Premiums for job-based insurance rose modestly for the third consecutive year, reflecting slowed spending, even as key elements of the federal health care law went into effect.

Family premiums rose 3 percent in 2014, one of the lowest increases tracked since the Kaiser Family Foundation and the Health Research & Educational Trust began surveying employers in 1999.

You are correct. I made a mistake. I meant a hospital service, not an ER. We couldn't open an ER, because we can't turn away people who don't pay, and thus we would go bankrupt.

I meant a hospital service. A service where you have people in a bed, with a nurse watching them. Can't do that without certificate of need. Which of course, the government limits, which drives up prices.

I guarantee the average price of a hospital stay wouldn't be $9,000, if anyone could open a hospital bed service, without any regulation.

But you are correct. I looked it up, and I did say "emergency", which was an error on my part.

They have to stabilize individuals with emergency medical conditions (if they want to be eligible for Medicare reimbursement, which they generally do). They don't have to be your primary care doctor because you have the sniffles. They might choose to be, but they're under no requirement to be.

Ok? So why are they closing for lack of reimbursement? Why don't they turn those people away?

It sounds like you're ridiculing the idea of relaxing requirements on ERs in the name of saving money. And yet I thought everything you're saying is in service of the idea that we need to relax requirements on medical facilities to save money. So I'm really not sure what you're saying or what your point is.

No, I am ridiculing that idea that having government funded health care is cheaper. It's not cheaper. It not only costs more money, but it also provides worse service.

People think they are going to 'save money' by having government pay for health care. No, taxes in the UK are massively higher than the US. The standard of living is lower, and ultimately their health care is worse.

That's where the problem is.

Odd. A deductible can't be higher than the total out-of-pocket maximum for a plan (obviously), and yet the legal OOP max for ACA-compliant single coverage this year is $6,600. So it isn't really possible to have a deductible as high as the one you quoted for an individual plan. Unless of course you're in a grandfathered plan that isn't even subject to the ACA, in which case I don't know why it's even entered into this conversation.

The Deductible on this plan is $10K.

That one only lasts 6 months.

That's another thing that is bugging me. All the policies I see that I can afford now, have a limited duration.

Before, I just has a flat out insurance policy that lasted as long as I kept paying the premium. Perhaps that's the key to your problem. Maybe limited duration policies are exempted from all the regulations. But that is also a problem, I hate the idea that I'll have to keep re-applying for health care.

You said your premiums are the same as they were ten years ago. You said they're $67. Doesn't particularly sound to me like you need help.

Ok, I'll explain this again.... I can see how it could be confusing.

Back in 2006.... I purchased an individual insurance plan for $67 a month. That was 2006. Not last year... not the last 5 years.

I had that policy for about 2 years I think. In 2012, I got this job where I am now. At this job, the premiums doubled. They doubled in 2013, and 2014.

That brings us to today. So I punched in the same information that I did back in 2006, and now as you can see, I can in fact get a policy for $67 a month..... but... it only lasts for 6 months, or 12 months.... the deductibles are $7,500 or $10,000, and the co-insurance is 30% on one of them.

To get the exact same policy I had before, well actually I can't. The cheapest I can find of the other plans, is $80 a month, and that's with a $6,300 deductible.

The one positive there is, I love the idea that I'm making other people pay for most of my health insurance. I disagree with the concept, but if people are stupid enough to pay for my health insurance... peachy. The more I can soak the left-wingers, the better.

"People are dying in the streets because all the ERs closed"? Get a grip.

Well if all the ERs close... what do you think is going to happen? Did you read the article? The reason that hospital closed their ER, is because the other hospital in the same area, closed theirs.

All the people that went to the first hospital, ended up at the second, and the second closed their ER too. So now I'm sure they are swamping a third ER, which of course will be forced to close as well.

Eventually...... people are going to start dying. How else do you see this pattern ending? Have you read Code Blue, about the ERs in Canada closing? People died. Welcome to reality. This is how it works.

