Is Obamacare going to make things worse?

[RDD_1210]

And in the mean time the IRS will hire 1600 or more new people to make certain that we all go out and purchase health insurance.....

Would you go without insurance if there was no fine?

 

[hboats]

And in the mean time the IRS will hire 1600 or more new people to make certain that we all go out and purchase health insurance.....

Would you go without insurance if there was no fine?

I'll answer for myself.

No, I wouldn't go without health insurance if there wasn't a fine. But at least I'd have the choice to do so if I wanted to.

America is supposed to be all about freedom, when we put silly laws that FORCE everyone to do something we lose our freedom.

There was no reason to pass this law, what we needed was to control the cost, not force everyone to sign up for something that is unaffordable.

Rick

 

[Bern80]

And in the mean time the IRS will hire 1600 or more new people to make certain that we all go out and purchase health insurance.....

Would you go without insurance if there was no fine?

Maybe some would, maybe some wouldn't. The point is the freedom to choose withouth the government penalizing you.

 

[RDD_1210]

And in the mean time the IRS will hire 1600 or more new people to make certain that we all go out and purchase health insurance.....

Would you go without insurance if there was no fine?

Maybe some would, maybe some wouldn't. The point is the freedom to choose withouth the government penalizing you.

Actually the point is those who "claim" they would go without it by choice, are either liars or would be a nuisance on the system when they get sick and then feel they should be treated and the rest of us have to pay for it because of their stupidity.

 

[Bern80]

Actually the point is those who "claim" they would go without it by choice, are either liars

Moving on to the slightly less baseless part of the post.........

or would be a nuisance on the system when they get sick and then feel they should be treated and the rest of us have to pay for it because of their stupidity.

In a free country one should also be free to make stupid decisions. If you don't want to purchase health insurance and you aren't in a financial position to cover the costs of what may come up, how is that any different than the system now for the people that can't afford it. Others that would choose not to purchase insurance would be the wealthy. They can cover the cost of health expenses out of pocket if they want to.

 

[SFC Ollie]

Would you go without insurance if there was no fine?

Maybe some would, maybe some wouldn't. The point is the freedom to choose withouth the government penalizing you.

Actually the point is those who "claim" they would go without it by choice, are either liars or would be a nuisance on the system when they get sick and then feel they should be treated and the rest of us have to pay for it because of their stupidity.

Fact is that many go without insurance because of the superman syndrome. My son used to be one of them until a ride to the emergency room cost him $2000. He signed up at work the following week. And yes he paid for it.
Me, I was promised free health and Medical for life by the same congress that is now forcing people to purchase health insurance. Again, they lied, I pay for it.

 

[Greenbeard]

To reach equilibrium you have to do a couple of things. Increase supply of physicians and/or decrease the demand for them.

And this law takes steps to do both. As I just pointed out, primary care workforce development plays a prominent role in the law. That means addressing the financial component of the primary care shortage, i.e. increasing aid to med students who choose primary care and shrinking the pay gap between primary and specialty care. It means addressing capacity, by building new primary care residency programs and creating new programs to train the non-physician primary care workforce, utilizing options like telemedicine, and so on. I'm all for building more medical schools but the politics of that are tough.

Decreasing demand either involves shutting people out or making medicine itself more efficient (fighting hospital-acquired infections and re-admissions, eliminating financial incentives for unnecessary treatment, making the very difficult jump to paying for quality). One of those is harder than the other but it's also the more exciting prospect. Although since you also seemed to touch upon wellness and prevention programs, note that there's a quite a bit of space dedicated to those in the law, as well.

In a free country one should also be free to make stupid decisions. If you don't want to purchase health insurance and you aren't in a financial position to cover the costs of what may come up, how is that any different than the system now for the people that can't afford it. Others that would choose not to purchase insurance would be the wealthy. They can cover the cost of health expenses out of pocket if they want to.