It sounds like you haven't lost any benefits (i.e., services covered by your insurance), you just have to pay more of the costs of those services when you access them. For someone complaining about the health habits of co-workers (they should pay their own costs!), I'm failing to see why you view this as a bad thing. Particularly when it's been effective at freezing your premiums for the last decade.

Again, every single time you say "It's been effective at freezing your premium", I'm going to respond with, you are wrong.... When the benefits are cut..... that's a rise in premiums.

When the amount that the insurance covers is LOWER..... that is an increase in cost.

A higher deductible.... is a cut in benefits. Example: If my premium is $67/mo and the deductible is $2,000... and then you pass a law, and now my premium is $67/mo, and the deductible is $7,500...... that's not holding premiums down.

Premiums have gone up drastically. Now I have to pay $221 a month to get a $2,000 deductible. $67/mo gets me LESS coverage.

I'm confused why that's difficult to understand. If the insurance covers less.... prices have increased.

I don't care about "it covers more services". I'd rather have an insurance policy that covers LESS services, at a more reasonable price. Cover just the services that I actually want... at a price I can afford. If it covers a hundred more services, at a price I can't afford.... that's fail, not a win.

You people screwed me, and most of the country.

 

[Andylusion]

Yup and everyone will be paying more for their benefits.

My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?

Your costs went up because the insurance companies still want to make a profit off of your health, or lack of.

All companies make a profit off of us. If they didn't, they wouldn't provide us anything.

The question is which system is better. I maintain that the previous system was better at providing us care at a better price, than the current.

You mandated that they cover people with pre-existing conditions. That drives up prices.
You mandated that they cover more services. That drives up price.
You mandated that they have a lower out-of-pocket max. That drives up price.

The more you require that insurance covers... the higher the price is on us.

 

[playtime]

Yup and everyone will be paying more for their benefits.

My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?

Your costs went up because the insurance companies still want to make a profit off of your health, or lack of.

All companies make a profit off of us. If they didn't, they wouldn't provide us anything.

The question is which system is better. I maintain that the previous system was better at providing us care at a better price, than the current.

You mandated that they cover people with pre-existing conditions. That drives up prices.
You mandated that they cover more services. That drives up price.
You mandated that they have a lower out-of-pocket max. That drives up price.

The more you require that insurance covers... the higher the price is on us.

The fundamental problem is healthcare for profit. Remove the profit factor & that problem goes bye-bye. The mandate now requires 80-85% of your premium is spent directly on your healthcare or you get a refund. You know what truly drives up cost?

Greed.

 

[Billo_Really]

Well first off, the Defense Budget isn't even close to $900 Billion. It's more like $670 Billion.

If you cut that in half, that's $335 Billion, and the current deficit is over $400 Billion, and is projected to increase to $800 billion in the next decade based on the social programs and expenses the government has committed to pay in the future.

In other words, cutting defense spending in half, isn't going to eliminate the deficit or pay down the debt at all period. The math is not on your side.

When you add in development projects, the costs of the wars, emergency funding from Congress, military programs buried in the DOE, Homeland Security and the intelligence agencies, the cost of military spending exceeds $1.2 trillion/yr.

Cut that in half and you have $600 billion to help pay down the deficit.

Nice theory. It's wrong theory, but it's a nice theory. When they jacked up taxes on Yachts, rich people stopped buying yachts. The yachting industry went in a free fall. Revenue was a tiny fraction of what they claimed it would be.

The failure in your theory is that you assume that financial transactions would continue as they do now without the tax. That's wrong. When you tax something, people change their behavior to avoid the tax. Just like major companies move their operations outside the US, to avoid Corporate Taxes.

No, the financial tax will not bring in all the revenue in the world to pay for all your little programs.

Really? Do you really think people will stop trading on Wall Street over a $0.003 tax for each transaction? That's ridiculous!

Why? Glass-Steagall would have done nothing to prevent the crash of 2008. Glass-Steagall would have prevented the government from fixing the crash of 2008. No other country has ever had a Glass-Steagall act, and yet the problem started here in the US.

It will do nothing solve anything. So.... why?

In '29, we had a stock market crash. Then Glass-Steagall was enacted. For over half a century, we had no economic meltdown. Then, few years after its repeal, we had another meltdown.

The 2008 crash was a direct result of deregulating the financial industry, the derrivitive bubble and predatory lending. Glass-Steagall would've prevented that by not allowing investment banks and savings banks to do business under the same roof.

So in your world, completely abandoning our ally to be overthrown, proving to the world we couldn't be trusted, resulting in a brutal, and insane dictator who is developing nuclear weapons, with the intent and purpose of attacking another of our ally.....

that to you is "honorable". But Reagan standing up to the Soviet Union, and helping the Germany people escape socialistic hell.... that's dishonorable.

You are a moron if you think that.

I don't know who you're talking about above, but Reagan had nothing to do with the fall of the Soviet Union. They ran out of money. Which is the same thing we are going to do, if we continue this bullshit war on terror.

No, we were never supposed to be a democracy. You clearly haven't read the Federalist papers and what the founding fathers said of democracy. As for being a hypocrite.... you would be in the know.

If the Founding Fathers wanted the Federalist Papers to be the law of the land, they would've included more of them in the Constitution.

Only if you are a Russian media plant. The BBC did a documentary about the whole thing. Are there Nazis in Kiev? Yes. Are there Nazis in the Russian Rebels? Yeah, actually most of them are. Why the heck do you think they believe Ukraine is rightfully part of mother Russia. It's a national socialist belief system.

I don't believe in supporting Nazi's military coup against a democratically elected government.

So that needs to end, assuming it's true. Great. What's it go to do with the topic at hand?

If you're not sure if its true, then try reading the Patriot and Military Commissions Acts. And for good measure, throw in the NDAA.

But you're right, we're getting off topic.


Obamacare is a big success.

 

[Andylusion]

Yup and everyone will be paying more for their benefits.

My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?

Your costs went up because the insurance companies still want to make a profit off of your health, or lack of.

All companies make a profit off of us. If they didn't, they wouldn't provide us anything.

The question is which system is better. I maintain that the previous system was better at providing us care at a better price, than the current.

You mandated that they cover people with pre-existing conditions. That drives up prices.
You mandated that they cover more services. That drives up price.
You mandated that they have a lower out-of-pocket max. That drives up price.

The more you require that insurance covers... the higher the price is on us.

The fundamental problem is healthcare for profit. Remove the profit factor & that problem goes bye-bye. The mandate now requires 80-85% of your premium is spent directly on your healthcare or you get a refund. You know what truly drives up cost?

Greed.

Then why is food cheaper in the US than anywhere else?
Why is computers, housing, and transportation, cheaper here than anywhere else?

Why does computer technology fall in price? Why has oil fallen in price?

Greed is the intellectually lazy way out, and it doesn't stand up to the facts.

If Greed was the answer, then every single apartment rental would be a million dollars a month.

That's not a valid explanation.

 

[playtime]

Yup and everyone will be paying more for their benefits.

My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?

Your costs went up because the insurance companies still want to make a profit off of your health, or lack of.

All companies make a profit off of us. If they didn't, they wouldn't provide us anything.

The question is which system is better. I maintain that the previous system was better at providing us care at a better price, than the current.

You mandated that they cover people with pre-existing conditions. That drives up prices.
You mandated that they cover more services. That drives up price.
You mandated that they have a lower out-of-pocket max. That drives up price.

The more you require that insurance covers... the higher the price is on us.

The fundamental problem is healthcare for profit. Remove the profit factor & that problem goes bye-bye. The mandate now requires 80-85% of your premium is spent directly on your healthcare or you get a refund. You know what truly drives up cost?

Greed.

Then why is food cheaper in the US than anywhere else?
Why is computers, housing, and transportation, cheaper here than anywhere else?

Why does computer technology fall in price? Why has oil fallen in price?

Greed is the intellectually lazy way out, and it doesn't stand up to the facts.

If Greed was the answer, then every single apartment rental would be a million dollars a month.

That's not a valid explanation.

Food is 'cheaper' here for a variety of reasons. Climate that is conducive for native crops & subsidies.