I've asked this in another thread but I don't remember if it was directed at you or not: if the law allowed you to opt out of the individual mandate but also required you in so doing to opt out of all the benefits of the law (which the mandate exists to make workable), would that be acceptable to you? Then you wouldn't have to buy insurance but you also wouldn't be protected from pre-existing condition exclusions should you develop a condition, you wouldn't have access to tax credits to help you buy in the individual market, and you wouldn't be able to obtain uncompensated care from hospitals (let's say you opt of all that for a period of 5-6 years or so). In other words, you wouldn't have to pay into the system--either by buying insurance or by making a direct penalty payment to the government--but you also wouldn't benefit from it financially or from the consumer protections it implements. Would that be acceptable?

 

[Marklbetya]

The problem with Obamacare, and most other Liberal policy, is that it's "Feel Good" governing with more heart than head.

Of course it feels good go provide everyone with health care. It also feels good to never have to work again and retire into a life of luxury. The government can't afford that either.

The US tax structure is not set up like that of other countries who have national health care. Not by a long shot. And now, with unemployment so high and everyone struggling to make ends meet, is the WORST time to try.

You have to be absolutely brainless to think that eliminating people with preexisting conditions can do anything by skyrocket costs. Can you wait until you have a car accident before buying auto insurance and expect the insurance company to pay for your repairs? Of course not. They'd go out of business. This is no different. And it's scary.

 

[saveliberty]

Is Obamacare going to make things worse?

Does a one legged duck swim in circles?

Nope, the government does one or more of the following:

1. Renames the duck a lizard.
2. Removes the opposing wing to give the duck balance.
3. Drains the lake.
4. Bars the media from seeing the duck. Does a duck swim in circles without the media present?

 

[Bern80]

Decreasing demand either involves shutting people out or making medicine itself more efficient (fighting hospital-acquired infections and re-admissions, eliminating financial incentives for unnecessary treatment, making the very difficult jump to paying for quality). One of those is harder than the other but it's also the more exciting prospect. Although since you also seemed to touch upon wellness and prevention programs, note that there's a quite a bit of space dedicated to those in the law, as well.

No it doesn't require shutting people out. Plenty of the reasons people require medical care of some type or another are preventable. We are an unhealthy nation in general. Over half of the nation is considered obese. All of us have an awful lot of control over the stress we put on the medical system. Of course no one is willing to accept it and do something about it, even though it's the easiest solution to the problem.

I've asked this in another thread but I don't remember if it was directed at you or not: if the law allowed you to opt out of the individual mandate but also required you in so doing to opt out of all the benefits of the law (which the mandate exists to make workable), would that be acceptable to you? Then you wouldn't have to buy insurance but you also wouldn't be protected from pre-existing condition exclusions should you develop a condition, you wouldn't have access to tax credits to help you buy in the individual market, and you wouldn't be able to obtain uncompensated care from hospitals (let's say you opt of all that for a period of 5-6 years or so). In other words, you wouldn't have to pay into the system--either by buying insurance or by making a direct penalty payment to the government--but you also wouldn't benefit from it financially or from the consumer protections it implements. Would that be acceptable?

I can't really answer that personally. Because a) I wouldn't choose to not buy insurance personally. And b) again it's not about what you or me or anyone else would choose. It's about the FREEDOM to choose. The second problem with the question is that if I say yes, I have to take all of your provisions there simply as givens that can't be changed. I say those provisions are part of the problem with the system being far too complex and some of them aren't inherently unfair to begin with. The pre-existing condition protections for example. I know it's hard but pretend you are a lender or insurance provider. You have two customers. One's a crappy driver the other has a spotless record. Are you really going to going to charge the shitty drive the same thing you would charge the good driver? Is that fair to the good driver?

 

[Greenbeard]

I can't really answer that personally. Because a) I wouldn't choose to not buy insurance personally. And b) again it's not about what you or me or anyone else would choose. It's about the FREEDOM to choose.

At present, your choice affects others. If you get uncompensated care, those costs are recouped from everyone else through taxes. However, if we alter the system in just inhumane enough a way that you can't get care, emergency or otherwise, unless there's no doubt you'll eventually pay for every penny of it (and you can't opt into an insurance pool simply for getting sick, effectively taking without paying your dues) then you can truly live unbounded to others. But you also won't have any safety net. You get to have your choice. And no one else has to pay for your poor decisions.

The second problem with the question is that if I say yes, I have to take all of your provisions there simply as givens that can't be changed. I say those provisions are part of the problem with the system being far too complex and some of them aren't inherently unfair to begin with. The pre-existing condition protections for example. I know it's hard but pretend you are a lender or insurance provider. You have two customers. One's a crappy driver the other has a spotless record. Are you really going to going to charge the shitty drive the same thing you would charge the good driver? Is that fair to the good driver?

Health insurance rating generally doesn't work in quite the same way as auto insurance rating. Rating in the former is often based on things like gender, genetics, age, and health factors beyond one's own control. Rating based on a health record is inherently different than rating based on a driving record.

That's not to say it doesn't make financial sense to charge the less healthy more for the same product, even if their health status is beyond their control for various reasons (and no, I'm not saying personal choices never play a role in determining health status), because that allows you to avoid adverse selection. If people can't be penalized for joining the insurance pool with a poorer health status, there's no reason to pay premiums until you get sick and need to draw from the pool. Obviously that's the entire reason the individual mandate exists--it replaces medical underwriting as the deterrent to free riding.

If health insurance rating were based only on a person's choices or actions, that would be one thing. But the genetic and social determinants of health (not to mention unavoidable rating factors like gender and age) are key to the underwriting process, which is why at its heart its a shitty process. And rightfully disdained by most of the public.

 

[Bern80]

At present, your choice affects others. If you get uncompensated care, those costs are recouped from everyone else through taxes. However, if we alter the system in just inhumane enough a way that you can't get care, emergency or otherwise, unless there's no doubt you'll eventually pay for every penny of it (and you can't opt into an insurance pool simply for getting sick, effectively taking without paying your dues) then you can truly live unbounded to others. But you also won't have any safety net. You get to have your choice. And no one else has to pay for your poor decisions.

And that's what I don't get. Why is health care so damn different? No one thinks twice about paying for any other type of good or service. You use a service you pay for it. I know seem people don't like the analogies between personal 'maintenance' and car maintenance, but the two things are really quite similar. You do your best to prevent catastrophes from happening, but sometimes shit happens anyway. When it happens to your car and you need it repaired, do you ever think for a second you won't have to pay for it? Of course not. Why should health care be any different? No you can't prevent the unexpected, but the fact is you know it can happen so there still isn't any excuse for preparing yourself for it. But HOW you prepare for it should be your choice. Just because you don't pay for health insurance doesn't mean your gonna get off scott free and not pay for service. It's amazing to me that people can't fathom any other way of paying for health care through any method other than insurance. Time to start thinking outside of the box.

If health insurance rating were based only on a person's choices or actions, that would be one thing. But the genetic and social determinants of health (not to mention unavoidable rating factors like gender and age) are key to the underwriting process, which is why at its heart its a shitty process. And rightfully disdained by most of the public.

[/QUOTE]

And honestly I think a lot of that could be helped by some DEregulating areas of the insurance industry. Again think outside the box. If you got to decide how your health care plan worked, how would you do it? Face it. There isn't a lot of choice out there when it comes to insurance and what you want it to cover. I can't believe I'm the only one that thinks more customization would be nice. so why aren't insurance plans more customizable? Because of regulation after regulation telling them what they must do. Or why isn't there more entrepreneurship in the area of health insurance? As a general ruile of the free market one will generally make a killing doing what people want. I think the problem is there is so much bereaucratic red tape to starting a company like that you have to be nuts to want that kind of headache

 

[auditor0007]

ER's need to learn and use the word:

Triage

and just start telling people who come in for visits, they are NOT emergency's and go to their regular doctors.

Oh come on now, that would make too much sense.

 

[boedicca]

ER's need to learn and use the word:

Triage

and just start telling people who come in for visits, they are NOT emergency's and go to their regular doctors.