Technology, as it is mass produced naturally brings cost down.

Who is going to rent an apartment for a million dollars as an avg going price when most people can't naturally afford that?
The avg landlord would not be in business very long. Demographics & location dictate the mkt. Housing in Bumfuck, Iowa will not be the same going rate as the exact same square footage of a dwelling in NYC.

Transportation is cheaper, yes.... but that is because a lot of taxes are built into gas & mass transit costs where there's a universal healthcare system... so the 'cost' is shared. I'd rather pay $10 for a gallon of gas if that meant no premiums, no copays, no co insurance, no out of pocket expenses ever again. Oil, right NOW is cheaper because ISIS is pumping it & selling it on the open market, Iran will also be dumping more for consumption that will help keep the glut going. And greed certainly factors in on the oil companies... BP is still fighting the decision to pay for causing the Gulf disaster.

Those are real facts.

 

[Andylusion]

Well first off, the Defense Budget isn't even close to $900 Billion. It's more like $670 Billion.

If you cut that in half, that's $335 Billion, and the current deficit is over $400 Billion, and is projected to increase to $800 billion in the next decade based on the social programs and expenses the government has committed to pay in the future.

In other words, cutting defense spending in half, isn't going to eliminate the deficit or pay down the debt at all period. The math is not on your side.

When you add in development projects, the costs of the wars, emergency funding from Congress, military programs buried in the DOE, Homeland Security and the intelligence agencies, the cost of military spending exceeds $1.2 trillion/yr.

Cut that in half and you have $600 billion to help pay down the deficit.

Nice theory. It's wrong theory, but it's a nice theory. When they jacked up taxes on Yachts, rich people stopped buying yachts. The yachting industry went in a free fall. Revenue was a tiny fraction of what they claimed it would be.

The failure in your theory is that you assume that financial transactions would continue as they do now without the tax. That's wrong. When you tax something, people change their behavior to avoid the tax. Just like major companies move their operations outside the US, to avoid Corporate Taxes.

No, the financial tax will not bring in all the revenue in the world to pay for all your little programs.

Really? Do you really think people will stop trading on Wall Street over a $0.003 tax for each transaction? That's ridiculous!

Why? Glass-Steagall would have done nothing to prevent the crash of 2008. Glass-Steagall would have prevented the government from fixing the crash of 2008. No other country has ever had a Glass-Steagall act, and yet the problem started here in the US.

It will do nothing solve anything. So.... why?

In '29, we had a stock market crash. Then Glass-Steagall was enacted. For over half a century, we had no economic meltdown. Then, few years after its repeal, we had another meltdown.

The 2008 crash was a direct result of deregulating the financial industry, the derrivitive bubble and predatory lending. Glass-Steagall would've prevented that by not allowing investment banks and savings banks to do business under the same roof.

So in your world, completely abandoning our ally to be overthrown, proving to the world we couldn't be trusted, resulting in a brutal, and insane dictator who is developing nuclear weapons, with the intent and purpose of attacking another of our ally.....

that to you is "honorable". But Reagan standing up to the Soviet Union, and helping the Germany people escape socialistic hell.... that's dishonorable.

You are a moron if you think that.

I don't know who you're talking about above, but Reagan had nothing to do with the fall of the Soviet Union. They ran out of money. Which is the same thing we are going to do, if we continue this bullshit war on terror.

No, we were never supposed to be a democracy. You clearly haven't read the Federalist papers and what the founding fathers said of democracy. As for being a hypocrite.... you would be in the know.

If the Founding Fathers wanted the Federalist Papers to be the law of the land, they would've included more of them in the Constitution.

Only if you are a Russian media plant. The BBC did a documentary about the whole thing. Are there Nazis in Kiev? Yes. Are there Nazis in the Russian Rebels? Yeah, actually most of them are. Why the heck do you think they believe Ukraine is rightfully part of mother Russia. It's a national socialist belief system.

I don't believe in supporting Nazi's military coup against a democratically elected government.

So that needs to end, assuming it's true. Great. What's it go to do with the topic at hand?

If you're not sure if its true, then try reading the Patriot and Military Commissions Acts. And for good measure, throw in the NDAA.

But you're right, we're getting off topic.


Obamacare is a big success.

Funny how "wars" now turned into intelligence gathering, homeland security, some mystery project in the DOE, and whatever else you tossed in there.

Well you can argue that if you want, but you are wasting your time. Those are not going away. Period. Not happening.

Do you really think people will stop trading on Wall Street over a $0.003 tax for each transaction? That's ridiculous!

Do you really think a $0.003 tax for each transaction is going to fund all the health care in the country? That's ridiculous!

Any significant tax, would have a significant effect. 3/10ths of a cent, isn't enough to fund anything.

In '29, we had a stock market crash. Then Glass-Steagall was enacted. For over half a century, we had no economic meltdown. Then, few years after its repeal, we had another meltdown.

You understand the concept that correlation doesn't equal causation?

I had a bowel movement today, and Obama was president. Therefore Obama causes poop.

Instead of just mindlessly assuming that two unrelated events are automatically connected, how about you look at the facts.

Fact: All the rest of the world, does not have a Glass-Steagal limitation. UK doesn't. Canada doesn't. Europe doesn't. China doesn't. Nowhere else has a any similar restriction.

Yet, the crash originated in the US.

Fact: The government in it's bid to fix the crisis, merged banks together. For example Bank of America, and Countrywide Financial. That merger, and dozens of other mergers the government brokered, would all have been illegal under Glass-Steagal, which in theory, would have made the crash many times worse than it was.

Fact: Most of the banks that crashed during the 2008 sub-prime crisis, would not have been effected by Glass-Steagall had it still been in place. Countrywide, was only a mortgage broker. IndyMac was only retail. Bear Stearns was only investment, Lehman Brothers was only investment, AIG was only insurance.

The vast majority of the banks that failed, were all banks that would not have been affected in any way, by Glass-Steagall. It would have done absolutely nothing to any of them.

Fact: Some of the banks that didn't fail, were banks that would have been broken up by Glass-Steagal. Bank of America, JPMorgan Chase, Morgan Stanley, and numerous others, all of which were able to survive the recession, would have been broken up under Glass-Steagall, and thus more likely to have crashed.

Fact: The housing price bubble that caused the crash to begin with, started in 1997, while the repeal of Glass-Steagall happened in 1999. It is absolutely impossible to blame the crash, on legislation that was passed two years after the bubble started.

Bottom line.... Glass-Steagall would not have stopped anything. If you want to put in back in place, fine, but you are not improving anything. You may likely be making things worse.

I don't know who you're talking about above, but Reagan had nothing to do with the fall of the Soviet Union. They ran out of money. Which is the same thing we are going to do, if we continue this bullshit war on terror.

Carter and Iran. He ditched our ally, which is why we have a huge problem with Iran right now. That's where your line of thinking leads us.

Again, if there was no war on terror... if there was no defense budget... we would still be in trouble. Math dude. Use a calculator. Social Security, and Medicare do not add up, period. You can point fingers and blame everyone on the planet, but yourself, but that doesn't change the fact those programs are not sustainable. None of the rest of your blaw blaw blaw, changes that they are not sustainable, no matter what else we do, or do not spend.

If the Founding Fathers wanted the Federalist Papers to be the law of the land, they would've included more of them in the Constitution.

The Federalist papers explain the Constitution, and the thinking behind the constitution, so that morons centuries later can't just make up whatever the heck they want, and claim that's what the constitution says.

I don't believe in supporting Nazi's military coup against a democratically elected government.

But clearly you do believe in tin foil hat conspiracy theories and Russian propaganda. Carry on.

Obamacare is a big success.

Again.... Yeah, perhaps more people have insurance.

But.... what about society as a whole?

Obamacare Insurance Premiums to Jump by up to 51%

51% increase in premiums? Are you really saying that's a 'success'? Screw over the public.... and get a few more people insurance?

And how exactly are they getting insurance? Oh, right.... they are buying subsidized plans. What does that mean? It means taxes will have to go up to pay for those premiums!