Oh come on now, that would make too much sense.

There's a necessary prerequisite for that: Malpractice Reform.

 

[auditor0007]

Would you go without insurance if there was no fine?

Maybe some would, maybe some wouldn't. The point is the freedom to choose withouth the government penalizing you.

Actually the point is those who "claim" they would go without it by choice, are either liars or would be a nuisance on the system when they get sick and then feel they should be treated and the rest of us have to pay for it because of their stupidity.

Simple solution: if you don't have insurance and you get sick, you don't get treatment. In order to receive treatment, you must show an ability to pay within a set amount of time. If you don't have the money, no treatment. And if you die, tough shit.

I have heard many people here state that they don't need health insurance because they are healthy. If they do get sick, then they will pay for it out of pocket, lmao. This is their right. I don't have a problem with that, they just shouldn't receive any treatment they can't pay for. The way it works now, these conservatives who demand their right not to be forced into purchasing insurance, will use the system to their advantage should they become sick. Then it will be their right for us to pay for them?

 

[boedicca]

Simple solution: if you don't have insurance and you get sick, you don't get treatment. In order to receive treatment, you must show an ability to pay within a set amount of time. If you don't have the money, no treatment. And if you die, tough shit.

That is not a simple solution. That is a heavy handed one-sized fits all version popular with those who favor government control.

How about letting the individuals involved actually make the decision? Many hospitals and medical practices provide pro bono work as part of their mission. As they are providing the service, they should decide whom they serve.

It's not a coincidence that, as goverment funded health care has comprised an ever increasing share of health care, the costs have been drive up for everyone, and the ability of the actual health care industry to provide pro bono work has been strained. Government doesn't increase the supply of health care - its interference just makes it more expensive. Of course, the by definition a sign of insanity response on the part of the big government types is to apply even more government interference.

 

[Greenbeard]

Government doesn't increase the supply of health care - its interference just makes it more expensive.

Really? Who funds the vast majority of medical residency training in the United States?

 

[boedicca]

Who makes the drugs and the technology? Who decides to be a doctor or a nurse in the first place, and often assumes huge student loan burdens to finance it?

We don't need government sponsored medical residency training - the private sector could handle that just fine if government weren't inflating the costs.

 

[SFC Ollie]

Who makes the drugs and the technology? Who decides to be a doctor or a nurse in the first place, and often assumes huge student loan burdens to finance it?

We don't need government sponsored medical residency training - the private sector could handle that just fine if government weren't inflating the costs.

Quite true, my daughter is an RN and never asked for or received a dime from anyone to pay for her schools. Girl worked her ass off to do it.

 

[Bern80]

Maybe some would, maybe some wouldn't. The point is the freedom to choose withouth the government penalizing you.

Actually the point is those who "claim" they would go without it by choice, are either liars or would be a nuisance on the system when they get sick and then feel they should be treated and the rest of us have to pay for it because of their stupidity.

Simple solution: if you don't have insurance and you get sick, you don't get treatment. In order to receive treatment, you must show an ability to pay within a set amount of time. If you don't have the money, no treatment. And if you die, tough shit.

I have heard many people here state that they don't need health insurance because they are healthy. If they do get sick, then they will pay for it out of pocket, lmao. This is their right. I don't have a problem with that, they just shouldn't receive any treatment they can't pay for. The way it works now, these conservatives who demand their right not to be forced into purchasing insurance, will use the system to their advantage should they become sick. Then it will be their right for us to pay for them?

I see some people are slowly catching on to the novel idea of paying for service rendered.........

Are you always going to be able to cover the cost of some unexpected health problem out of pocket? Of course not. Are you always going to be able to cover the cost of that unexpected blown radiator on your car? Of course not. The point is you figure it out. Maybe you have to work out a payment plan. Maybe you put it on a credit card. Whatever. This whole people use the system and don't pay for it thing is a red herring. Last I checked the hospital, like anywhere else is capable of billing you.