So let's recap. Insurance premiums have increased 51%, and now our taxes will have to go up to pay for those subsidized policies.

Success! We screwed over the public from two directions at the same time! Go Obama Care! Screwing over the public for decades to come! Yay!

Do you not see why the public isn't all happy about your "success"?

 

[Andylusion]

Yup and everyone will be paying more for their benefits.

My benefit costs went up by 30% this year because of the ACA. Wonder what is on the horizon for next year?

Your costs went up because the insurance companies still want to make a profit off of your health, or lack of.

All companies make a profit off of us. If they didn't, they wouldn't provide us anything.

The question is which system is better. I maintain that the previous system was better at providing us care at a better price, than the current.

You mandated that they cover people with pre-existing conditions. That drives up prices.
You mandated that they cover more services. That drives up price.
You mandated that they have a lower out-of-pocket max. That drives up price.

The more you require that insurance covers... the higher the price is on us.

The fundamental problem is healthcare for profit. Remove the profit factor & that problem goes bye-bye. The mandate now requires 80-85% of your premium is spent directly on your healthcare or you get a refund. You know what truly drives up cost?

Greed.

Then why is food cheaper in the US than anywhere else?
Why is computers, housing, and transportation, cheaper here than anywhere else?

Why does computer technology fall in price? Why has oil fallen in price?

Greed is the intellectually lazy way out, and it doesn't stand up to the facts.

If Greed was the answer, then every single apartment rental would be a million dollars a month.

That's not a valid explanation.

Food is 'cheaper' here for a variety of reasons. Climate that is conducive for native crops & subsidies.

Technology, as it is mass produced naturally brings cost down.

Who is going to rent an apartment for a million dollars as an avg going price when most people can't naturally afford that?
The avg landlord would not be in business very long. Demographics & location dictate the mkt. Housing in Bumfuck, Iowa will not be the same going rate as the exact same square footage of a dwelling in NYC.

Transportation is cheaper, yes.... but that is because a lot of taxes are built into gas & mass transit costs where there's a universal healthcare system... so the 'cost' is shared. I'd rather pay $10 for a gallon of gas if that meant no premiums, no copays, no co insurance, no out of pocket expenses ever again. Oil, right NOW is cheaper because ISIS is pumping it & selling it on the open market, Iran will also be dumping more for consumption that will help keep the glut going. And greed certainly factors in on the oil companies... BP is still fighting the decision to pay for causing the Gulf disaster.

Those are real facts.

That can't be! Greed should drive up the cost of technology, making food super expensive! Doesn't matter what the climate is, greed should drive up the cost no matter how much is produced.... right? Greed is the only answer.

Greed should drive up the cost of a rental, regardless... right?

So you are saying that greed isn't the dominating factor in the market?

Oh but you are wrong..... sorry you are wrong. There are co-pays and co-insurance, and there are out-of-pocket expenses in nearly all "universal" care systems.

But wouldn't greed keep the prices up? Are you saying ISIS isn't greedy? Iran isn't Greedy? Doesn't greed drive up prices on everyone? Or is greed not the defining factor of a market?

Here's my problem....

When you talk about health care, you completely ignore all market forces, and blame everything on "greed", as if there are no other relevant factors at play.

And yet, when we apply the "greed theory of economics" to any other situation, you instantly go to "well this market force prevents it", or "that market force stops it". And you would be right.

Free-market Supply and demand, keep prices low for food, for oil, for rentals, for homes, on and on and on...........

You are correct. But again, you magically eject your brain, dump your intelligence, and lemmingly go back to "greed" when we talk about health care.

My answer.... Greed isn't the problem. There are market problems caused by government regulations and interventions, that have led to the issue.

Proof? Well, why can you get $100,000 surgeries in India, for $18,000? Greed. They are greedy. They want to earn a profit. They want to make money. So to attract customers, they found cheaper ways, to make a profit, for greed.

Greed isn't the problem. Profit, isn't the problem. It's government regulations and controls in this country, that have disabled the price suppressing system of competition for profit, that has led to exploding prices.